THE SKILL BUILDING CURRICULUM

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Primer Hands On-Child Welfare
THE SKILL BUILDING CURRICULUM Module 5 Planning,
Governance and System Management
Developed by Sheila A. Pires Human Service
Collaborative Washington, D.C. In partnership
with Katherine J. Lazear Research and Training
Center for Childrens Mental Health University of
South Florida, Tampa, FL Lisa Conlan Federation
of Families for Childrens Mental
Health Washington, D.C.
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Factors Influencing Group Process
Adapted from The Pheiffer Book of Successful
Team-Building Tools, Edited by Elaine Biech.
2001 by John Wiley Sons, Inc.
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Coming together is a beginning. Keeping together
is progress. Working together is success.
H. Ford
Building Systems of Care A Primer. Washington,
D.C. Human Service Collaborative. (2004)
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Planning Structure Issues

• Leadership
• Staffing
• Time and place of meetings
• Stakeholder involvement
• Committees or work groups
• Communication or dissemination of information
• Outreach to broader constituencies
• Outreach to and involvement of diverse and
  disenfranchised constituencies
• Linkage to related reform/planning initiatives
• Resources

Pires, S. (2002). Building systems of care A
primer. Washington, D.C. Human Service
Collaborative.
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Stages of Planning For Systems of Care
STAGE 1 Form workgroup STAGE 2 Articulate
mission STAGE 3 Identify goals and guiding
principles STAGE 4 Develop the population
context STAGE 5 Map resources and assets STAGE
6 Assess system flow STAGE 7 Identify
outcomes and measurement parameters STAGE 8
Define strategies STAGE 9 Create and fine-tune
the framework STAGE 10 Elicit feedback STAGE 11
Use framework to inform, plan evaluation, and
technical assistance STAGE 12 Use framework to
track progress and revise theory of change
Hernandez, M. Hodges, S. (2003). Crafting logic
models for systems of care Ideas into action.
Tampa, FL University of South Florida
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A Planning Process for Family and Childrens
Service Reform
Outcomes For Children and Families
The System As It Is Now
The System As It Should Be
Principles
Reinvestment Commitment Financing Options
Multi Year Steps
Leadership and Professional Development
Strategy Cross Community Cross Agency
Governance Strategy State County Community
Combined Fiscal Program Strategy ---------------
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Friedman, M. (1994). Washington, D.C. Center for
the Study of Social Policy
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Elements of Effective Planning Processes

• Are staffed
• Involve key stakeholders
• Involve families and youth early in the process
  and in ways that are meaningful
• Ensure meaningful representation of racially and
  ethnically diverse families and youth
• Develop and maintain a multi-agency focus
• Build on and incorporate related programmatic
  and planning initiatives
• Continually seek ways to build constituencies,
  interest, and investment
• Pay attention to sustainability and growth of
  system changes from day one

Pires, S. (1991). State child mental health
planning. Washington, DC Georgetown University
Child Development Center, National Technical
Assistance Center of Childrens Mental Health.
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Strategies for Involving Families and Youth in
Planning

• Share information about planning meetings by
  working with family/youth organizations and
  community agencies, such as Big Brothers/Big
  Sisters, Boys and Girls Clubs, Family
  Organizations, Family Preservation services
  agencies, etc.
• Provide orientation/training for families/youth
  about current policies, plans and workgroups
  (i.e., CFSR plan, PIP workgroups).
• Have involved family/youth leaders engage other
  families/youth to be involved.
• Provide on-going mentorship/support (i.e., Family
  Service Workers engage youth/family to become
  involved in planning).
• Hold planning meetings in the evenings/weekends,
  at community centers, schools, and recreation
  centers.
• Conduct focus groups/interviews/surveys to
  solicit views of many families/ youth.
• Pay stipends, transportation, child care provide
  food.
• Conduct facilitated sessions for planning group
  to explore attitudes about race, culture,
  families and youth.
• Publicly acknowledge the contributions of
  individual families and youth.

Adapted from Emig, C., Farrow, F. Allen, M.
(1994). A guide for planning Making strategic
use of the family preservation and support
services program. Washington, D.C. Center for
the Study of Social Policy Childrens Defense
Fund.
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Cultural and Linguistic Competence in Planning

• Conduct on-going assessments of the environment
• Build support for change
• Identify, acknowledge, engage, and partner with
  formal and informal leadership
• Identify and develop needed resources and enhance
  leadership capacity
• Articulate values, establish a mission, and set
  goals
• Plan action steps in partnership with diverse
  families/youth and communities
• Develop strategies to sanction or mandate the
  incorporation of cultural knowledge into policy
  making, infrastructure and practice.
• Adapted from Cross, T., Bazron, B., Dennis, K.,
  Issacs, M. (1989). Towards a Culturally
  Competent System of Care Vol. 1. NCCC

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Cuyahoga County Planning Process Structure
System of Care Oversight Committee Chaired by
Deputy County Administrator for Human
Services Includes a Broad Representative
Stakeholder Group, e.g., major child serving
systems, families and youth, Neighborhood
Collaboratives, providers, researchers
Cultural Linguistic Competence
Social Marketing
Sustainability
Family Youth Involvement
Evaluation Research
Training Coaching
Staffed by System of Care Office
Pires, S. (2006). Primer Hands On Child
Welfare. Washington, D.C. Human Service
Collaborative.
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Definition of Governance
Decision making at a policy level that has
legitimacy, authority, and accountability.
Pires, S. (1995). Definition of governance.
Washington, DC Human Service Collaborative.
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Definition of System Management Day-to-day
operational decision making
Pires, S. (2002). Building systems of care A
primer. Washington, D.C. Human Service
Collaborative.
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Key Issues for Governing Bodies

• Has authority to govern
• Is clear about what it is governing
• Is representative
• Has the capacity to govern
• Has the credibility to govern
• Assumes shared liability across systems for
  target population

Pires, S. (2000). Key issues for governing
bodies. Washington, DC Human Service
Collaborative.
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Examples of Types of Governance Structures

• State and/or local interagency body
• Non profit board of directors
• Quasi governmental entity
• Tribal government
• Hybrids

Pires, S. (2002). Building systems of care A
primer. Washington, D.C. Human Service
Collaborative.
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Evolving Governance Structure
Illustration 1.2A
Policy Level Local Governing Board
Agency Directors Family
Advocacy Organizational Representative
Operational Level
DSS Director
Bring the Children Home SOC Supervisor and Staff
Bring the Children Home Service Managers
Families Served Other Agency Workers
BRING THE CHILDREN HOME STATE LEGISLATION
Illustration 1.2B
COUNTY EXECUTIVE
Agency Directors Family/Youth Reps. DSS Director
Providers Forum
Local Governing Board
SOC Team Leader
Bring the Children Home Interagency Service
Management Team
Families/Youth Served Other Agency Workers
Bring the Children Home Service Managers
Pires, S. ( 2006). Evolving governance structure.
Washington, DC Human Service Collaborative.
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System Management Day-to-Day Operational
Decision Making

• Key Issues
• Is the reporting relationship clear?
• Are expectations clear regarding what is to be
  managed and what outcomes are expected?
• Does the system management structure have the
  capacity to manage?
• Does the system management structure have the
  credibility to manage?

Pires, S. (2002). Building systems of care A
primer. Washington, D.C. Human Service
Collaborative.
17
Examples of Types of System Management Structures

• State and/or local interagency body
• Quasi-governmental entity
• Non profit lead agency
• Public sector lead agency
• For profit commercial managed care entity
• Coalition management

Pires, S. (2002). Building systems of care A
primer. Washington, D.C. Human Service
Collaborative.
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Examples of Management Accountability
Cuyahoga County Management Structure
Sarasota Co. and Milwaukee Co. Management
Structures
Deputy County Administrator for Human Services
Sarasota County Coalition for Families Children
System of Care Office
Milwaukee Co. Division of Child Mental Health
Subsets of Children Families Involved in Child
Welfare
All children involved in child welfare
Children in or at risk for residential placement
Children with serious behavioral health challenges
Subset of cw population Children in/at risk
for RTCs
Youth who are status offenders
0-3 population Early Intervention engagement
challenges
Pires, S. (2006). Primer Hands On Child
Welfare. Washington, D.C. Human Service
Collaborative.
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Examples of Relationships Between Governance and
Management Structures
Cuyahoga County, OH
Sarasota County, FL
Locally-Based, Representative Governance Board
State/District Office
Interagency Governing Body
Contract
Lead Public Agency SOC Office
Coalition Management Entity
Pires, S. (2006). Primer Hands On Child
Welfare. Washington, D.C. Human Service
Collaborative.
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Example of Governance/Management Structure
State Funding Pool
Financer/ Payers
Local Allocation
County Alliance
Purchaser
Case Rate for each enrolled child

• Care Management Entity
• Organize and manage provider network
• Staff and manage child and family team process
• Care management, including case management and
  utilization management/utilization review
• Quality assurance
• Outcomes management /monitoring
• Management Information System (tracks children,
  services, dollars)

Provider
Provider
Provider
Pires, S. (1996). Contracted system management
structure. Washington, DC Human Service
Collaborative.
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Examples of Types of Family/Youth Partnership in
System Governance and Management

• Input/evaluation of key management
• Input/evaluation of quality of services and
  programs
• Local system of care input
• Resource allocation
• Service planning and implementation
• Policies and procedures
• Grievance and resolution procedures

Conlan, L. (2003). Implementing family
involvement. Burlington, VT Vermont Federation
of Families for Childrens Mental Health.
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Culturally Competent Management Structures

• Hire from diverse communities
• Incorporate quality improvement that addresses
  issues important to racial and ethnic communities
  (e.g., disparity and disproportionality)
• Outreach to and engage racially/ethnically
  diverse stakeholders, other minority
  populations
• Conduct cultural self assessments

Pires, S. (2006). Primer Hands On Child
Welfare. Washington, D.C. Human Service
Collaborative.