Connecting Circles of Care

1. Connecting Circles of Care A System of Care: A cultural diverse family driven program for children with severe emotional disturbances Jlg CCOC

2. Connecting Circles of Care How does this system of care work to change the current services? • Culturally and Linguistically Competent Providers and Practices • Family and Youth Driven Services • Wraparound Strength Based Services • Multi-agency, Coordinated, Community Based Care • Respite Care

3. What are Wraparound Services? • An approach to care planning and service provision that organizes and manages the delivery of multiple services, treatments, and supports to a child and the child’s family in ways that are flexible, individualized, strengths-based, family driven, culturally responsiveand effective. Wraparound processes are organized around all key life domains (home, school, and community living).

4. Wraparound team Systems of care blend clinical services and natural supports. CCOC Wraparound teams consist minimally of: • A Parent/Family Partner • A Family Support Worker • A Licensed Therapist

5. THE HONOR OF ONE IS THE HONOR OF ALL

6. Culture-based Wraparound • Integrates wraparound into the youth and family’s culture • Staff are culturally matched and view the world through the eyes of a family’s culture • Expertise in a particular culture requires decades of immersion • Realizes that a youth or family member’s perceptions of, and level of trust, for staff from different cultures may impair relationship formation no matter how culturally competent staff may be • Wraparound • Integrates culture into wraparound • Trains staff to respect and understand family viewpoints and then adapt services to the culture • Trains staff in the principle of cultural competence in 4-40 hours • Focuses on culturally competent techniques of staff to develop therapeutic relations

7. Wraparound • Often does not offer youth and families the choice to have culturally and linguistically matched professionals • Translation with a qualified interpreter is considered sufficient • Culture is often seen as a family’s traditions and ways of doing • Wraparound is accountable to families and local agencies • Culture-based Wraparound • Offers youth and families the choice to have culturally and linguistically matched professionals • Fully bilingual staff provided to ensure that true meanings are not lost and family members can emotionally process easier in their first language • Culture is seen as part of traditions in cultural groups (specific family traditions are honored and valued, but not seen as culture) • Wraparound is accountable to families, cultural communities, cultural organizations, and local agencies

8. Rural Butte County • Butte County is located in the Central Valley north of the state capital, Sacramento. The Census bureau’s last estimate in 2008 has our population as 220,337. The county seat is Oroville. • Butte County is watered by the Feather and Sacramento Rivers. Butte and Big Chico Creeks are tributaries to the Sacramento River. It is the site of Feather Falls, the sixth largest waterfall in the United States. Lake Oroville is located east (and upriver) of the city of Oroville. The lake’s dam is the largest earthen dam in the U.S.

9. Underserved demographics • Farmlands ~ valley • Rural unincorporated towns • Foothills • Indian reservations • Tribal Housing

10. Butte County Census 2008http://quickfacts.census.gov/qfd/states/06/06007.html Butte County CA • White 88.8% 76.6% • Black 1.7% 6.7% • American Indian / Alaska Native 2.2% 1.2% • Asian 4.1% 12.5% • Native Hawaiian / Other Pacific Islander 0.2% 0.4% • Persons reporting two or more races 3.1% 2.6% • Hispanic or Latino origin 12.9% 36.6% • White not Hispanic, 76.9% 42.3%

11. Economic Characteristics Butte County % CA % Families below poverty level 11.6 9.6 Individuals below poverty level 18.2 13.2 Unemployment Jan 2010 15.1 13.2

12. Housing CALIFORNIA RANKS Extent of child homelessness 48 Child well-being 15 Risk for child homelessness 28 State policy and planning and adequate Overall rank 40* *States ranked 1-50 1=best, 50=worst ~The National Center on Family Homelessness

13. Barriers to Service • Lack of trust of services and providers • Poverty/low income • Language • Transportation • “mountain” stigma • Child Care • Weather • Disasters • Lack of services in their local zip code • Lack of Cultural competency by providers • Poor housing (or lack thereof) • PTSD or other mental health diagnosis’ • Soul Wound

14. Intergenerational and Historical trauma Research • Intergenerational trauma was first written about in 1966 when mental health professionals were seeing large numbers of children of holocaust survivors. • Children of survivors have consciously and unconsciously absorbed their parents’ trauma. • The trauma experience becomes a family legacy.

15. Military entrance Gang Affiliation Substance Abuse Domestic Violence Depression Mistrust of governmental and other agency systems – fear of the oppressor Child Abuse Suicide Common Manifestations of Intergenerational Trauma& Coping Skills

16. Community as essential part of program development • Dinner and lunch and follow up with local African American Pastors and their congregations • Met with Hmong Civic leaders • Met with Providers serving the Latino communities • Gathering of Native Americans • Meeting with rural communities who survived fire disaster with follow up services at their local school • Governance Body includes community members, family and youth.

17. Considerations when working with rural communities • Recognize that even well adjusted individuals have been impacted by intergenerational trauma • Recognize that lack of trust is usually systematic and not personnel • Understand definitions of how communities view themselves • Understand definitions of family

18. Considerations when working with rural communities • Understand that entering a families’ home is entering a sacred place. • Understand that what you are teaching or assisting a family with must be complimentary to their culture for it to work • Understand that your family has strengths and your job is to augment those strengths

19. Lessons Learned • Food served must be acceptable to all cultures • Diversity within the racial or ethnic cultures (traditional vs. non traditional) • Ensure that ‘new’ staff understand program and the ‘thinking outside the box’

20. Connecting Circles of Care Butte County, CA Butte County Behavioral Health Northern Valley Catholic Social Services Feather River Tribal Health, Inc. www.connectingcircles.com