Clermont FAST TRAC, a System of Care initiative of the Clermont County Mental Health & Recovery Board, is funded by a grant from the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
Ohio Family and Children First (OFCF) is a partnership of government agencies and community organizations committed to improving the well-being of children and their families. As a mutli-agency umbrella, OFCF focuses on bringing individuals, agencies and organizations together to better serve children and families.
OFCF was created by state law in 1993, to help families seeking services for their children.
Each board of county commissioners was to establish a county Family and Children First council.
Clermont County Family and Children First has established the following:
ARTICLE I – NAME
The name of this organization shall be Clermont County Family and Children First Council, hereinafter known as the “Council”.
ARTICLE II – MISSION
The mission of the Council is to promote and facilitate communication and collaboration among ClermontCounty child and family serving agencies to ensure that ClermontCounty infants, children, adolescents and their families receive the most appropriate services to enable youth to develop adequate skills in preparation for a successful adulthood.
ARTICLE III – VALUE STATEMENT
The Council espouses the values of Ohio’s commitments to child well-being, which are:
ARTICLE IV – PURPOSE
The Council is established pursuant to the Ohio Revised Code, Section 121.37, and shall be the entity responsible for the planning and coordination of services to multi need children and families in ClermontCounty and other duties described in Section 121.37 of the Ohio Revised Code.
ARTICLE V – FUNCTIONS OF COUNCIL
The Council shall have the following functions pursuant to the Ohio Revised Code, Section 121.37 (B)(2):
A. Referrals to the cabinet council of those children for whom the county council cannot provide adequate services.
B. The development and implementation of a process that annually evaluates and prioritizes services, fills service gaps where possible, and invents news approaches to achieve better results for families and children.
C. Participation in the development of a countywide, comprehensive, coordinated, multi-disciplinary, interagency system for infants and toddlers with developmental disabilities or delays and their families, as established pursuant to federal grants received and administered by the department of health for early intervention services under the “Individuals with Disabilities Education Act of 2004”.
D. Maintenance of an accountability system to monitor the county council’s progress in achieving results for families and children.
E. Establishment of a mechanism to ensure ongoing input from a broad representation of families who are receiving services within the county system.
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The Council shall have the additional functions of:
A. The planning and provision of services for multi-need children and their families.
B. The furtherance of interagency collaboration to increase effectiveness, accessibility, and reduce fragmentation in service delivery.
C. The establishment of a coordinated delivery of services.
D. The receipt and administration of grants as needed to carry out the Council’s functions.
E. The review and approval of Council policies and procedures.
F. The performance of duties described in the Ohio Revised Code, Section 121.37.
G. To assure Help Me Grow compliance with the Ohio Department of Health Bureau of Early Intervention Services policies, including procedural safeguards.
H. To approve the annual FCF budget.
I. To conduct and engage in any other lawful business or activities.
ARTICLE VI – FUNCTIONS OF THE ADMINISTRATIVE AGENT
The administrative agent shall have the following functions:
To hire, supervise and evaluate FCF staff with the input of the Council
To enter into agreements or administer contracts with entities to fulfill specific Council business
To provide financial stipends, reimbursements, or both, to family representatives for expenses related to Council activity
To submit an annual budget to the Council for approval
To approve spending in accordance with the approved budget
To have the power to carry out Council duties ARTICLE VII – MEMBERSHIP
A. Mandated Council Membership
Pursuant to Ohio Revised Code, Section 121.37(B)(1), the Council must include the following individuals:
At least three (3) individuals whose families are or have received services from an agency represented on the Council or another county’s Council. Where possible, the number of members representing families shall be equal to twenty (20) percent of the Council’s membership;
The Executive Director of the ClermontCounty Mental Health and Recovery Board.
The Health Commissioner, or the Commissioner’s designee, of the Clermont County General Health District.
The Director of Clermont County Department of Job and Family Services;
The Director of Clermont County Children’s Protective Services;
The Superintendent of the Clermont County Board of Developmental Disabilities;
The superintendent of the city, exempted village, or local school district with the largest number of pupils residing in the county, as determined by the Department of Education, which shall notify each Board of County Commissioners of its determination at least biennially;
A school superintendent representing all other school districts with territory in the county, as designated at a biennial meeting of the superintendents of those districts;
A representative of the municipal corporation with the largest population in the county;
The President of the Board of County Commissioners, or an individual designated by the Board;
A representative of the regional office of the Department of Youth Services;
A representative of ClermontCounty’s Head Start agency, as defined in the Ohio Revised Code, Section 3301.31;
A representative of the county’s early intervention collaborative established pursuant to the federal early intervention program operated under the “Individuals with Disabilities Education Act of 2004”;
A representative of a local nonprofit entity that funds, advocates, or provides services to children and families. Pursuant to Ohio Revised Code, Section 121.37(B)(5)(a), the Administrative Agent of the Council shall send notice of a member’s absence if a member listed in division (B)(1) of this section has been absent from either three (3) consecutive meetings of the Council or a Council subcommittee, or from one-quarter of such meetings in a calendar year, whichever is less. The notice shall be sent to the board of county commissioners that establishes the county council and, for the members listed in divisions (B)(1)(b), (c), (e), and (l) of this section, to the governing board overseeing the respective entity; for the member listed in division (B)(1)(f) of this section, to the board of mental retardation and developmental disabilities that employs the superintendent; for a member listed in division (B)(1)(g) or (h) of this section, to the school board that employs the superintendent; for the member listed in division (B)(1)(i) of this section, to the mayor of the municipal corporation; for the member listed in division (B)(1)(k) of this section, to the director of youth services; and for the member listed in division (B)(1)(n), to that member’s board of trustees.
B. New Membership
Any local public or private agency or group that funds, advocates, or provides services to infants, children, adolescents and families may request to have a representative become a member of the Council. The process for requesting new membership is as follows:
The agency representative shall submit in writing his/her interest in serving on the Council and his/her commitment to the Mission of the Council to the Council Chairperson/s.
Upon receipt of the agency’s letter of intent, the Council Chairperson/s shall place the matter on the next month’s agenda of the Council.
The agency representative shall be present at any Council meeting concerned with acceptance or denial of an agency’s request and be given an opportunity to state his/her intent to join the Council and answer any and all questions posed by the Council.
After the agency’s statement and Council questions, a vote shall be taken of all members as to the acceptance or denial of the agency’s participation on the Council.
In order to be accepted, the motion must receive two thirds (2/3) of Council members’ votes. C. Designating a Representative
Any non-mandated member or a mandated member as allowed per the Ohio Revised Code may designate a representative to attend meetings in the event that a member cannot attend.
The said designee shall be deemed to be empowered to commit the resources of the agency they are representing.
A member shall provide the designee with a proxy to give to the Chairperson/s of the Council indicating that the person is representing the member or a member may ask that the FCF Program Manager keep a standing proxy on file for when the member must be absent from meetings.
The Council Chairperson/s, if a non-mandated member or a mandated member as allowed per the Ohio Revised Code, may designate a representative to attend a meeting in their absence. The said designee shall be empowered to vote for the Chairperson/s, but the said designee shall not chair the meeting. D. Membership Terms
All Council members are on-going members of the Council unless the member requests to no longer serve on the Council. If the request is made to no longer serve on the Council, their designee, as allowed per the Ohio Revised Code, must replace that member.
E. Member Voting
Each Council member shall cast one vote.
Council members shall abstain from voting on any matter that is a potential conflict of interest for the agency they represent.
The Chairperson/s shall not vote, except in the event of a tie vote. When a tie vote occurs, the Chairperson/s shall cast one vote. ARTICLE VIII – OFFICERS
Officers of the Council shall be a Chairperson and a Vice-Chairperson; or Co-Chairpersons.
The Chairperson/s shall appoint a Nominating Committee at the regular meeting of the Council in November to present nominations for officers to be elected at the December meeting. All officers shall be elected by the Council from among the nominated members. Election shall be by majority vote.
Each officer shall serve a one (1) year term and may be elected to continuing terms as determined by a majority vote.
The term of office for all officers shall begin on January 1 of each calendar year.
Vacancies in any office may be filled by the Council at any regular meeting, or at a special meeting called for that purpose. C. Powers and Duties
The officers of the Council shall have such powers and duties as generally pertain to their respective offices, and such further powers and duties as from time to time may be conferred by the Council, including but not limited to the following:
Chairperson/s – Preside at all meetings of the Council; establish committees and subcommittees as required to carry out Council activities; serve as a ex-officio member of all Council Committees; represent and act on behalf of the Council as authorized by the Council; and exercise such other duties as may appertain to the office.
Vice Chairperson – Exercise the authority and fulfill the duties of the Chairperson in the absence of that officer; and exercise such other duties as may be assigned by the Chairperson. ARTICLE IX – MEETINGS
A. The Council is constituted under the Ohio Revised Code, Section 121.22, and therefore operates as a public body.
B. All meetings of the Council shall be open to the public, except that the Chairperson/s may elect to go into executive session, as provided by the Ohio Revised Code, Section 121.22 (G:1-6).
C. The Council shall not be bound in any way by any statement or action on the part of any individual member or employee, except when such statement or action is in pursuance of specific instructions or authorities granted by action of the Council.
D. Thirty-three percent (33%) of the mandated and non-mandated members, or their designees as allowed per the Ohio Revised Code, of the Council constitutes a quorum and must be present in order for a vote to be taken.
E. A Council member may appoint a designated representative if and when the member cannot attend a particular meeting, as allowed per the Ohio Revised Code.
F. A majority vote of this quorum is required to approve a motion or take action. No more than one-half (50%) of the votes may be from one (1) agency.
G. The Council shall meet not less than ten (10) times per year. Regular meetings shall be held monthly, unless otherwise ordered by the Chairperson.
H. Special meetings may be called by the Chairperson/s or upon written request of at least three (3) members. The purpose of the meeting shall be stated and, except in case of emergency, at least three (3) days’ notice shall be given.
I. The regular meeting in December shall be known as the annual meeting and shall be for the purpose of electing officers, receiving reports of officers and committees, and other business that may arise.
J. Agendas will be sent to the Council members before regular meetings.
ARTICLE X – COMMITTEES
All Committees are empowered by the Council and will make regular reports to the Council. Committees include:
A. Executive Committee
Executive Committee members shall be nominated and elected at the December Council meeting.
Executive Committee members shall serve a one (1) year term starting January 1, with no limit on the number of terms that may be served.
The Executive Committee shall meet only when the Council Chairperson or Co-Chairperson calls a meeting.
A majority of the Executive Committee must be present, either in person, by telephone or by e-mail (when appropriate) for a decision to be made.
If an Executive Committee member is not available to participate in the Executive Committee meeting, that member is not allowed to have another representative participate in his/her absence.
The Council gives the Executive Committee the power to make decisions in the best interest of the Council when a time-sensitive situation arises between Council meetings that needs resolution prior to the next scheduled Council meeting. B. Dispute Resolution Committee
The Dispute Resolution Committee shall function as the complaint or concern team of the Council.
Children (when age appropriate), parents, agencies, Council members and FCF staff shall have access to the Dispute Resolution Committee per the Dispute Resolution policy.
The Dispute Resolution Committee shall be chaired by the Family and Children First Program Manager and shall consist of 4 additional Council members as appointed by the Chairperson.
The Program Manager shall be a permanent member of the committee, while the additional Council members shall serve a one (1) year term.
If a complaint or concern is regarding the FCF Program Manager or an agency sitting on the committee, a substitute member will be asked to sit on the committee in that person’s place.
The Dispute Resolution Committee will meet as necessary to resolve disputes.
The Dispute Resolution Committee will meet at least annually to review all disputes/concerns to determine trends and/or service areas for improvement.
All FCF agencies shall have their own complaint/concern policy or procedure. The FCF Dispute Resolution Committee will be used secondary to that agency’s policy or procedure and in regard to FCF functions and decisions.
C. Early Childhood Coordinating Committee
The Council shall have an Early Childhood Coordinating Committee (ECCC) to assist the Council in the design, coordination and implementation of a comprehensive, coordinated, interdisciplinary, family-centered system of services for families with a child 0-6 who is or may be at risk for multi-need/multi-system services.
The Committee may include: – A representative from the Clermont County General Health District; – A representative from Clermont County Department of Job and Family Services who is able to represent Medicaid;
– A representative from Clermont County Children’s Protective Services who is able to represent foster care;
– A representative from the Clermont County Board of Development Disabilities;
– A representative from the Clermont County Mental Health and Recovery Board;
– One (1) or more representatives from Local School Districts;
– Parent representatives with knowledge and experience of multi-system services in Clermont County;
– FCF Program Manager;
– Representative from the FCF Administrative Agent;
– At least one (1) representative from Clermont County Head Start or Early Head Start;
– Help Me Grow Contract Manager;
– At least one (1) representative for coordinating educational services to homeless children;
– At least one (1) representative from a child care agency or child care resource and referral;
– Additional members at large.
The Committee may reorganize annually, select Chairperson/s, set meeting times, determine goals and agendas, and develop work groups as determined by the overall group. The Committee shall provide monthly reports to Council, and conduct business with the ongoing input and support of Council.
D. Ad Hoc Committees
The Chairperson/s shall appoint other committees deemed necessary to carry out the functions of the Council. Examples of Ad Hoc Committees are: Priority Committees, Finance Committee, and Policy and Procedure Committee.
ARTICLE XI – PARLIAMENTARY AUTHORITY
Council meetings shall be conducted in accordance with the latest edition of Robert’s Rules of Order.
ARTICLE XII – AMENDMENT OF BYLAWS
These Bylaws may be amended at any regular meeting of the Council by a two-thirds (2/3) vote of members, provided that the amendment has been submitted in writing at the previous Council meeting.
Service Coordination (also called Wraparound): The primary function of Wraparound is to develop a collaborative plan of action for multi-need infants, children and adolescents upon referral. A child may be considered a multi-need child if he/she exhibits needs that could be served by more than one FCF involved agency (CCBDD, Juvenile Court, Help Me Grow, mental health or substance abuse services, among others). The Service Coordination Plan details the process of Service Coordination and Wraparound.
Karen Scherra, Executive Director Director, ADAMHS Board
Clermont County Mental Health & Recovery Board
2337 Clermont Center Drive
Batavia , OH 45103
Judy Eschmann, Director DJFS Clermont County Dept. of Job and Family Services
2400 Clermont Center Drive
Batavia , OH 45103
Tim Dick, Deputy Director Children’s Protective Services Clermont County Dept of Job and Family Services 2400 Clermont Center Drive
Batavia , OH 45103
Dan Ottke, Superintendent Superintendent of Bd of DD Clermont County Board of Dev. Disabilities
P. O. Box 156
Batavia , OH 45103
Julianne Nesbit, Public Health Commissioner Deputy Health Commissioner Clermont County Public Health
2275 Bauer Road Batavia , OH 45103
Matt Mitchell, Program Director Non Profit Agency Pressley Ridge
7162 Reading Road, Suite 900
Cincinnati , OH 45237
Berta Velilla, Director Head Start Child Focus, Inc.
555 Cincinnati-Batavia Pike Cincinnati , OH 45244
Jeff Weir, Superintendent Superintendent County Educational Service Center
2400 Clermont Center Drive
Batavia , OH 45103
Dr. Keith Kline Superintendent Superintendent, Largest School District West Clermont Local School District 4350 Aicholtz Road, Suite 220
Cincinnati , OH 45245
Stephen Rabolt, County Administrator Board of County Commissioners Board of Clermont County Commissioners Office
101 E. Main Street
Batavia , OH 45103
Jean Houston Families Connected, Inc. P.O. Box 8
Owensville , OH 45160
Mary Jo O’Brien Parent Starr* Edwards Parent Naomi Garretson Parent Kimberleigh Szaz, Director, Early Childhood Early Intervention The Thomas Wildey Center
P.O. Box 8
Owensville , OH 45160
Jeff Wright, City Manager City Manager, Largest City City of Milford 745 Center Street, Suite 200
Milford , OH 45150
Matt Earley, Superintendent Superintendent, Other School District Williamsburg Local School District
549 Main Street Williamsburg , OH 45176 Gary Bryant, Director Juvenile Court Clermont County Juvenile Court
2339 Clermont Center Drive
Batavia , OH 45103
Brenda Cox Families Connected, Inc. P.O. Box 8
Owensville , OH 45160
Laura Nazzarine, Director of Special Education School West Clermont Local Schools 4350 Aicholtz Road, Suite 220
Cincinnati , OH 45245
Steve Goldsberry, VP of Addiction Services Alcohol and Drug Treatment Agency Clermont Recovery Center, a division of Greater Cincinnati Behavioral Health
1088 Wasserman Way, Suite B Batavia , OH 45103
Margaret Jenkins, Extension Educator OSU Extension OSU Extension
P.O. Box 670
Owensville , OH 45160
Kristin Shrimplin, YWCA YWCA of Greater Cincinnati 898 Walnut Street
Cincinnati , OH 45202
Lori Watkins, Program Coordinator Help Me Grow The Thomas Wildey Center
P.O. Box 8
Owensville , OH 45160
Charles Youth Masija-Jmes Porterfield, Senior Juvenile Probation Officer Department of Youth Services Department of Youth Services
800 Broadway Street, 3rd Floor
Cincinnati, OH 45202
Gretchen Behimer, AM, MSS, LISW-S
Can my child and family receive services through Clermont County Family & Children First?
To be eligible for Wraparound:
Wraparound youth and families may have access to an array of services including parent peer support, respite, in-home supports, as well as the wide spectrum of services already available through existing service providers.
The wraparound process is a tool for building constructive relationships and support networks among youth with emotional/behavioral challenges, their families, teachers and other caregivers. This process, which is based on a family-centered, strength-based philosophy of care, is used to guide service planning for children with or at-risk of emotional and behavioral disabilities and their families. In wraparound, a team works to identify the underlying needs, interests, and limitations of families and service providers, and to develop a plan that addresses these interests using natural, community supports whenever possible (Eber, Nelson and Miles, 1997; Burchard 2000).
A comprehensive Wraparound referral form is available by clicking here: Wraparound Referral 10-09 FAST TRAC. Referrals are accepted from families, schools, agencies and providers. Referrals can be securely made through the Family & Children First (FCF) website, http://www.clermontfcf.org/ or faxed to 513-732-7491.
What is wraparound?
The wraparound process is a tool for building constructive relationships and support networks among youth with emotional/behavioral challenges, their families, teachers and other caregivers. This process, which is based on a family-centered, strength-based philosophy of care, is used to guide service planning for children with or at-risk of emotional and behavioral disabilities and their families. In wraparound, a team works to identify the underlying needs, interests, and limitations of families and service providers, and to develop a plan that address these interests using natural, community supports whenever possible (Eber, Nelson and Miles, 1997; Burchard 2000).
Can my youth and family receive support through the wraparound program? The most basic eligibility criteria for wraparound are that the youth and/or legal guardian must be a resident of Clermont County, the youth must be 0-21 years old, and the youth must have a mental health diagnosis or an emerging mental health diagnosis. The Clermont County wraparound program serves youth who are involved with more than one system or agency or eligible to be served by more than one system or agency.
Youth and families involved in wraparound may have access to an array of services, including parent peer support, respite, in-home support and intensive in-home therapy, as well as the wide spectrum of services already available through existing service providers.
Peer Support Partners (PSP) provide support to families involved with Wraparound. Each PSP currently parents, or recently parented, a child with mental health and/or behavioral challenges and is/was involved in multiple systems. Peer Support Partners are caregivers who have been through the systems with their child and have reached the level that they want to help support other families in the Wraparound process. Peer Support Partners work as a team member to coach, support and connect families not only to services/resources, but also assist them to engage within their community and within the Wraparound system. They have an understanding and common life experience that no other team member brings to the table. Their primary roles:
PSP services are offered to each family entering Wraparound. Families may decline PSP services and still participate in Wraparound. Families may request PSP services at any stage of the process and one will be assigned to them.
To be eligible for respite, a child and family must be involved in Wraparound. The Wraparound team must agree that respite is a support that would benefit the child and/or family. Respite is offered two Saturdays per month from 9:00 AM to 3:00 PM at the Thomas A. Wildey Center, 2040 US Hwy 50, Batavia, OH. Spaces are limited! Once respite is written into your Wraparound plan, your child/family will be referred to Clermont County Board of Developmental Disabilities Gift of Time Respite, a Parent Cooperative with a volunteer component. For more information on respite services, please contact your Wraparound Facilitator.
Help Me Grow (HMG) Early Intervention Services aim to identify and serve children under the age of three with developmental delays and disabilities as provided for under the federal Individuals with Disabilities Education Act (IDEA). Funded by the Ohio Department of Developmental Disabilities and the Clermont County Board of Developmental Disabilities, Clermont County Help Me Grow communicates with parents, doctors, hospitals, child care providers and other community agencies to identify children with potential developmental delays or specific diagnoses.
Parents and caregivers with concerns regarding their child’s development can have their infant or toddler evaluated by an interdisciplinary team at absolutely no cost to the family. Children are evaluated for delays in the areas of adaptive, cognitive, communication, physical, and social-emotional development. Once your child is determined eligible for services, an Early Intervention Team will support you and your family through the process. The team includes a Service Coordinator, Physical Therapist, Occupational Therapist, Speech Therapist, Developmental Specialist and if needed a specialist in hearing and vision. One member of the team will be assigned as your Primary Service Provider (PSP) and will visit you and your child regularly at home or other community settings. At each visit, your PSP will help to address your questions and work toward the goals you have identified in your Individualized Family Service Plan (IFSP). Together you will find ways to support your child during everyday activities.
Help Me Grow (HMG) Home Visiting is available for first time expectant mothers, as well as first time parents of a child up to the age of 6 months. Once your child is determined eligible for services, Help Me Grow Home Visiting can work with a family up to the that child’s 3rd birthday. Funded by the Ohio Department of Health, Every Child Succeeds provides Home Visiting services through Beech Acres in Clermont County.
The Help Me Grow Home Visiting program strives to: increase healthy pregnancies; improve parenting confidence and competence; increase family connectedness to community and social supports; and improve child health, development, and readiness. Home Visitors provide expectant or new parents with the information, support and encouragement they need through a voluntary, high-quality home visiting service.
Family Driven Care-What Does That Mean?
The vision that families can drive their plans for services or supports is a new concept to many families, as well as providers of services. The 2003 President’s New Freedom Commission on Mental Health report, “Achieving the Promise: Transforming Mental Health in America,” mandates that families must be the center of the system of care and must drive the services provided. Therefore, services/supports have evolved within systems to achieve the goal to make services family-driven.
The following article shares how systems are working toward family-driven care:
The “Need for a Definition of Family Driven Care,” (Gary M. Blau, Trina W. Osher and David M. Osher; March 2005) gives background regarding how Systems of Care are working toward the goal set by the Freedom Commission.
A good deal is known about effective mental health intervention, the importance of family and youth engagement, and the importance of cultural competence. However, this knowledge is not yet reflected in how mental health and related services are delivered to most children, youth, and their families. This gap between what we know and what we do contributes to children, youth and families dropping out of treatment, cost-ineffective interventions, and treatment failure.
The problem extends well beyond the mental health system. In traditional mental health treatment, it is reflected in poor outcomes realized by child welfare, education, juvenile justice, and substance abuse interventions. It is also reflected in the limited success of selective and indicated prevention interventions in the mental health area.
In 2003, the President’s New Freedom Commission on Mental Health addressed this problem (as well as the related problems for adult consumers) in “Achieving the Promise: Transforming Mental Health Care in America.” Goal 2 of the report calls for “consumer and family driven care.” The report cites research showing that hope and self-determination play a key role in recovery. The report insisted that families “must stand at the center of the system of care.” The report also said that the needs of children, youth, and families must “drive the care and services that are provided.” The report did not say what family driven care should look like, although it did make five recommendations:
Develop an individualized plan of care for every adult with a serious mental illness and child with a serious emotional disturbance.
Involve consumers and families fully in orienting the mental health system toward recovery.
Align relevant Federal programs to improve access and accountability for mental health services.
Create a Comprehensive State Mental Health Plan.
Protect and enhance the rights of people with mental illnesses.
Why Promote Family-Driven Care?
Families, youth consumers, and family oriented practitioners echo the findings and recommendations of the Commission. They know that outcomes are better when families have a key voice in decision-making.
Families know what works for them. Therefore, it makes sense that they drive service delivery decisions. Their experience is holistic. In other words, they do not have a mental health part, a child welfare part, a juvenile justice part, and so forth. Families focus on the concrete challenges that they face all day and every day. Families also know their strengths and their limitations. Families know the difficulties they face. Families can see change in how they or their children are doing on a daily basis. They know how a program, agency, or system works (or doesn’t work) for them. Most importantly, without family comfort and buy-in, children and youth won’t participate in services. Also, family voice is listened to by politicians and public officials. Families’ passion and persistence are necessary to transform mental health services. Families and youth can help the systems realize the coordination and collaboration that is important to improving mental health outcomes.
Collaboration is difficult to achieve. Systems have mandates that create silos, staff work in environments that afford little time to collaborate, and professionals participate in communities of practice that make it hard to partner across disciplines. Families and youth, who experience their needs holistically and feel a powerful need for coordination and collaboration, can play a key role in pushing professionals to do the heavy lifting that will result in effective collaboration.
Providing family-driven care requires a major change in how people think and act. There must be administrative support to change behaviors and relationships. Developing, promoting, and supporting a commonly accepted definition of family-driven care is a necessary step in helping people change how they think and act.
Steps in the Process
At the spring 2004 meeting, the Council for Collaboration and Coordination (the CCC) asked the Federation of Families for Children’s Mental Health to help develop a clear definition of the term “family-driven.” Gary Blau, Trina and David Osher, the authors of, “The Need for family Driven Care”, took on this task. The process for developing the definition involved a sequence of activities, which always included asking for feedback. Feedback after each activity was incorporated into a new draft of the definition that was then used for the next activity.
The first steps were:
Forming an expert panel; and Interviewing recognized leaders in the family movement. These two activities provided information that was used to develop the first draft definition. This draft was used to stimulate feedback in open forum discussions at a national meeting in June 2004. More input, gathered during the summer and fall of 2004 from staff of the Child, Adolescent and Family Branch (at SAMHSA) and a variety of audiences around the country resulted in a series of eight drafts. Then, the Family Workgroup of the CCC held a conference call to discuss the definition and provided a number of specific suggestions. After these suggestions were incorporated, the draft was sent out to the original expert panel members. Their feedback and comments led to further refinements.
By February 2005, a working definition of Family-driven Care, along with principles and characteristics, was developed. From February to October 2005, the definition was circulated widely and more feedback was collected. There was a webinar (seminar on the internet), and the draft definition was posted on several internet sites. A PowerPoint presentation was made available. The authors presented the draft definition at dozens of conferences. A wide variety of people discussed the definition in seminars and workshops throughout the country. Reaction was very positive during this time. There was wide acceptance for the definition among leaders in all the systems that serve children with mental health needs, including professionals from education, child welfare, mental health, juvenile justice, and health. Families liked the definition very much, but asked to add something about how the definition applies to funding services. A few additions were made in November 2005, and the definition has since been widely used.
Family-driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes:
Choosing supports, services, and providers; Setting goals; Designing and implementing programs; Monitoring outcomes; Partnering in funding decisions; and Determining the effectiveness of all efforts to promote the mental health and well-being of children and youth. Guiding Principles of Family-Driven Care
Families and youth are given accurate, understandable, and complete information necessary to set goals and to make choices for improved planning for individual children and their families.
Families and youth, providers and administrators embrace the concept of sharing decision-making and responsibility for outcomes.
Families and youth are organized to collectively use their knowledge and skills as a force for systems transformation.
Families and family-run organizations engage in peer support activities to reduce isolation, gather and disseminate accurate information, and strengthen the family voice.
Families and family-run organizations provide direction for decisions that impact funding for services, treatments, and supports.
Providers take the initiative to change practice from provider-driven to family driven.
Administrators allocate staff, training, support and resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and families.
Community attitude change efforts focus on removing barriers and discrimination created by stigma.
Communities embrace, value, and celebrate the diverse cultures of their children, youth, and families.
Everyone who connects with children, youth, and families continually advances their own cultural and linguistic responsiveness as the population served changes.
Family and youth experiences, their visions and goals, their perceptions of strengths and needs, and their guidance about what will make them comfortable steer decision making about all aspects of service and system design, operation, and evaluation. Characteristics of Family-Driven Care
Family-run organizations receive resources and funds to support and sustain the infrastructure that is essential to insure an independent family voice in their communities, states, tribes, territories, and the nation.
Meetings and service provision happen in culturally and linguistically competent environments where family and youth voices are heard and valued, everyone is respected and trusted, and it is safe for everyone to speak honestly. Administrators and staff actively demonstrate their partnerships with all families and youth by sharing power, resources, authority, responsibility, and control with them. Families and youth have access to useful, usable, and understandable information and data, as well as sound professional expertise so they have good information to make decisions. Funding mechanisms allow families and youth to have choices. All children, youth, and families have a biological, adoptive, foster, or surrogate family voice advocating on their behalf. Putting Families behind the Wheel
The term “family-driven care” can be thought of as a road trip. Picture a comfortable car or minivan filled with good traveling companions. The main passenger is a child who has a mental health need. The driver is the child’s family. The rest of the passengers have been invited along because they know a lot about child development, education, health, family support, psychology, literacy, housing, employment, and other things families need to have a good quality of life. The family knows where they want to go, but need help choosing a good route and getting there safely. The traveling companions share what they know and discuss all the options together with the driver. Then the family takes the wheel and drives the car along the chosen route. The driver gets help along way, if it is needed. At the end of the trip, everyone celebrates their success together.
This image of a journey was presented to the New Freedom Commission by the Federation of Families for Children’s Mental Health. The image has been used to help families and professionals understand how to apply the definition of family-driven care in their everyday lives in the real world. Some practical strategies for taking the wheel have been developed to get folks started on their own journey.
The guiding Principles of Family Driven Care was updated in 2008 to reflect 10 principles.
UPDATED VERSION OF FAMILY-DRIVEN CARE (2008)
Family-driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes:
Choosing culturally and linguistically competent supports, services, and providers; Setting goals; Designing, implementing and evaluating programs; Monitoring outcomes; and Partnering in funding decisions. Guiding Principles Families and youth, providers and administrators embrace the concept of sharing decision-making and responsibility for outcomes. Families and youth are given accurate, understandable, and complete information necessary to set goals and to make informed decisions and choices about the right services and supports for individual children and their families. All children, youth, and families have a biological, adoptive, foster, or surrogate family voice advocating on their behalf and may appoint them as substitute decision makers at any time. Families and family-run organizations engage in peer support activities to reduce isolation, gather and disseminate accurate information, and strengthen the family voice. Families and family-run organizations provide direction for decisions that impact funding for services, treatments, and supports and advocate for families and youth to have choices. Providers take the initiative to change policy and practice from provider-driven to family-driven. Administrators allocate staff, training, support and resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and families and where family and youth run organizations are funded and sustained. Community attitude change efforts focus on removing barriers and discrimination created by stigma. Communities and private agencies embrace, value, and celebrate the diverse cultures of their children, youth, and families and work to eliminate mental health disparities. Everyone who connects with children, youth, and families continually advances their own cultural and linguistic responsiveness as the population served changes so that the needs of the diverse populations are appropriately addressed. 1Source: National Federation of Families for Children’s Mental Health www.ffcmh.org SAMHSA Child, Adolescent and Family Branch Center
Families are involved in all areas of our System of Care. Below are ways families are involved:
What is youth driven care? It wasn’t long ago that youth and their parents were more often viewed as an obstacle in the way of their OWN treatment. Naturally, there was resistance which grounded any attempt towards progress. It wasn’t until professionals began involving youth, with their valuable insight, that things began to get better. Our goal is for youth to be brought to the table and be a part of the team in a meaningful way for their invaluable lived knowledge.
Youth driven care means that youth play an active role in their treatment and care. That means that youth should be able to participate in groups and meetings that involve them. They should have the opportunity to share how they feel, what they think is best and what works and what doesn’t work. When youth help guide their care, they are more likely to have success and to have things get better.
Youth empower youth. It’s important that youth are connected and united with other youth so they can share and advocate for one another. It’s also important that they can come into a professional environment prepared. There are opportunities for youth to develop their skills and connect with other youth. Once a month we have a training or a social event that is open to youth of all backgrounds. All these events are planned by youth and relevant to what these youth feel are important.
Cultural competence requires that organizations to have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally; the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve; and incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically consumers, key stakeholders and communities.
In 2010, the Ohio Department of Mental Health & the Multiethnic Advocates for Cultural Competence (MACC) adopted the statewide definition of Cultural Competence as “a continuous learning process that builds knowledge, awareness, skills and capacity to identify, understand and respect the unique beliefs, values, customs, languages, abilities and traditions of all Ohioans in order to develop policies to promote effective programs and services.”
SAMHSA, the Substance Abuse & Mental Health Services Agency, supports the following definitions:
Cultural Competence is the understanding and appreciating the differences in individuals, families, and communities, which can include: thoughts, speech, actions, customary beliefs social forms and material traits of a racial, religious or social group. It also affects age, national origin, gender, sexual orientation or physical disability.
Linguistic Competence is the capacity of an organization and its personnel to communicate effectively and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities. This may include the use of bilingual staff, interpretation services and assistive technology.
You may also hear the term Cultural Broker. A Cultural Broker is an individual who is able to navigate the culture by being either a part of the group or having the capacity to speak the language of the group. A Cultural Broker is accepted by the group as being “one of us”.
In Clermont County, we are working to promote Cultural & Linguistic Competence through Cultural Conversations. The purpose of Cultural Conversations is to provide information and activities that enhance cultural discovery, educate people on how to be more culturally sensitive to others in the community and at work and to support the appropriate services that honor the ethnic, racial, and linguistic background of individuals accessing the FAST TRAC system of care. Activities are open to persons living or working in Clermont County and to the families of FAST TRAC system of care and are provided FREE of charge. Cultural Conversations activities include:
Book Club – you can receive a copy of the book selection and participate in the discussion.
Friday e-mail blasts provide a short bit of cultural information. To be added to the list, please contact firstname.lastname@example.org
Ouch! That Stereotype Hurts training is a diversity training module provided FREE in a 1 hour or 2 hour format.
Lunch and Learn trainings
The Clermont County Mental Health and Recovery Board has partnered with the University of Cincinnati’s School of Social Work to conduct evaluation research on all programs within the FAST TRAC System of Care. The project will determine the extent to which local FAST TRAC programs including Wraparound, Peer Support Partners, Transition to Independence, School-based Mental Health Prevention Services, and Cultural and Linguistic Competency training initiatives are effective in achieving their desired outcomes. It will also attempt to identify how and why certain aspects of these programs contribute to the continued success of the families served by FAST TRAC. Lastly, the project will collect and analyze data, as well as disseminate findings from a longitudinal outcomes study with a subsample of 225 families served by FAST TRAC.
The evaluation research team is led by Michael McCarthy, Ph.D., Assistant Professor in the School of Social Work at the University of Cincinnati. Rachel Smith, MHSc., functions as the primary Data Manager and analyst for the local FAST TRAC programs. Jeff Schellinger, LPCC, coordinates the activities of the FAST TRAC longitudinal outcomes study. Jonathan Sutter, MSW, manages the collection and analysis of data specific to FAST TRAC’s Wraparound program, with a particular focus on the implementation of new technologies for improving efficiency. Daniel Hargraves, MSW, is responsible for project marketing including the drafting of professional- and lay-versions of quarterly Evaluation Briefs. The entire team works closely with youth, parents, families, treatment professionals, FAST TRAC personnel, and interagency collaborators in the design and implementation of the evaluation research plan.
The research team has offices on campus at the University of Cincinnati and travel frequently throughout Clermont County for data collection and meetings with study collaborators. The team provides leadership and works side-by-side with partners in designing, collecting data, and disseminating results.