Bryan Samuels, Commissioner Administration on Children, Youth and Families

1. Strengthening Psychotropic Medication Management: Another Step in Improving Well-Being for Children and Youth in Foster Care Bryan Samuels, CommissionerAdministration on Children, Youth and Families

2. Joining Forces: Federal and National Collaboration • Administration for Children and Families • Centers for Medicare and Medicaid Services • Substance Abuse and Mental Health Services Administration • Agency for Healthcare Research and Quality • Food and Drug Administration • National Institute of Mental Health • American Academy of Child and Adolescent Psychiatrists • American Association of Pediatrics • Centers for Healthcare Strategies • National Association of Mental Health Program Directors • National Association of Medicaid Directors • National Resource Center for Youth Development • PolicyLab at Children’s Hospital of Philadelphia • Rutgers University • Tufts University • Etc. Because Minds Matter

3. HHS Activities to Support States • Interagency Workgroup • Communications: • Tri-agency letter to State Directors • Information Memorandum & Program Instruction • CMS Information Bulletin • Webinars • Online Resources (www.childwelfare.gov) • Alignment of ongoing activities • Cross-system Summit, Because Minds Matter Because Minds Matter

4. Other Opportunities and Resources • CHCS Quality Improvement Collaborative • MEDNET Consortium • AHRQ Systematic Review of Interventions for Children Exposed to Maltreatment and Family Violence • Youth Guide for Talking about Psychotropic Medications • APA/DOJ Training on Evidence-Based Practices for Child Welfare • T-MAY (Treatment of Maladaptive Aggression in Youth) Guidelines • Etc. Because Minds Matter

5. Goals of the Summit: Collaborating for Change Because Minds Matter

6. Context: Caregiver Risk Factors for Children Known to Child Welfare Because Minds Matter

7. Children with Substantiated and Unsubstantiated Reports of Maltreatment Are at Similar Risk for Poor Outcomes Because Minds Matter

8. Risk of Social-Emotional Problems and Use of Psychotropic Medications among Children Known to Child Welfare, by Age Group Because Minds Matter

9. Risk of Social-Emotional Problems and Use of Psychotropic Medications among Children Known to Child Welfare, by Placement Type Because Minds Matter

10. Most Common Mental Health Diagnoses among Children in Foster Care Receiving Psychotropic Medications Because Minds Matter

11. Psychotropic Medication and Behavioral Health Service Use Use of specialty mental health services separately and in combination with psychotropic medications among children meeting clinical criteria for mental health need Because Minds Matter

12. Promoting Well-Being in the Context of Maltreatment Adapted from Impact Youth Services, 2011; http://impactyouthservices.com/goals.htm ACYF-CB-IM-12-04: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2012/im1204.pdf Because Minds Matter

13. ACYF-CB-IM-12-04: Promoting Social and Emotional Well-Being for Children and Youth Receiving Child Welfare Services • Focus on child & family level outcomes • Progress monitor for reduced symptoms and improved child/youth functioning • Proactive approach to social and emotional needs • Developmentally specific approach • Promotion of healthy relationships • Build capacity to deliver EBPs http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2012/im1204.pdf Because Minds Matter

14. “…although children who have been maltreated face immense challenges, they are incredibly resilient. We also know that even among children who do develop social-emotional, behavioral, and mental health problems, healing and recovery are possible. With the right tools and capacity, child welfare systems can identify the complex needs of children who have experienced maltreatment and deliver targeted, evidence-based services that help young people overcome the social and emotional impact of abuse and neglect. By addressing these needs, we increase the likelihood that children in foster care will exit to positive, permanent settings, with the skills and resources they need to be successful in life.” Testimony of Bryan Samuels, Commissioner, Administration on Children, Youth and Families, to the U.S. Senate Committee on Homeland Security and Governmental Affairs, Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security, December 1, 2011. Because Minds Matter

15. Strengthening Management of Psychotropic Medications Because Minds Matter

16. Emerging Opportunity: NCINQ • The National Collaborative for Innovation in Quality Measurement (NCINQ) is one of 7 AHRQ/CMS Centers of Excellence in Pediatric Quality Measures Program. • NCINQ is developing performance measures in a variety of areas, including care for children in child welfare. Data sources may include administrative data, health insurance claims, medical records, and surveys. • NCINQ is actively seeking State input into these measures. States are invited to participate in focus groups to inform their development. • States are also invited to implement the measures using their data systems to test their feasibility, with support from NCINQ. Fall 2012 into 2013. Because Minds Matter

17. Moving Forward Together • Ongoing Enhancement of APSRs • Upcoming GAO Report • Engagement of Stakeholders • Facilitation of Communication for Future Directions Because Minds Matter