The Building Bridges Initiative (BBI) · q A Qualified Residential Treatment Program (QRTP) for...
Transcript of The Building Bridges Initiative (BBI) · q A Qualified Residential Treatment Program (QRTP) for...
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TheBuildingBridgesInitiative(BBI):AdvancingPartnerships.ImprovingLives.
TexasBuildingBridges:Youth,Families,Agencies,andProvidersTransformingResidentialInterventionandAchievingPositiveOutcomes– OverviewofBBIMay 23, 2018
Presentedby:SherriHammack,Coordinator,BuildingBridgesInitiative
Top5 ToExpect*inthenext3-5years
1. Expectlessmoneyfromlocal,stateandfederalgovernments.
2. Expectservicepurchaserstowanttobuyresultsandnotservices.
3. Expectanemphasisondurableresultsthatcanbesustainedfor6– 12monthspost-residentialdischarge.
4. Expectmovementfromchild-centeredtofamily-focusedservicedelivery.
5. Expectfastermovestowardpermanency forchildrennotreturninghome.
*FromTomWoll’s40TrendsReport,January2014
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ManyCompellingReasonsToReduceOverrelianceOnCongregateCare.
Youth placed in congregate care are less likely to find permanent homes than
those who live in family settings.
Congregate care placements cost child welfare systems three to five times the
amount of family-based placements, and for poorer outcomes.
Current law requires that children be placed in the least restrictive setting
possible while maintaining the child’s safety and
health.
Youth who live in institutional settings are at greater risk of
developing physical, emotional, and behavioral
problems
Rightsizing Congregate Care: A Powerful First Step in Transforming Child Welfare Systems, Annie E. Casey Foundation, 2000-http://www.aecf.org/resources/rightsizing-congregate-care/Kids Count Data Snapshot on Foster Care Placement, Annie E. Casey Foundation, May 2011 – http://www.aecf.org/resources/kids-count-data-snapshot-on-foster-care-placement/Dozier, M., Zenanah, C.H., Wallin, A.R., Shauffer, C., 2012, Institutional Care for Young Children: Review of Literature and Policy Implications – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600163/Barth R.P., 2002 Institutions vs. Foster Homes: The Empirical base for a Century of Action (says “Debate” but article says “Action”) –https://bettercarenetwork.org/sites/default/files/Institutions%20vs%20Foster%20Homes.pdf
KVCContactInformation
ChadE.Anderson,LSCSWChiefClinicalOfficerWayneSimsKVCHealthSystems,Inc.ChairBoardofDirectors(FormerPresidentandCEO)KVCHealthSystems,Inc.21350W.153rdStreet,Olathe,KS66061(913)[email protected]@kvc.org
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FamilyFirstLegislation:What’sComing?
FamilyFirst
TheFamilyFirstPreventionServicesActwaspassedintolawonFebruary9,2018aspartoftheBipartisanBudgetActof2018.
Thelaw,P.L.115-123expandstheuseofTitleIV-Echildwelfareentitlementdollarstoprevententryintofostercare
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PreventionServicesØServicesandprogramsmustbetrauma-informedandbeclassifiedas“promising”,“supported”,or“well-supported”basedonanevidencestructuredevelopedbytheCaliforniaEvidence-BasedClearinghouseforChildWelfare
ØAllqualifiedthreeprogramcategoriesmustbe:• Providedunderanorganizationalstructureandtreatmentframeworkthatusesatrauma-informedapproachandprovidestrauma-specificinterventionsthataddresstrauma’sconsequencesandfacilitatehealing
• Documentationofwhatthepracticeconsistsofandhowitisadministered
• Noevidenceofharmorriskofharm• Overallevidencesupportsthebenefits• Outcomemeasuresarereliable,validandadministeredconsistentlyandaccurately
5/17/18
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RestrictionsonFederalReimbursementOtherthanFosterFamilyHomes
EligibleSettingsforTitleIV-Ereimbursement:
1. Licensed(stateortribalapproved)fosterfamilyhomewithsixoffewerchildrenthatadherestothereasonableandprudentparentingstandard
q Exceptionscanbemadeforyouthwithachildtheyareparenting,siblinggroups,childrenwithseveredisabilities
2. Licensedprivate,orpublicchildcareinstitutionwithnomorethan25children:
q AQualifiedResidentialTreatmentProgram(QRTP)forchildrenwithseriousemotionalorbehavioraldisordersordisturbances
q Asettingthatspecializesinprenatalorparentingsupportsq Asupervisedindependentlivingprogramforyouthover18q Ahigh-qualityresidentialcareprogramforyouthatriskoforfoundto
beavictimofsextrafficking
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RestrictionsonFederalReimbursementOtherthanFosterFamilyHomes
EligibleSettingsforTitleIV-Ereimbursement:
3. Alicensedresidentialfamily-basedsubstanceusetreatmentfacilityforfamilies
q ThechildiseligibleforTitleIV-Emaintenancepaymentsforupto12monthsregardlessofeligibilityundertheAFDClink
q Thechildmusthaveacaseplanthatrecommendssuchaplacement
q Thechildmustbeconsideredacandidateforfostercare
q Facilitymeetsrequirements:substanceabuse,parenteducation,individualfamilycounselingservicesundertreatmentframeworkthatunderstands&recognizestypesoftraumaandprovidedinatrauma-informedapproach
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BBICorePrinciplesFamilyDriven
&YouthGuidedCare
Cultural&Linguistic
Competence
ClinicalExcellence&
QualityStandards
Accessibility&
CommunityInvolvement
TransitionPlanning&Services*
*betweensettings&fromyouthtoadulthood
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ForMoreInformationonFamilyFirstPreventionServicesActP.L.115-123
ØFamilyActLaw- summary:https://www.congress.gov/bill/115th-congress/house-bill/253 andfulltext:https://www.congress.gov/bill/115th-congress/house-bill/253/text
ØChildWelfareLeagueofAmerica:https://www.cwla.org/families-first-act/
ØTheAnnieE.CaseyFoundation:http://www.aecf.org/blog/family-first-prevention-services-act-will-change-the-lives-of-children-in-f/
ØChildren'sDefenseFund-� shortsummary:http://www.childrensdefense.org/library/data/ffpsa-short-summary.pdf
� detailedsummary:http://www.childrensdefense.org/library/data/family-first-detailed-summary.pdf
� implementationtimeline:http://www.childrensdefense.org/library/data/ffpsa-implementation.pdf
BBIMissionIdentifyandpromotepracticeandpolicyinitiativesthatwillcreatestrongandcloselycoordinatedpartnershipsandcollaborations betweenfamilies,youth,community- andresidentially-basedtreatmentandserviceproviders,advocatesandpolicymakerstoensurethatcomprehensiveservicesandsupportsarefamily-driven,youth-guided,strength-based,culturallyandlinguisticallycompetent,individualized,evidenceandpractice-informed,andconsistentwiththeresearchonsustainedpositiveoutcomes.
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BBIhasMANYPartners;severallisted:
EndorsetheBBIJointResolution
• GotoBBIWebSite(www.buildingbridges4youth.org)
• ReadBBIJointResolution(JR)
• E-mailDr.GaryBlau([email protected])orBethCaldwell([email protected])orSherriHammack([email protected])thatYouWouldLiketoEndorseBBIJR
• BePutonListServetoReceiveBBINewlyDevelopedDocuments
• BeFirsttobeInvitedtoBBIEvents
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BBIJointResolution
Includesacommitmentto:
“…strivetoeliminatecoercionandcoerciveinterventions(e.g.,seclusion,restraintandaversivepractices)…”
(http://www.buildingbridges4youth.org/sites/default/filesBB-Joint-Resolution.pdf)
RECENTLY RELEASED!: ▫ Successfully Engaging Families Formed by Adoption: Strategies
for Residential Leaders ▫ How-to Guide for Transforming to Short-term Residential (supported
by the Casey Foundation) ▫ Guide for Judges on Best Practices in Residential (w/ ACRC) ▫ Case Study: Leading Innovation Outside the Comfort Zone: The
Seneca Family of Agencies Journey▫ Fiscal Strategies that Support the Building Bridges Initiative Principles▫ Cultural and Linguistic Competence Guidelines for Residential Programs▫ Handbook and Appendices for Hiring and Supporting Peer Youth
Advocates▫ Numerous documents translated into Spanish (e.g., SAT; Family and
Youth Tip Sheets)▫ Engage Us: A Guide Written by Families for Residential Providers▫ Promoting Youth Engagement in Residential Settings
GotoBBIWebsitewww.buildingbridges4youth.org
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BBIWeb-BasedTrainingProgramsAvailablehttps://theinstitute.umaryland.edu/onlinetraining/programcategory.cfm?ottype_id=30
•BestPracticesintheUseofPsychiatricMedicationsforYouthDuringResidentialInterventions(1.5CEUs)•CulturalandLinguisticCompetence(Part1):WhyDoesitMatter?(2CEUs)•CulturalandLinguisticCompetence(Part2):ImplementationStrategies(2CEUs)•CulturalandLinguisticCompetence(Part3):OnaOne-to-OneLevel(1.5CEUs)•FirstStepsforLeadersinResidentialTransformation(2CEUs)•IncludingFamilyPartnersonYourTeam(2CEUs)•Pre-hiring,Hiring,Supporting,andSupervisingYouthPeerAdvocatesinResidentialPrograms(2CEUs)•SuccessfulStrategiesforTrackingLong-termOutcomes(1CEU)•Youth-GuidedCareforResidentialInterventions(2.5CEUs)
2014Book:ResidentialInterventionsforChildren,AdolescentsandFamilies:ABestPracticeGuide
Thereareseveraloptionsforordering:• tollfreephone:at1-800-634-7064• fax:1-800-248-4724• email:[email protected]• website:www.routledgementalhealth.com• (20%discountw/webordersusingcodeIRK71;• freeglobalshippingonanyordersover$35)
Ordersmustincludeeither:theTitle: ResidentialInterventionsforChildren,AdolescentsandFamilies:ABestPracticeGuideOR theISBN:978-0-415-85456-6
Note: Asafederalemployee,GaryBlaureceivesnoroyaltiesoranyotherremunerationforthisbook. AnyroyaltiesreceivedbyBethCaldwellandBobLiebermanwillbeusedtosupportyouthandfamilyempowermentconsistentwithBBI.
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Comingin2019~ANewBook!
TransformingResidentialInterventions:
PracticalStrategiesandFutureDirections
• FamilyDriven&YouthGuidedCare
• Cultural&LinguisticCompetence
• ClinicalExcellence&QualityStandards
• Accessibility&CommunityInvolvement
• TransitionPlanning&Services(betweensettings&fromyouthtoadulthood)
BBICorePrinciples
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ResearchonResidentialEffectiveness
▫ Recidivism– AllCategoriesofChildren/Youth
• 68%inOneState(2009)forallLicensedResidentialProgramsvs.Damar Services(BBIimplementer)withrangesfrom3-15%
▫ LengthsofStay– Children/YouthinMHSystem
• NYS(Average:14monthsin12+years)vs.Florida(<6monthsin3years)
SomeOfTheCriticalIssues
FromtheResearchResidential-SpecificResearchShowsImprovedOutcomesWith:
▫ ShorterLengthsofStay▫ IncreasedFamilyInvolvement▫ StabilityandSupportinthePost-ResidentialEnvironment(Walters&Petr,2008).
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SOMEEXAMPLESOFWHEREBBIISHAPPENING
ExamplesofWhereBBI/ResidentialTransformationWorkHAS/IS Happening
• ComprehensiveStateInitiatives(DE,IN,MA,CA- Initially4Regions/Pilots– goingstatewidebycountyin2017/2018)
• StateLevelActivitiesHappenedorCurrentlyUnderway(AZ,FL,IL,KY,LA,MI,ND,NH,NJ,NM,NV,ND,NY,OK,RI,SC,TX,VA,WA,WV&Georgia;inCA&MD– ProviderAssociationsLed)
• Current orPreviousCounty/CityLevelInitiatives(Cities:NYC,Philadelphia;Counties:Monroe/Westchester,NY;Maricopa,AZ;PA:clusterofsixcountiesNEpartofstate)
• ManyIndividualResidentialandCommunityProgramsAcrosstheCountry
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NEW HAMPSHIRE
NFINorth,Inc.
NFINorth- DavenportSchooltakesgreatprideintheBuildingBridgesInitiativeanddecidedfromthestartofthisprojectthattheonlywaytoevokeonthisjourneywastoduesothroughalensthatallowedforopenandhonestexaminationofpracticesaswellasopenandhonestcommunicationamongstFamily,Youth,andStaff.
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NFINorthContactInformation
NFINorthArrayofServicesJenniferAltieri603-586-4328jenniferAltieri@Nafi.com
Massachusetts
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BBIinMassachusetts:CaringTogether
• AdoptionofBBIframeworkforreprocurementofallDMH&DCFresidentialservicesforyouth
• Adoptionofinteragencyrestraint/seclusioninitiative&SixCoreStrategies©
• Commitmenttotrauma-informedcare
• Development/expansionoffamily&youthroles▫ ParentPartners▫ PeerMentors
• Developmentof:▫ Continuum(in-homeresidentialservicewithteam)▫ OccupationalTherapyinmoreintensiveprograms▫ Highintensitycommunityservices
BBIinMassachusetts:CaringTogether
FlexibleServiceModels▫ Followingintocommunity (includingsupportinhomeschools)
DCF&DMHJointly:▫ Developedstandards&outcomes▫ Overseeingimplementation▫ Providingoversight▫ Coordinatingutilizationmanagement▫ Engaginginqualitymanagementactivities▫ DevelopingsharedIT(reporting/documentation)
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PlummerYouthPromise
Acommunitycommittedtoprovidingallchildrenthesupportnecessarytosuccessfullynavigateintoadulthood
Everyyoungpersonhasafamilyunconditionallycommittedtonurture,protect,andguidethemtosuccessfuladulthood
TheVision TheDreamAdopted 2009 Adopted 2015
• BetterprogrammingdidNOT=betteroutcomes
• PrimaryFocusonPermanency• FocusonFamilySearchandEngage&ParentingSupport/Education
• FocusonBuildingCommunitySupportNetwork
PlummerYouthPromise
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ContactInformationBBIMassachusetts
JaniceLeBel,PhD,ABPPDirectorofSystemsTransformation,
Child,Youth&FamilyServicesMADept.ofMentalHealth25Staniford StreetBoston,MA02114Phone:[email protected]
PlummerYouthPromise
JamesE.ListerExecutiveDirectorPlummerYouthPromise37WinterIslandRoadSalem,MA01970978.744.1099ext.113978.744.9772faxhttps://[email protected]
CALIFORNIA
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CaliforniaResidentialProject
Transformationfromlong-termcongregatecareandtreatmenttoshort-termstabilizationandtreatmentwithfollowalongcommunity-basedservices
Vision:LACountyRBSProjectThecreationofastrength-based,family-centered,needs-drivensystemofcarethattransformresidentialfacilitiesfromlong-termplacementstoshort-termfamilydrivenopentherapeuticcommunities,whicharenotplace-basedandconcurrentlyprovideforseamlesstransitionstocontinuingcommunitycare,whichsupportthesafety,permanencyandwell-beingofchildrenandtheirfamilies.
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KeyElementsofPracticeModel• OneChildandFamilyTeamAcrossallEnvironments
• CarePlanningUnifiesResidentialandCommunityTreatment(Wraparound)
• FamilySearch,Engagement,PreparationandSupportfromDay1
• BuildingLifeLongConnectionsandNaturalSupportsfromDay1
• ConcurrentCommunityWorkWhileinResidential
• 24/7MobileCrisisSupportWheninCommunityPhase
• CrisisStabilizationWithoutReplacement(14days)
• RespiteintheCommunity
ImportantCARBSStudyFindings• Thenegativerelationshipbetweenthetotalnumberofresidentiallybasedservices(RBS)placementchangesandachievingpermanencyishighlysignificant,indicatingthatthechanceofachievingpermanencydecreasedby84%witheachadditionalplacement.Inaddition,thechanceofachievingpermanencydecreasedby28%witheveryadditionalmonthofayouth’saveragelengthofstayinanRBSplacement.
• ThechanceofcompletingRBSdecreasesby15%witheveryadditionalmonthofayouth’sstayinanRBSplacement,basedonaveragelengthofstay,andthechanceofcompletiondecreasesby66%witheachadditionalplacement.
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SenecaFamilyofAgenciesMarkNickell
RegionalExecutiveDirector
Comingin2018:JournalofResidential
TreatmentforChildren&Youth:
TheChangingRoleofResidentialInterventionby:LeBel,Galyean,Nickell,Caldwell,Johnson,Rushlo
&Blau
FAMILIES TAKE CARE OF KIDS BEST
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Who Is Your Loneliest
Child?
LIGHTING THE FIRE OF URGENCYFAMILY FINDING AND THE WRAP-AROUND PROCESS
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AdditionalRBSResources
InformationontheCaliforniaRBSReformCoalitionprojectandotherCountymodelscanbefoundat:www.rbsreform.org
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ContactInformationLosAngelesCounty
Dr.MichaelJ.Rauso,DivisionChiefDepartmentofChildrenandFamilyServicesResourceManagementDivision425ShattoPlace,Suite303LosAngeles,CA90010(213)351-5861/[email protected]
WilliamP.Martone,Former/Long-termPresident&CEOHathaway-SycamoresChildandFamilyServices210SouthDeLaceyAve.Suite#110Pasadena,CA 91105626-831-6850/[email protected]
SanFrancisco/SantaClaraCounty
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MarkNickell,RegionalExecutiveDirectorSanFrancisco&[email protected] m.(510)432-278
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MINNESOTA
FamilyAdolescentsandChildrenTherapyServicesInc(FACTS)/MN
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KeyElementsofPracticeModelCollaborativeIntensiveBridgingServicesSM – CIBS• BuildsCollaborativePartnershipsbetween:
CaseManager,FamilyTherapist,ChildandFamily,andRTC
• Ecologyisthetargetofinterventionnotjustthefamily
• CIBSisa3PhaseIntensiveSystemicIn-homeTherapyModelIntegratedwitha30dayResidentialplacement▫ Phase1: Initialengagementandassessmentoffamilyandchildin-home,2to4weeks▫ Phase2: IntensiveRTCservices,continuationofintensivein-homeandRTCtherapy30-45days,childspendsregulartimewithfamilyinthehome,socanpracticeskillsbeinglearnedinRTCwithhome;▫ Phase3: Intensivein-hometherapywithchildhome
KeyElementsofPracticeModel• CIBSisnotRTCasusual– RTCfocusduringPhase230daysison:▫ SkillsPracticenotMastery▫ IntenseFamilyFocus▫ FrequentHomeTime▫ Co-TherapywithChildandFamilywithFamilyTherapistandRTCTherapist▫ 3Staffingwithin30dayswithallpartnersandchildandfamily.
• SameFamilyTherapiststayswiththefamilyfrombeginningtoclosingthroughall3phasesofCIBS,FamilyTherapisthas5to7weeklycontacts
• FamilyTherapisthassmallcaseloadsbetween4to5
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KeyElementsofPracticeModel• Focusisonbuildingskillsofchildrentobettermanagetheiremotionsandbehaviorandtoincreaseparents’capacitytomanagetheirchild’semotionsandbehaviors
• 2014DakotaCountyMNDataEvaluation24monthsafterRTC30dayplacementtocompareCIBSYouthswithYouthinResidentialPlacement.▫ CIBSyouths– 58ComparisonYouth– 34
• SubsequentRTCPlacements24monthsafterRTC:• CIBS76%youthhadnofurtherplacements• Comparisonyouth35%hadnofurtherplacement
• Costsforadditionalservicesduring2yearspostRTCplacement• CIBS(14youth)$236,928.10• ComparisonGroup(22youth)$689,780.89
• CostSavingsof $452,852.80• ServicesarepaidthroughInsuranceandCounty
ContactInformation
•LynnVanBlarcum,MA,LMFTExecutiveDirector(651)[email protected]
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ExamplesfromtheNewBBIGuide!
NEW YORK
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TheChildren’s Village
Jeremy Kohomban
INDIANA
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DamarServices,Inc.FocusonFamilies:• believingthatyouthbelongwiththeirfamilies• rapidengagementisessential▫ “everydaymatters!”
• creatingmultiplemodesofengagingyouth&families▫ insistingondailycontact
• cliniciansofficesareinthecommunity– notintheprogram(s)• empoweringfamiliestochoosetheirstaffandbearbitersofinterventionswiththeirchild
• recognizingfamiliesasexpertsinneedofadditionalskillsandsupport
• harnessing‘youthpower’andactivelyincludingtheirexpertiseand/ordevelopingnewroles
Jim Dalton
DamarServices,Inc.Long-TermOutcomes(Recidivism)
• Datadynamicallycollectedto5-yearspost“discharge”
2005 4% 2011 9%2006 11% 2012 6%2007 9% 2013 11%2008 3% 2014 12%2009 8% 2015 15%2010 6% 2017 12%
• Recidivismtypicallyoccurswithinthefirst12monthspostdischarge
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Damar:PracticeImprovement
Definitionof“Recidivism”
Duringthe5-yearspost“discharge”fromtheresidentialcaresetting,theyouthisnotplacedinasimilar
orhigherlevelofcare.
DamarServices,Inc.
CriticalIncidentofPrimaryConcernIf24hoursgoesbyandayouthisnotwithhis/herfamily
and/orinhis/herhomecommunity,itisconsideredaCriticalIncidentfortheAgencyandaplanofaction/correctionmustbesubmittedtotheCOO*.(Note:Phonecallsdonotcount.)
*InternalQualityPlusThresholdis95%forAgency.Ifit’snotmeasured,it’snotmanaged.
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Damar:NowWeKnow!!
OurJobisnottocurekidsbutrathertohelpkidsandtheirfamiliesnegotiatethebasictasksofeverydaylife.
“Residentialtreatment” shouldbeorientednotsomucharoundremovingproblemskidsbringtocarebuttowardestablishingconditionsthatallowchildrenandfamiliestomanagesymptomsandcrisesmoreeffectivelyathomeandinthecommunity.
COULDYOURTEXASRESIDENTIALPROGRAMSDOTHIS?
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2009>>>GuaranteedOutcomes!
Ifayouthrequiresre-admissionpost“discharge,”
itisFREE.
What if youguaranteed your outcomes?
DamarContactInformation
Dr.JimDalton,PresidentandCEODamarServices,Inc.www.damar.org(317)[email protected]
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DoYouTakeBigSteps?SmallSteps?
• TakeAnyStep!AllStepsCount
• ANumberofFamily-Driven&Youth-GuidedPracticesHaveBeenIdentifiedThatSupportBetterOutcomes
StepsBeingTakenacrosstheCountry…
• UsingBBIdocumentstoprovideguidancetoresidentialandcommunityproviders
• Holdingregionaland/orstatewideBBIforums
• Rewritingregulation/licensingbasedonBBIprinciples/practices
• DevelopingBBIteamsanddevelopingplansforstate-specificprojects
• RevisingfiscalstrategiestosupportreplicationofBBIinformedprogrammodels
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ConsistentChallengesFaced• Moststateagencydocuments/regulatoryoversight(e.g.,contracts;licensing;Medicaid)donothavebestpracticeexpectationsandoftenhavepracticescontra-indicatedforeffectiveoutcomes
• Differentsystems(e.g.,probationofficers;childwelfareworkers)notsupportiveoffocusonreunification/workingw/familyinhome/community
• Manyresidentialprogramshavenothadopportunitytolearn/understand/implementeffectivepracticestoengagefamilies/promotefamily-drivencare
• PermanencyPracticeModels(e.g.,FamilySearch&Engage/FamilyFinding/ExpandingSupportNetwork):nourgency
• Insufficientcommunitybasedresources&supports• Residentialprogramsstillstrugglingwithcoerciveinterventionsandhigh#ofincidents(e.g.,restraint/seclusion/policecalls/runaways/aggression)
“You never change things by fighting existing reality. To change something, build a new model that makes the
old model obsolete.”- Buckminster Fuller
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AfterreviewofResidentialResearch
• Dr.JamesWhittaker:“Ihavemorefaithinawholeclothapproachwherewestartwithasetofprinciples,changetheory,structureandthenselectalimitedarrayofkeyinterventionstoimplementit….Thisseemstomemoreconsistentwithwhatsuccessfulnon-TRCEBP’ssuchasMulti-systemicTherapyandMulti-DimensionalTreatmentFosterCarehavedone,thansimplyanapproachthataggregatesevergreaternumbersofEBP’sinaresidentialsetting.”
ElementsofEffectivePracticeforChildrenandYouthServedbyTherapeuticResidentialCare
|ResearchBrief/CaseyFamilyPrograms(2016)
Expecttofliptheresidentialparadigm:bringresidentialinterventionintothehomeandFULLYincorporatefamily&youthvoiceandchoiceintotheprogram!
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BBIContactInformationwww.buildingbridges4youth.org
Dr. Gary [email protected]
240-276-1921
Beth [email protected]
413-717-0855
Sherri [email protected]
512-964-6164
Lloyd Bullard [email protected]
301-437-2378
JuRon [email protected]
404-242-3150
ReferencesBazelon CenterforMentalHealthLaw(n.d.).Factsheet:Childreninresidentialtreatmentcenters.RetrievedonOctober4,2016,http://www.bazelon.org/LinkClick.aspx?fileticket=D5NL7igV_CA%3D&tabid=247Beherns,E.&Satterfield,K.(2006,August).Reportoffindingsfromamulti-centerstudyofyouthoutcomesinprivateresidentialtreatment.Presentedatthe114thAnnualConventionoftheAmericanPsychologicalAssociationatNewOrleans,LA.RetrievedonMarch28,2017,http://aspeneducation.crchealth.com/files/2012/06/Residential_Treatment_Outcomes_Study.pdfDodge,K.A.,Dishion,T.J.,&Lansford,J.E.(2006).Deviantpeerinfluencesininterventionandpublicpolicyforyouth.SocialPolicyReport,XX,1. AnnArbor,MI:SocietyforResearchinChildDevelopment.Frensch,K.M.,andCameron,G.,(2002).Treatmentofchoiceoralastresort?Areviewofresidentialmentalhealthplacementsforchildrenandyouth,ChildandYouthCareForum ,31(5),307-399.
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ReferencesHair,H.J.(2005).Outcomesforchildrenandadolescentsafterresidentialtreatment:Areviewofresearchfrom1993to2003.JChildFamStud,14(4),551-575.
Noftle,J.W.,Cook,S.,Leschied,A.,St.Pierre,J.,Stewart,S.L.,Johnson,A.M.(2011).Thetrajectoryofchangeforchildrenandyouthinresidentialtreatment.ChildPsychiatryandHumanDevelopment,42,65-77.
OntarioCentreforExcellenceforChildandYouthMentalHealth(2012,April).Evidencein-sight:Optimallengthofstayinresidentialtreatmentforhighriskyouth.RetrievedonFebruary7,2017,http://www.excellenceforchildandyouth.ca/sites/default/files/eib_attach/LengthofStayResidential_FINAL_REPORT.pdf
Rhule,D.M.(2005).Takecaretodonoharm:Harmfulinterventionsforyouthproblembehavior.ProfessionalPsychology:ResearchandPractice,36(6),618-625.
Walter,U.M.&Petr,C.(2007).Residentialtreatment:Areviewofthenationalliterature.Lawrence,KS:UniversityofKansas.RetrievedonSeptember10,2016,http://childrenandfamilies.ku.edu/sites/childrenandfamilies.drupal.ku.edu/files/docs/residential%20treatment.pdf
The Children’s VillageKeeping Children Safe and Families Together since 1851
Jeremy Christopher Kohomban, Phd.President and CEO
The Children’s Village and Harlem [email protected]
childrensvillage.org@jeremycv (twitter)
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Iftheseweremyownchildren
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Hastings Hornell Hart (1851-1932): The Children’s Village, Prison Authority, Children’s Advocate and President the National Conference of Charities and Correction
“Inordertorestrictandultimatelytoputanendtotheproductionofdefectivedelinquents,itisnecessarytorestrictthepropagationofthefeeble-minded varietyofthehumanrace.HastingsHart,Nov12th,1912
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Howdoesthishappen?
VALUE
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BECAUSE,implicitbias influenceshowweseethosewhoweserve.
Implicitbiasdrivespersonal/groupactionandinfluencespolicy.
Implicitbias-relativelyunconsciousandautomaticprejudicejudgment,attitudesandsocialbehaviortowardssociallystigmatizedgroups
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Boarder Baby
Throw-Away Kid
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Sexually Trafficked
Toxic Stressed
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Attachment Disordered
Disconnected Youth
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OppositionalDefiant
APERSISTENTTHEME
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And….Whenitcomestothesechildren
…theoneswhocomefromcommunitiesweleastvalue,weoftenignore orareintentionally blindtothesocialjusticecontext.Rather,weveryquicklybegintoseethesechildrenasHastingsHartdid,defectivedelinquentsandfeeble-minded.Ourlanguagehaschanged,butweoftencommunicatethesamemessage.Theyarebroken,theyaredifferent,theyarenotlike“mychildren”
Iftheseweremyownchildren
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Iftheseweremyownchildren
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included
treated as important
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supported
encouraged
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celebrated
listened to
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belong
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breath
PRACTICE #1Belonging is the non-negotiablefoundation on which success is achieved. All cognitive & social-emotional competence begins here.
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Actions we can take • Find and engage family (one parent
only represents 50% of all options)• One appropriate, willing adult
relationship.• Reject any solution that is not
connected to a person or a true relationship
PRACTICE #2be cognizant of
unconscious bias
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Actions we can take:• We are all impacted by implicit bias.
Recognize it• Raise above Racial Anxiety.• Reject the convenient. Kids need all of us.• Engage in the conversation, we are the
greatest aspirational democracy.• Create privilege!
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Actions we can take:• Remind yourself and everyone you know,
most often pain, loss, loneliness, hopelessness and despondency is the truebattle we fight.
• Remember, poverty is rarely a choice
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17,300adultslivinginSanDiego65%reportedatleastoneACE20%reportedatleast3ormoreACEs75%werewhite95%wereover30yearsofage40%graduatedfromcollege36%hadsomecollegeTheyweremiddleincome($40Kand$150K)
Actions we can take:Remind yourself of what you know:
• Trauma does not = failure
• Resilience is what we value in our own lives and in the people we love.
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PRACTICE #3 Give Voice
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CredibleMessengersTHEBRAVEHEARTShttps://www.facebook.com/BraveheartsMOVENY/
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PRACTICE #4Evidence and Outcomes Matter
Example:AfterCare WestchesterCountyNY
Year Total Recidivism2013 144 6%2014 155 5%2015 173 3.5%2016 190 2.6%2017 152 1.3%
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PRACTICE #5
Inaworldofexperts,beaservant
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The Children’s VillageKeeping Children Safe and Families Together since 1851
Jeremy Christopher Kohomban, Phd.President and CEO
The Children’s Village and Harlem [email protected]
childrensvillage.org@jeremycv (twitter)
TheBuildingBridgesInitiative(BBI):AdvancingPartnerships.ImprovingLives.
TexasBuildingBridges:Youth,Families,Agencies,andProvidersTransformingResidentialInterventionandAchievingPositiveOutcomes– Family-DrivenCareMay 23, 2018
Presentedby:SherriHammack,Coordinator,BuildingBridgesInitiative
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FamilyDrivenCare:What’sItAllAbout?
WhatisFamilyDriven?FamilyDrivenmeansfamilieshaveaprimarydecisionmakingroleinthecareoftheirownchildrenaswellasthepoliciesandproceduresgoverningcareforallchildrenintheircommunity,state,tribe,territoryandnation.
Thisincludes:• Choosingculturallyandlinguisticallycompetentsupports,services,andproviders;
• Settinggoals;• Designing,implementingandevaluatingprograms;• Monitoringoutcomes;and• Partneringinfundingdecisions.
Source:FederationofFamiliesforChildren’sMentalHealth
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WhyIsItImportant?• Strongestpredictorofpost-transitionsuccess,aftereducation,issupportfromfamily
• Fiftypercent(50%)ofyouthwhohaveagedoutwilllivewithsomememberoftheirfamilywithinacoupleofyears (aboutequallydividedbetweenparentsandotherrelatives)
Source:Courtney,M.,2007;Courtney,M.,etal,2004
• “Workwithfamilyissuesandonfacilitatingcommunityinvolvementwhileadolescentsareinresidentialtreatmentmayhaveassistedtheseadolescentstomaintaingainsforasmuchasayearafterdischarge..”
Source:Leichtman,M.,etal,2001
“Theeffectivenessofservices,nomatterwhattheyare,mayhingelessontheparticulartypeofservicethanonhow,when,andwhyfamiliesorcaregiversareengagedinthedeliveryofcare.Whiletraditionalformsofcareapproachedmentalhealthtreatmentinahierarchicaltopdownapproach(withtheclinicianmaintainingsomedistancefromtherecipientsoftreatment),thisapproachisnotreflectedinnewerformsofservicedelivery.Itisbecomingincreasinglyclearthatfamilyengagementisakeycomponentnotonlyofparticipationincare,butalsointheeffectiveimplementationofit.“
Source:Burns,B.etal,1999,p.238
WhyisitImportant?
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Family-drivenCare:WhatareyourProgram’s
Strengths?
Writedown1or2strengths
What Can Programs Do?
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PutanURGENTANDSTRONGFocusonPermanencyPractices– ‘doingwhateverittakes’toensureeverychild
hasapermanenthomeANDthatyourstaffareworkingwiththefamilymemberstoensuresuccessfuldischarge
FROMPRE-ADMISSION
DownloadfollowingdocumentfromtheBBIwebsite:ABuildingBridgesInitiativeGuide:FindingandEngagingFamiliesforYouthReceivingResidentialInterventions:KeyIssues,Tips,andStrategiesforResidentialLeaders
ESPECIALLY:AppendixA:FamilyFindingandEngagementModels
www.buildingbridges4youth.org
1st:THEMOSTIMPORTANTSTEP:
TheImportanceofPermanency• Familyconnectionsareassociatedwithimprovedoutcomes
• Lackofpermanencymakespasttraumaticeventsmoredifficulttomanage
• Connectionswithfamilyincreasespositiveidentitydevelopment
• Treatmentalonedoesnotmeettheneedsofyouthwithoutfamilyconnections
“RightsizingCongregateCare:APowerfulFirstStepinTransformingCWSystems”,AnnieE.CaseyFoundation,2009
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HireFamilyPartners/Advocates2nd MOSTIMPORTANTSTEP:
• Hiremultiplefamilypartners/advocates
• Haveseniorfamilypartneraspartofexecutiveteam&providesupervisiontoallfamilypartners
• Havefamilypartners(ANDFAMILYMEMBERS)aspartofEVERYorganizationalworkgroup/committee/taskforce
• Havefamilypartnersshareofficeswithotherstaff–spreadthroughouttheorganization
HireFamilyPartners/Advocates
• Theyserveasco-trainersinstafforientationandongoingtrainingprograms
• Theyserveaspartofhiringgroupstohirestaff
• Theyserveaspartofevaluationteamstoevaluateeachindividualstaff
• “Nothingaboutuswithoutus!”
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• DevelopAStrategicPlantoSuccessfullyEngageFamiliesandOperationalizeFamily-drivenCare
Go to the BBI website download, review and planto use the BBI Self-Assessment Tool as part of your strategic plan
www.buildingbridges4youth.org
3rd MOST IMPORTANT STEP:
AsPartofaStrategicPlanHaveallleadershipteammembersreadandreadandread:
• BBIFamilyTipSheets (longandshortversions)&BBIEngageUs:AGuideWrittenbyFamiliesforResidentialProviders
• MassachusettsDepartmentofMentalHealthCreatingPositiveCulturesofCareGuideChapters:
▫ SuccessfullyWorkingwithFamilyPartners
▫ EmbracingFamily-drivenCare
• Avarietyofothermaterialstosupportincreasedunderstandingandimprovedknowledge-base(seereferencesatendofthischapterandinthePositiveCulturesofCareGuideChaptersreferencedabove)
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Board/ExecutivesFocusingonSpecificAreas
IfTheseAreasareNotAlreadyinPlace,ConsiderIncludinginaStrategicPlan
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Board/ExecutiveFocusAreas▫ LeadershipPassionatefocusontransformationtowardsFDC(alaBillAnthony:walkthewalkvs.justtalkthetalk)
▫ Agencyclearvalues(e.g.,strength-based,trauma-informed,individualized&flexible;family-driven;youth-guided;culturalandlinguisticcompetence;communityintegrated)
▫ 100%staffcompetentinskills which=values(primarily:respect/compassion/empathy/listening/choice/kindness/patience)
▫ Multipleprogrampracticesclearlyspelledoutforeachvalue
▫ SophisticatedSupervision Systems– especiallyClinical
SmallStepExampleRaquelHatter,CEOoflargeresidentialprogram,wentbacktoheragencyafterthefirstBBISummitandimplementedmultipleimprovements,including:
• Primaryfocusonwelcomingfamiliesasfullpartners
• Hiredseniorexecutivefocusedonfamily• RewrotejobdescriptionstoincludeFDC• Madesupervisorsaccountable(someeventuallyaskedtoleave)
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Board/ExecutiveFocusAreasFullyimplementing:▫ FamilySearch&EngageorFamilyFindingorOtherPermanencyPractices▫ Wraparound/Child&FamilyTeams▫ BestPracticeClinicalEngagementSkills(i.e.variationsofFunctionalFamilyTherapy/Multi-systemicTherapy)▫ Clearexpectationsforalldisciplinesofstafftoworkinterchangeablyinresidential,home&community
Board/ExecutiveFocusAreasUsingDatatoInformPractice:▫ Restraint/Seclusion▫ AchievingPermanencyforEveryChildinaSHORTTimeframe▫ PuttingintoPlaceforEveryChildaBroadCommunitySupportNetwork▫ PrecipitousDischarges▫ Hospitalizations▫ Re-admissionsintoOut-of-homeCare/HospitalsforallYouthatLeast1to2YearsPostDischarge
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THE NEW BAR IS HOW CHILDREN AND FAMILIES ARE DOING 6 MONTHS TO 3 YEARS POST DISCHARGE
WHATS HAPPENING IN THE COMMUNITY IS WHAT COUNTS
Board/ExecutiveFocusAreasQualityImprovement:▫ %ofYouthSpendingTimeEveryDaywithFamilyMembersand/orinCommunityEngaginginPro-socialActivitiesw/Pro-socialPeers
▫ %ofFamilyMembersMetwithEveryWeek
▫ %ofFamiliesConnectedtoandPartofFamilySupportGroupsinCommunity
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Board/ExecutiveFocusAreas▫ EnsureFiscalStrategiesthatSupportWorkingwithFamiliesintheirHomesandCommunitiesduringandpostresidentialstays(i.e.6monthsto2yearspost)
▫ OfferLongTermSupport:Respite/In-homeservice
▫ SetExpectationsinStaffJobDescriptions/ContractsforMinimum%ofTimeStaffSpendinCommunitiesw/Families
▫ RenamePositions(i.e.‘ClinicalStaff’ Become‘ReunificationSpecialists’)toEmphasizeFocusonPermanency/Reunification
Board/ExecutiveFocusAreasEnsureExecutiveTeamMembers:▫ HaveOpenDoorPolicyforFamilyMembers
▫ AtLeastOneTeamMemberMeets/GreetsEvery NewFamily
▫ AtLeastOneTeamMemberInterviewsEveryFamilyIndividuallyatDischargeandAgain– 6MonthsPostDischarge
▫ AndAllAgencyStaffRepresenttheCultures/Ethnicities/Races&SpeaktheLanguagesoftheYouthandFamiliesServed
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StaffofAllDisciplinesImplementingaVarietyofFamily-DrivenPractices
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ExamplesofPracticesYouWouldSee:
▫ EveryStaffis‘DirectorofFirstImpressions’(TitleUsedInNewZealandorganization)
▫ FamiliesCanCometoProgram24/7▫WarmandComfortablePhysicalEnvironments▫ FamiliesCangotoEveryPartoftheProgram–SpendingTimeinTheirChild’sRoomandClassroomandActivities
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ExamplesofPracticesYouWouldSee:
• LoseTheWords‘Home-Visits’
• FamilyFocusGroupsDecideEducationOfferingsforFamilies
• FamiliesCalledEverydaytoShareChildStrengths– NotJustAboutIssues&EncouragedtoCallMultipleTimesDaily
• YouthCallDifferentFamilyMembersMultipleTimesDaily
ExamplesofPracticesYouWouldSee:
• EnsureFamiliesHaveDedicatedTimetoTalkwithFrontLineStaff
• MakeitaPracticetoConsultwithFamiliestoSeekCounselandEngageTheminDecision-making
• CreateOpportunities(i.e.WeekendCamping)forFamiliestobeProudoftheirChildren/toCreatePositiveMemories
• SupportSiblings
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ExamplesofPracticesYouWouldSee:
• NOMOREGROUPREC– AllRecreationFocusedonYouthIndividualInterests/Talentsandany‘Group’ActivityInvolvesSiblings/Families/ExtendedFamilies- i.e.Cousins
• GatherTickets/Freebies forFamiliestoUsewithChildren(maybewithastaffforsupport)
• DevelopCloseCollaborationswithClinicalExpertiseinCommunity(e.g.,Trauma;SubstanceAbuse;DomesticViolence)&Supports(e.g.,Housing;CommunityActivities;PeerMentors;Respite)
StrategiesForEngagingwithFamiliesFromLongDistances
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HavePolicies/Practices/StaffTrainingtoENCOURAGE:
• YouthCallingasManyFamilyMembersasPossibleANDFriendsWheneverWant/NeedTo
• HaveManyPhones/NoRestrictionsonWhenCanUse(ExceptMaybeSchool/AfterCertainTimeofNight)
• AllowCellPhones(w/Security– i.e.PhotosTaking/VideoTurnedOff)
• Skype/GoogleChatDAILY
HavePolicies/Practices/StaffTrainingtoENCOURAGE:
• Do‘WhateverItTakes’ toGetYouthHome2xWeekMinimum(andWhenCrisisComesUp;ALSO- DONOTALLOWYOUTHTOMISSANYIMPORTANTFAMILYEVENTS)– Upto3PlusHoursDrive1-way/WorkedonRevisingBudgetItemsi.e.Gas$
• Develop/LicenseCommunityProgramsinCommunitiesYouthComeFromAND/ORDevelopStrongPartnerships(e.g.,JointValues;JointTraining;FormalSign-offs)
• HaveStaffPhoneandEmailRegularly– ESPECIALLYTOSHARESTRENGTHS;CommunicateOften;
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HavePolicies/Practices/StaffTrainingtoENCOURAGE:
• Trainclinicalstafftodofamilysystemsworkonthephone(justforsomemeetings– MOSTSHOULDHAPPENINHOMES)
• Haveaclinicalstaffandafamilyadvocateworkinthecommunitymostyouth/familiesreside(alaSCO/NYC)
• Getagranttobuyi- Pads/laptopsandrent(i.e.$1)forfamilies(or- ifchargemore- return$’swhenreturned)
• Createbackandforthartproject/binderforfamiliesandyouthtoworkon2to3xweeklyordailyandeithertakeeachweekendhomeand/orscan/emailbackandforth(alaSCO/NYC)
ExamplesofAFEWFDCPractices
• Mission/ValuesemphasizeFDCasprimaryfocus• Orientation/Training/SupervisiononFDCCommitment• UseofFamilyFinding/Search&Engage;focusonpermanency
• HiringofFamilyPartners/Advocates• SiblingSupport• Clinical/otherexpertiseinengaging/workingw/families(e.g.,MST;FFT;Wraparound)
• Clinical/staffworkinhomestosupportproblem-solvingrealissues(notresidentiallycreatedchallenges)
• Familieswelcome24/7• Losewords‘homevisits’/’homepasses’– timewithfamilyandinhomecommunitybeginsatadmission(notprivilege)
• Staff/youthcallfamiliesfrequently
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WhatToBeCautiousOf:• EventsonResidentialCampuses(why?)
• LackofSophisticated/CommittedClinicalSupervisors
• GroupResidentialRecreation(why?/whotoinvite?(BuildMemorieswithFamilies)
• ResidentialHolidayTraditions(“IsitAbouttheProgramorAbouttheYouth/Family?”)
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ExamplesofAFEWYGCPractices• Mission/ValuesemphasizeYGCasprimaryfocus• YouthAdvocates/peerMentors• MeaningfulYouthAdvisoryCouncil• Orientation/Training/SupervisiononYGC/TICInterface&Commitment• UnderstandingofImpactofTrauma(e.g.,useofsensory;repetitive/rhythmical;NO/VERYLOWrestraint/Seclusion/AWOLS/Police calls
• Individualized(truly)approaches(safety/soothingplans–PREVENTION/TEACHINGapplicableathome/school
• Eliminatepoints/levels/focusonconsequencesandbehaviormanagement(Compassionateinquiryvspraise)
• Majorstafffocusonyouthvoice/choice• Youthengaged/supportedincommunityactivitiesmatchingindividualskills/talents/passions
• Youthhavecellphones(w/filters)callfamily/approvedfriendoften• Focusonyouthleadership/advocacyskills• Educationflexibility/creativity
Whatcanyoudotoimprovefamily-drivencareoryouth-guidedcareinyourprogram?
Thinkof:•1improvementyoucanmakeinthenexttwoweeks?
•1improvementyoucanmakeinthenextsixmonths?
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BBIContactInformationwww.buildingbridges4youth.org
Dr. Gary [email protected]
240-276-1921
Beth [email protected]
413-717-0855
Sherri [email protected]
512-964-6164
Lloyd Bullard [email protected]
301-437-2378
JuRon [email protected]
404-242-3150
Presentedby:TaraThomas,CertifiedFamilyPartner:TheHarrisCenterfor
MentalHealthandIDD
WhatFamiliesWantfromProviders
May23,2018
TexasBuildingBridges:Youth,Families,Agencies,andProvidersTransformingResidentialInterventionandAchievingPositiveOutcomes
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WhatFamiliesWantfromProviders
• AcknowledgementAttheDoor
• OpenCommunication• IdentifytheFamilyConnection
• Access to NurturingEnvironment
• Resource Tools• Trauma-Informed• Continuing Education• CompassionandEmpathy
Acknowledgement At the Door
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IdentifytheFamilyConnection
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AccessToaNurturingEnvironment
Resource Tools
• ParentPeerSupportfromaParentwithResidentialInterventionExperience
• SupportGroups• FamilyTherapy• EducationalPrograms• EmploymentOpportunities
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Trauma-Informed• CreatingaSafeEnvironment
• IdentifyingTriggers• BuildingRelationshipsandConnectedness
• SupportingandTeachingEmotionalRegulations
ContinuingEducation
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FindingHisWay…..KristopherAlexanderThomas
CompletedasuccessfulprograminaTexasResidentialTreatmentFacility,graduatedfromHighSchoolintheSummerof2017andwentontostartcollegethatfall.Kristopherisnowinanindependentlivingprogram,livingonhisown(witharoommate),workingfull-timewhileattendingclasses.Although,hestillexperienceshisowndailystrugglesandtrials,heishappy,confidentandblessedbeyondmeasureJ
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MeetTaraThomas
• Certified Family Partner at TheHarris Center for MentalHealth and IDD for 3years.
• Mother of 3 Young Men (18-21yrs)
• Has walked alongside over100+ families in Harris County
ResourcesforFamilies:
www.ffcmh.orgwww.samsha.orgwww.nami.orgwww.mha.org
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Thankyou.
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THE KRAUSE CHILDREN’S CENTER•OPENED IN 1995•PROVIDES 24 HOUR THERAPEUTIC RESIDENTIAL SERVICES TO GIRLS AGES 12-
17 WHO HAVE EXPERIENCED “SIMPLE” TRAUMA TO CHRONIC AND COMPLEX TRAUMA.
•TOTAL CAPACITY OF 60 WITH AVERAGE DAILY CENSUS OF 57.•SERVE SPECIALIZED AND INTENSIVE LEVEL OF CARE.•ONE OF 10 RESIDENTIAL TREATMENT CENTERS IN TEXAS WHO WORK WITH
INTENSIVE PSYCHIATRIC TRANSITION PROGRAM (IPTP) LEVEL OF CARE.•ON-SITE CHARTER SCHOOL THROUGH TRINITY CHARTER SCHOOLS (TCS).
WHAT STARTED OUR BBI JOURNEY•OUR BEGINNING… OPENING STORY
BY AMANDA•WE STARTED WITH RESEARCH.. A
LOT OR RESEARCH•A PILOT WITH BBI•TRAINING, TRAINING, TRAINING •COMMUNITY PARTNERSHIPS This Photo by Unknown Author is licensed under CC BY
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POSITIVE OUTCOMES
•WE HAD AMAZING OUTCOMES IN RESTRAINT REDUCTION BY 60% AFTER A 9 MONTHS PILOT WITH BBI
•YOUTH AND EMPLOYEE MORALE WHEN UP AS WELL ON SATISFACTION SURVEYS
• NO MORE REFUSALS BY YOUTH DURING ADMISSIONS•REDUCED EMPLOYEE TURNOVER
RESTRAINT REDUCTION 2016
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21 34 51 37 55 30 30 16 9 13 4050
100150
2016 Monthly Personal Restraint Totals
Restraints
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RESTRAINT REDUCTION 2017
14 14 20 14 7 12 4 5 4 8 11 1020406080
100120
2017 Monthly Restraint Totals
Restraints
RESTRAINT DATA – 3 YEARS
•2015= 504 RESTRAINTS•2016= 404 RESTRAINTS•2017= 114 RESTRAINTS•EACH YEAR OUR ACUITY MIX OF IPTP/INTENSE/SPECIALIZED
LOC SERVED WENT UP
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ROAD BLOCKS • MOVING AWAY FROM A LEVEL SYSTEM-
DON’T DO TOO MUCH AT ONE TIME
• GETTING EVERYONE TRAINED AND ON THE SAME PAGE
• EDUCATING THE COMMUNITY- CHANGE TAKES TIME
This Photo by Unknown Author is licensed under CC BY-NC
This Photo by Unknown Author is licensed under CC BY-NC-ND
FUTURE FOR KRAUSE•MOVING AWAY FROM THE LEVEL SYSTEM WITH A DEFINED PLAN•SEEKING A FAMILY ADVOCATE VOLUNTEER POSITION•FUNDRAISING FOR ADDITIONAL RESOURCES FOR FAMILIES •ADDITIONAL TRAINING ON CULTURAL AND LINGUISTIC COMPETENCE•SETTING UP WRAPAROUND SERVICES PARTNERSHIPS•ONGOING NETWORKING IN THE COMMUNITY TO HAVE ADDITIONAL
RESOURCES AND PARTNERSHIPS
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BBIContactInformationwww.buildingbridges4youth.org
Dr. Gary [email protected]
240-276-1921
Beth [email protected]
413-717-0855
Sherri [email protected]
512-964-6164
Lloyd Bullard [email protected]
301-437-2378
JuRon [email protected]
404-242-3150