THE SKILL BUILDING CURRICULUM

1. Building Systems of Care: A Primer for Child Welfare and Primer Hands On-Child Welfare THE SKILL BUILDING CURRICULUM Developed by: Sheila A. Pires Human Service Collaborative Washington, D.C. In partnership with: Katherine J. Lazear Research and Training Center for Children’s Mental Health University of South Florida, Tampa, FL Lisa Conlan Federation of Families for Children’s Mental Health Washington, D.C.

2. Primer Hands On-Child Welfare Web-Based Training and Technical Assistance Materials To Support: • Intensive 2-day capacity-building sessions, or shorter topical training sessions on individual modules, or materials for targeted technical assistance Includes: • Skill building curriculum, case scenarios, exercises, handouts, PPT slides, and Primer Creates: • Network for peer support and technical assistance, linked by list-serve

3. Module 1 – Purpose and Organization • Purpose • Ways to Use • Components • Target Audience • Objectives • Training Methods • Strategic Framework • Elements of Strategic Planning

4. Primer Hands On-Child Welfare OBJECTIVES • To strengthen the knowledge base and skills of system of care leaders to operate strategically in system building • To give system of care leaders teaching tools to use in their respective communities • Build a network of individuals grounded in a common strategic framework for building systems of care Pires, S., Lazear, K., Conlan, L.( 2003). “Primer Hands On”; A skill building curriculum. Washington, D.C.: Human Service Collaborative.

5. Ways to UsePrimer Hands On-Child Welfare • As a self-contained, intensive two-day training covering all Modules: provides an overall strategic framework; • As separate training sessions on individual Modules: allows in-depth focus on a given area; • As material that can be drawn on by technical assistance providers/consultants: supports targeted technical assistance. Pires, S., Lazear, K., Conlan, L. (2003). “Primer Hands On”; A skill building curriculum. Washington, D.C.: Human Service Collaborative.

6. Module 2 - Context: System Building Definitions, History, Values, Principles and Characteristics • System of Care (SOC) Definition • Administration for Children and Families (ACF) System of Care Sites • SOC History • Child Welfare SOC Activities • Avoiding “Categorical Systems of Care” • -Alamance County, NC • Organizing Framework Supported by Core Values • Full Range of SOC Values and Principles • Synergy with Values of Family Support and Youth Development Movement -Wraparound Milwaukee • -Handout 2.1 – Alabama’s R.C. Goals and Principles • -Nevada, Kansas, North Carolina, Oregon and North Dakota • SOC Operational Characteristics • Consistency with CFSR Systemic Factors Resonance between SOC and CFSR Outcomes • SOC as a “Differential Response System” for Child Welfare • -Oregon continued

7. Module 2 - Context: System Building Definitions, History, Values, Principles and Characteristics • System Problems • Fractured Accountability • SOC Connected to Larger System Reform • Need for Frontline Practice Change • How Families Become Involved with SOC • Family-Centered Practice Approach • Shifts in Roles & Expectations of Families & Youth • Shifts in Child Welfare Decision Making Practice Change at Multiple Levels - Policy, Management, Frontline & Community • Non-Categorical Vs. Categorical System Reform • Population Focus • Prevalence and Utilization • A Population-Driven Systems Approach • State Commitment and Local Ownership • Definition of Evidence-Based and Promising Practices • Examples of Evidence-Based and Promising Practices • -California’s Evidence-BasedClearinghouse for Child Welfare • Shared Characteristics of Evidence-Based & Promising Practices • Returning to Values, • -Exercise 2.1 – Assumptions and Values

8. Module 3 - Process and Structure in System Building • Definition of Structure • Example of Structure’s Impact • -Wraparound Milwaukee • Important Points about Structure • Targeted Case Management System • Functions Requiring Structure in Systems of Care • Core Elements of System Building Process • Components of Effective Leadership • Leadership Styles • Elements of Partnership • Challenges to and Strategies for Collaboration • Catalysts for Reform • Managing Complex Change • -Cuyahoga County, Ohio (Cleveland)Family-to-Family

9. Module 4 – Cross-Cutting, Non-Negotiable Characteristics: Family/Youth Partnership and Cultural/Linguistic Competence • -Exercise 4.1 Attitudes Toward Families, Youth and Culture • Non-Negotiable Characteristics of System of Care • Defining Family & Youth • How Systems of Care are Structuring Family and Youth Involvement at All Levels • Applicability of a Family-Driven Approach to Court-Involved Families • -Milwaukee, Wisconsin,Wraparound Milwaukee • Addressing Families Capacity and Willingness to Partner • -Jefferson County, Colorado • -Handout 4.1 TheRhode Island Family Coalition for Family Support& Involvement Family-Centered Practice: How are We Doing? • Definition of Youth-Guided • Roles for Youth • Barriers to Youth Partnership • Family & Youth Networks of Support & Advocacy • The Role of Family-Directed Associations and Organizations • -Missouri Youth Advisory Board; Texas Regional Advisory Groups continued

10. Module 4 – Cross-Cutting, Non-Negotiable Characteristics: Family/Youth Partnership and Cultural/Linguistic Competence • Cultural Competence Realities • Theories, Disparities and Disproportionality in Child Welfare • Examples of Partnerships to Address Disproportionality • -Children of Color Project, Woodbury County (Sioux City) Iowa • -Texas Community Advisory Committees On Disproportionality • -Collaborative Circle for The Well-Being of South Dakota’s Native Children • Positive Outcomes from Addressing Disproportionality • -Wake County, North Carolina • Definitions of Cultural and Linguistic Competence • Cultural Competence Continuum • Organizational Cultural Competence • Cultural Competence Core Elements

11. Module 5 – Planning, Governance, and System Management • (Organization of Remaining Training Modules; Orientation to Team Work) • FUNCTION: Planning • Issues for Structuring Planning • Stages of Planning • Elements of Effective Planning Processes • Strategies for Involving Families and Youth in Planning • Culturally Competent Planning Process • -Cuyahoga County, Ohio (Cleveland) • FUNCTION: Governance • Definition of Governance • Definition of System Management • Key Issues for Governing Entities • Types of Governance Structures • -Cuyahoga County, Ohio • Example of an Evolving Governance Structure continued

12. Module 5 – Planning, Governance, and System Management • FUNCTION: System Management • Key Issues for System Management Structures • Types of System Management Structures • -Sarasota County, Florida • Locus of Management Accountability for Target Population • -Sarasota County Coalition, Florida • -Milwaukee County, Wisconsin • -Cuyahoga County, Ohio • Relationship between Governance and System • System Management Structures • -Sarasota County, Florida • -Cuyahoga County, Ohio • Involving Families and Youth in System Management • Culturally Competent System Management Structures • -Team Work (Team Meeting #1)

13. Module 6 – Outreach and Engagement, Organized Pathways to Service/Supports; Screening, Assessment and Evaluation; and Service/Support Planning • Function: Outreach and Engagement • Outreach and Engagement Issues • Roles for Families and Youth in Outreach and Engagement • Culturally Competent Community Engagement • Examples of Culturally Competent Outreach and Engagement • -Everglades Health Center, Dade County, Florida • -Hmong Resource Center, St. Paul, Minnesota • -Abriendo Puertas Family Center, Miami, Florida • Caseworkers’ Role in Outreach and Engagement: Home Visits • Function: Organizing a Pathway to Service/Supports • An Organized Pathway to Services/Supports • Examples of Organized Pathways • -Cuyahoga County • -Wraparound Milwaukee, Milwaukee County • -Collaboration for Families and Families, Sarasota, Florida • Burden on Families • Family-Centered System Entry • -Maryland Governor’s Office on Children

14. Module 6 – Outreach and Engagement, Organized Pathways to Service/Supports; Screening, Assessment and Evaluation; and Service/Support Planning • Functions: Screening, Assessment, Evaluation and Services Planning • Definitions of Screening, Assessment, Evaluation and Service Planning • Screening, Assessment, Evaluation and Service Planning in Child Welfare • Child Welfare Case Worker’s Role in Assessment and Service Planning • Comprehensive, Strengths-Based Principles • -Mississippi Division of Children and Family Services • Comprehensive, Strengths-Based Approaches in Child Welfare • -Handout 6.1 – Arizona Department of Health Services: A Comparison of Six Practice Models • Elements of Wraparound and Family Group Conferencing • Examples of Wraparound Approaches in Child Welfare • -Handout 6.2 – Kansas Department of Social and Rehabilitation Services Family-Centered Practice • An Individualized Approach to Services/Supports Planning • -EQUIPO, Abriendo Puertas Family Center, Miami, Florida • Characteristics of a Well-Documented Services/Supports Plan • The Team Approach continued

15. Module 6 – Outreach and Engagement, Organized Pathways to Service/Supports; Screening, Assessment and Evaluation; and Service/Support Planning • Family Partnerships and Cultural Competence in Screening Assessment, Evaluation and Services/Supports Planning • Accurate and Accessible Information • Families with Repeat Involvement with Child Welfare • -Pennsylvania’s Allegheny County Department of Human Services • Use of Common Screening and Assessment Tools • Role of CASA Volunteers, Guardians Ad Litem and Judges in Service Decision Making • Role of Supervision and Coaching • -Team Work (Team Meeting #2)

16. Module 7 – Service Array and Financing • Function: Array of Service and Supports • Overview • Importance of Medicaid Managed Care for Child Welfare • Array of Services and Supports – NRCOI Framework • Purposes of NRCOI Framework • Examples of States/Communities Using NRCOI Service Array Framework • -Nebraska and Pulaski County, Virginia • -Handout 7.1 – National Child Welfare Resource Center for Organizational Improvement: Service Array Framework • Example of a Broad Array of Services and Supports in a System of Care • -Dawn Project in Marion County, Indiana • Evidence-Based and Effective Practices • Examples of Evidence Based Practices for Families and Children Involved in Child Welfare • Examples of Non-Evidence Based Practices • -Hawaii • -Handout 7.2 – Examples of Potentially Harmful Programs and Effective Alternatives • Challenges to Implementing Evidence-Based Practices • Strategies and Incentives for Implementing Evidence-Based Practices • -District of Columbia • Universal Versus Targeted Services • Culturally Competent, Family/Youth-Driven Service Array • Role of Family-Run Organizations • -Parent Support Network – Rhode Island • Family/Youth Role in Evidence-Based Practice • Development continued

17. Module 7 – Service Array and Financing • Function: Financing • Overview of Financing Streams • Major Child Welfare Funding Streams • Advantages and Disadvantages of Specific Funding Streams • Creating “Win-Win” Financing Scenarios • Thinking of Financing across Systems • Financing Strategies and Structures • Examples of Financing Strategies • -Wraparound Milwaukee • -Central Nebraska Integrated Care Coordination Unit • -El Paso County, Colorado • -North Carolina State System of Care Collaborative • -Cuyahoga County, Ohio • -Maryland • -Miami, Dade County, Florida- The Children’s Trust Fund • -Spokane County, Washington continued

18. Module 7 – Service Array and Financing • Comprehensive Strategy • Diversity of Federal Grant Site Funding • Diversified Funding Sources and Approaches for Family Organizations • Example: Diversified Funding Sources & Approaches at the Parent Support Network of Rhode Island • Medicaid Strategies • -New Mexico and Arizona – Managed Care Waivers • -NewJersey, Minnesota, Kansas, New York, Vermont,Indiana, Wisconsin, Arkansas, Florida, Georgia, Maryland, Mississippi, Montana, South Carolina, and Virginia – HCBS Waivers • -Massachusetts, Los Angeles County, and Pennsylvania - EPSDT Lawsuits • -Vermont and New York - Targeted Case Management • -New Jersey – Administrative Case Management • -Minnesota and Wisconsin – TEFRA Option • -Milwaukee Wraparound • First Steps • Steps in a Strategic Financing Analysis • Tools to Support Families and Staff • -Oregon’s Cost Center and Object Code Matrix • -Handout 7.3 – The “Matrix” from Oregon’s System of Care • -Team Work (Team Meeting # 3)

19. Module 8 – Provider Network, Natural Supports; Purchasing and Contracting • FUNCTION: Provider Network • Provider Network Options • Characteristics of Effective Provider Networks • Examples of Incentives to Providers to Change Practice • Importance of Natural Helpers • Roles for Natural Helpers • -Cuyahoga County (Cleveland) – F2F • -Cedar Rapids, Jacksonville, Louisville andSt. Louis – CPPC Strategies • -Family Finding – Washington State and Santa Clara County, CA • Mecklenburg County, North Carolina • Pinellas County, Florida • -San Antonio, Texas – Community Partnerships in Child Welfare • -East Little Havana, Miami, Florida – Abriendo Puertas Center – EQUIPO • Families and Youth as Providers • Infrastructure to Support Families and Youth as Providers

20. Module 8 – Provider Network, Natural Supports; Purchasing and Contracting • FUNCTION: Purchasing/Contracting • Purchasing/Contracting Structures • -Southern State • Capitation and Case Rates • Example of System Using Capitation and Case Rate • Progression of Risk • Purchasing Quality Care • Examples of Purchasing Strategy Tied to Reform Goals • -Massachusetts- Continuous Quality Improvement • -Connecticut • -Team Work (Team Meeting #4)

21. Module 9 – Care Management, Utilization and Quality Management • Function: Care Management • Service Coordination versus Care Management • -Nebraska – Integrated Care Coordination Units • Care Management Principles • Importance of Structuring Care Management • A Continuum of Service Coordination/Care Management • Types of Care Managers • Pros and Cons of Different Structures • Function: Utilization Management (UM) • Utilization Management (UM) • Principles for Utilization Management • Aligning UM Interests and Responsibilities • -Pennsylvania – Early Warning System

22. Module 9 – Care Management, Utilization and Quality Management • Function: Quality Management (Continuous Quality Improvement) • Quality Management • -Handout 9.1 – Massachusetts Department of Social Services Continuous Quality Improvement Program (Discussion Guide for Learning Forums) and CQI Process Scenario • -Contra Costa County, California • -Missouri – Quality Assurance Practice Development Reviews • Purposes of UM and Evaluation Data • Types of Data Reports and Their Use • Example of Use of Data for Continuous Quality Improvement • -Michigan – Child and Adolescent Functional Assessment Scale • Examples of Outcomes Measures Related to CFSR • -Integrated Care Coordination Unit • -Early Integrated Care Coordination Unit • -Wraparound Milwaukee • -Large Group Discussion

23. Module 10 – Brief Introduction to and Discussion of Other Functions(e.g., Human Resource Development, External and Internal Communication, Training and Technical Assistance) • Other Important SOC Functions • FUNCTION: Human Resource Development • Human Resource Development Overview • Culturally Competent, Family/Youth-Driven HRD Strategies • Staffing Systems of Care • -District of Columbia – student loan repayment • A Cross-System Training Focus • -Clark County, Nevada and St. Mary’s County, Maryland • -North Carolina- System of Care Child and Family Team Curriculum and Training Workgroup • FUNCTION: Communication • External and Internal Communication • -North Carolina – Local Collaborative Communication Committee • Social Marketing, Media and Public Relations • -Kansas Family Centered System of Care • -Oregon’s System of Care Goals and Performance Measures • -Illinois’ Don’t Write Me Off: Foster Kids Are Our Kids • FUNCTION: Protecting Confidentiality • Confidentiality and Rights Protection • FUNCTION: Information Management • Information Management • -Cuyahoga County, Ohio – Synthesis • Technical Assistance and Training • -De-Brief; Instructions for List Serve; Wrap Up

24. Additional Materials • Case Scenarios – Urban, Rural, Suburban • Exercises • Handouts • Trainer’s Addendum • Acronyms • Glossary • Web Links • LISTSERV Instructions • Evaluation • Complete Primer Hands On – Child Welfare Slides

25. Primer Hands On-Child Welfare Available on the Web at: www.nrcoi.org