FY11 Annual Progress Report Scott County Decategorization

Program

Submitted by: Nicole Mann, LMSW

Decategorization Coordinator

December 1, 2011

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1) Summarize the project’s key activities during the previous fiscal year: Scott County Decategorization Program’s intention for fiscal year 2011 was to stay true to the mission of Decategorization, helping youth and families by enhancing the infrastructure to include strength based services that are preventive, family centered and community-based in order to reduce use of restrictive approaches that rely on institutional, out-of-home, and out-of-community care to meet the diverse needs of the community. During fiscal year 2010 Scott County Decategorization coordinated with Scott County Community Partnerships for Protecting Children (CPPC) and held a community forum on March 5, 2010 to capture the needs of youth and families in Scott County. Information gathered at the community forum revealed a need for coordinated mental health services for youth, expansion and development of mental health services to provide youth specific mental health services in their community, and ongoing program funding (see Attachment A). In response to the community forum the Scott County Decategorization entered into a Memorandum of Understanding with the Iowa Department of Human Services, Child Health Specialty Clinics, Center for Disabilities and Development, and Community Circle of Care in Dubuque, Iowa to provide technical assistance for developing a System of Care in Scott County. Through the technical assistance with Community Circle of Care, Scott County Decategorization is being provided with technical assistance for community stakeholders, providers, and individuals; assistance with developing System of Care values; sharing lessons learned with the community regarding experiences in North East Iowa; hired and supervising staff hired through the grant process and provide necessary tool and supplies to perform their duties (i.e. Community Planner, Family Systems Coordinator, and Youth Coordinator); and provide analysis of children’s mental health delivery service system. The Scott County Children’s Mental Health System of Care Commission was created to provide oversight and was created to research and design accessible, effective and equitable resources to optimize Scott County children’s mental and behavioral health delivery systems. The following Scott County Kids staff assists this committee:

Ryan Bobst – Scott County Kids Community Planner

Dawn Knutson – Scott County Kids Family Systems Coordinator

Megan Heffernen – Scott County Kids Youth Coordinator The following University of Iowa technical assistance staff assists this committee:

Vickie Miene – Community Circle of Care Program Director The following individuals serve on this committee:

Scott Hobart –Chairperson – Seventh Judicial District Chief Juvenile Court Officer

Marcy Mendenhall – Scott County Kids Executive Director

Gary Lippe – Iowa Department of Human Services Eastern Service Area Manager

Dr. Robert Anderson – Genesis Health Group Pediatrician

Kim Riley – Scott County Parent

Scott Crane – United Way of the QCA Executive Director

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Matt Mendenhall – Community Foundation of the Great River Bend Vice President of Programs

Nicole Mann – Scott County Decategorization Coordinator The following general public participates with this committee:

Judy Collins – Scott County Community Member Scott County community members were invited to a Scott County Children’s Mental Health System of Care Community Forum on December 15, 2010 to be a part of the beginning planning stages of Scott County Children’s Mental Health System of Care efforts and learn about the Children’s Mental Health System of Care core values and guiding principles. There were 30 community stakeholders in attendance representing a wide range of local agencies. Community members understand the high cost of serving youth with mental health services and are willing to discuss how to better utilize funding to assist youth with mental health needs (See Attachment B). The Scott County Kids Community Planner completed 10 additional focus groups in Fiscal Year 2011 with local providers, community members, and youth. During each focus group participants had the opportunity to identify community priorities to assist with the development and implementation of a System of Care in Scott County (See Attachment C). Scott County Children’s Mental Health System of Care Commission invited community members and physicians to come hear from Dr. Jane Foy, a professor of pediatrics at Wake Forest University School of Medicine, speak on increasing a community’s capacity to effectively care for children with mental health issues. The meeting was held on Wednesday, April 27, 2011 and had about 60 community members and 30 local medical professionals attend. Scott County Decategorization in collaboration with Area Health Education Center and Vera French Community Mental Health Center hosted a Mental Health 1st Aid training on March 22 and 23, 2011. The Mental Health 1st Aid training had 12 participants who expressed an overall satisfaction with the training and recommend future trainings during fiscal year 2012. Scott County Decategorization continued to be the contractor for the Scott County CPPC and Iowa Youth Dream Team site. During fiscal year 2011 Scott County CPPC hosted a Family Team Meeting training on October 27, 28, and 29 2011 with 28 participants. Through the Iowa Youth Dream Team grant that Scott County CPPC was awarded in 2009, Scott County CPPC was also to have their AmeriCorps member trained, coached, and mentored in the Iowa Youth Dream Team process during fiscal year 2011which will allow for program stability. Scott County CPPC was also able to put together supplies for transitioning youth which includes suitcases, cleaning supplies, hygiene items, household supplies, and etc. Any youth who has an Iowa Youth Dream Team through Scott County CPPC is supplied with items to assist with their transition.

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In order to stay in tune with the needs of the community, Scott County Decategorization staff members continue to participate on numerous community planning committees, community outreach, and training opportunities. The following is a list of the current meetings and trainings attended by Scott County Decategorization staff:

City of Davenport Weed and Seed Youth Committee

Davenport Schools – Davenport Network for Community and School Partnerships

Scott County Children’s Mental Health System of Care Commission

Parent Partner Project Management Team

Scott County Early Childhood Iowa o Contracts Management o Public Awareness

7th Judicial District Summit

Scott County CPPC

Iowa Youth Dream Team (IYDT) Shared Decision-Making Committee

Scott County School Health Initiative

Homeless Youth Coalition

Present monthly at the Scott County Board of Health

Quad City Health Initiative (QCHI) o QCHI Mental Health Task Force and Committee Chair

Scott County Kids Health Committee

Community Foundation of the Great River Bend Funders Forum

Community Foundation of the Great River Bend Co-Investment Committee

Scott County Regional Authority Executive Board

Bettendorf Chamber Early Childhood Committee

National Association of Social Workers Iowa Chapter

Scott County Health Department Accreditation Committee

St. Ambrose Master of Social Work Continuing Education Committee

NASW Disproportionality Diversity Work Group

See Clearly to Learn Vision Committee

Early Childhood Coordinating Council

Statewide DMC

Promise Neighborhoods

Quality Preschool Initiative Demonstration

Parenting Inside Out

Bettendorf Middle School 8th Grade Career Fair

Every Child Counts

Iowa Permanency Summit

United Way CIM Training

Voices for the Silenced: Affirming & Empowering Approaches to Working With GLBT Youth, Racial Minority Youth, & Siblings in the Child Welfare System

18th Annual Legislative Breakfast

4th Annual Mental Health Awareness Conference

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Disentangling Disproportionality: Race, Poverty, and the Overrepresentation of Children of Color in the Child Welfare System

Davenport Schools Welcoming Walkthroughs Scott County Decategorization continues to utilize an email distribution list that has significantly grown over the last year; currently there are approximately 105 individuals on the list including State Legislators. One week prior to a Decategorization Board meeting the Scott County Decategorization Coordinator emails information regarding the meeting, including agendas to everyone on the distribution list. This community email list is a convenient way to distribute Request for Proposals (RFP) notices, program information, meeting agendas, job listings, and upcoming trainings. This strategy has increased the number of public attending our Decategorization meetings. This method was helpful during the release of the Parent Partner RFP to cover Cedar, Des Moines, Henry, Lee, Louisa, Muscatine, and Scott Counties. Scott County Decategorization also continues to use the plan that was developed in fiscal year 2010 for building capacity and achieving outcomes (See Attachment D). Weaving together program requirements with board decision-making assists Decategorization Board members to focus on effective programming and fiscal accountability. 2) Describe the project’s progress in reaching the desired outcomes of their

project plan during the previous state fiscal year: Scott County Decategorization identified the following goals in the fiscal year 2011 annual plan: to act as the catalyst in bringing multiple community stakeholders together to meet the community needs; improve services in the community that will assist in the achievement of the Child and Family Service Review outcomes of child well-being, safety and permanency; to maintain positive leadership role in the community and a reputation for excellence through the continuity of qualified staff and board members; and to continue to be fiscally responsible with state funds. Scott County Decategorization was successful in meeting all goals identified in fiscal year 2011. Scott County Decategorization achieved these goals by maintaining active relationships with community stakeholders, participating in and initiating community planning processes, working closely with the Iowa Department of Human Services and Juvenile Court Services, providing professional development opportunities to assist with staff development, completing all required contractual training as identified by the state of Iowa, promoting the importance of the 28E, and by maintaining a subcontract with Bi-State Regional Commission for the purposes of obtaining necessary financial and personnel services. Scott County Decategorization stayed true to the mission of Decategorization with all contracts. Programs that were funded in fiscal year 2011 had projected outcomes to keep youth out of the child welfare and juvenile justice systems, improving family functioning, improving the educational wellbeing of children, and increasing informal

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family supports. These outcomes were closely monitored by the Decategorization Coordinator and were reported to the Scott County Executive Board. During Decategorization Board meetings the members reviewed the outcomes and gave input on modifications and recommendations to contract holders. 3) Describe any planning adjustments and lessons learned during the fiscal

year: The Scott County Executive Board has always tried to find ways of implementing preventative, stable funding within our service area to better assist youth and families. In previous years this has been difficult due to the administrative rules in Iowa Code Chapter 232.188, Decategorization projects were permitted to carryover unspent funding for one additional year. However, Decategorization sites are not notified of the carryover amount until October or November which has limited the competitive bidding process and the ability to execute a long term contract and effectively begin a new service prior to the end of the fiscal year. DHS contracting specialists outline that an RFP process can take anywhere from six to nine months to complete, which in return makes it challenging for new programs to get started. Contractors have a short amount of time to hire and train staff, become established in the community, and have an effective referral process. Decategorization board members and contractors have been reluctant to take the considerable financial risks to embark on such projects when they do not know if the project can be sustained from year to year due to the unstable carryover funding process. Nevertheless, Scott County Decategorization staff remained committed to educating local legislators about the funding regulations. Local legislators were invited to Decategorization board meetings and community events. During fiscal year 2011 legislative changes were made in House File 649 allowing Scott County Decategorization to carry forward funds for two succeeding years, which will allow the board to make more impactful decisions to meet community needs. 4) Decat Funded Programs Project 1) Parent Partner, DCAT3-11-094, Child Abuse Council Description: The purpose of this contract is to provide coordination, implementation, and oversight of the Parent Partner Program for Cedar, Des Moines, Henry, Lee, Louisa, Muscatine, and Scott Counties. The Parent Partner Program is designed to provide better outcomes around re-abuse and reunification. The goal of the Parent Partner Program is to help parents who are currently involved with the Iowa Department of Human Services (DHS) be successful in completing their case plan goals. This is achieved by matching a Parent Partner with parents who are currently in the DHS system and have a child removed. Parent Partners are mentors who have had previous involvement with DHS and have been successfully reunified with their children for at least a year.

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Key Activities: The Performance Measures for this service are:

Develop Policies and Procedures for Parent Partner Program by April 1, 2011

Develop Methodology for Evaluating Parent Partner

Implementation of Parent Partner Program in Cedar, Muscatine and Scott Counties within the fourth quarter of fiscal year 2011 and in Des Moines, Henry, Lee, and Louisa Counties within the third quarter of fiscal year 2012

Parent Partner Coordinator will work with the Iowa Department of Human Services to locate and hire potential Parent Partners by May 1, 2011

Begin planning activities for Des Moines, Henry, Lee, and Louisa Counties. Progress in reaching desired outcomes:

All timelines were met. Planning adjustments and lessons learned: This contract has been renewed for another year. Expenditures: FY11 Contract Amount: $26,049.00 FY11 Total Expended: $20,836.29 Project 2) Functional Family Therapy Training, DCAT8-08-288, Families, Inc. Description: The purpose of this contract is to have Families Inc. complete Phase III certification for Functional Family therapy as a component of working with youth in the Juvenile Justice System. Key Activities: The Performance Measures for this service are:

95% of staff members assigned to this project will receive the training listed in the Scope of Services section of this contract.

95% of staff members assigned to this project will indicate satisfaction with the training received.

95% of staff members will have gained a working knowledge of the core constructs, phases, assessment and intervention techniques of the Functional Family Therapy model as indicated through post tests.

95% of staff members assigned to this project will have the applicable knowledge to utilize the Clinical Services System in the workplace as indicated through post tests.

Progress in reaching desired outcomes:

100% of staff members assigned to this project received the required training.

100% of staff indicated satisfaction with the training received.

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100% of staff gained a working knowledge of the core constructs, phases, assessment and intervention techniques of the Functional Family Therapy model as indicated through post tests.

100% of staff has gained applicable knowledge to utilize the Clinical Services System.

Planning adjustments and lessons learned: Families Inc successfully completed all phases of the Functional Family Therapy model. As there was no longer a need to provide training this contract ended June 30, 2011. Expenditures: FY11 Contract Amount: $17,000.00 FY11 Total Expended: $12,828.00

Project 3) Probation Violator’s Weekend Program, DCAT3-11-164, Family Resources, Inc. Description: The purpose of this contract is to provide an alternative setting to detention for youth involved in the Juvenile Court System who have violated their probation agreement. The purpose of the Probation Violator's Weekend Program is to help deter youth from committing future violations of their probation agreement. Key Activities: The Performance Measures for this service are:

80% of youth enrolled in the Probation Violator's Weekend Program will complete the program

60% of youth completing a Probation Violator's Weekend Program will not re-offend for the duration of this contract period

100% of the time Juvenile Court will be notified within one hour when the referred juvenile offender(s) does not sign in for the Probation Violator's Weekend Program or a youth leaves the program prior to the established exit time.

Progress in reaching desired outcomes:

100% of youth enrolled in the Probation Violator's Weekend Program completed the program

100% of youth completing a Probation Violator's Weekend Program did not re-offend for the duration of this contract period

100% of the time Juvenile Court was notified within one hour when the referred juvenile offender(s) does not sign in for the Probation Violator's Weekend Program or a youth leaves the program prior to the established exit time.

Planning adjustments and lessons learned: This program is not typically covered by Decategorization funding, however, through the exception to Decategorization policy Director Charles Palmer agreed to funding the program due to one of the program goals being to reduce the use of restrictive

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approaches that rely on institutional, out-of-home, and out-of-community care and would decrease admissions to the Scott County Juvenile Detention Center for probation violations, which would in turn allow the youth to stay in their home and avoid long term institutionalization. This contract was only for one contract term and ended June 30, 2011. Expenditures: FY11 Contract Amount: $27,000.00 FY11 Total Expended: $17,239.95 Project 4) In Home Brief Intensive Services, DCAT8-10-169A, Lutheran Services in Iowa Description: The purpose of this contract is to provide in-home family-centered brief intensive services to children (age six to seventeen) in Scott County who are not currently involved with but are at-risk of becoming involved in the juvenile justice system and/or child welfare system. Key Activities: The Performance Measures for this service are:

90% of children and families will have no involvement in the child welfare system

90% of children and families will have no involvement in the juvenile court system

75% of families will show improvement in functioning

75% of families will have at least one informal support added by the close of a case

60% of school age children will improve school performance (i.e., behavior, truancy, and/or homework completion) for three months after services are completed

Progress in reaching desired outcomes:

98.5% of children and their families had no involvement in the child welfare system

98.25% of children had no new involvement in the juvenile court system

84.25% of families showed improvement in functioning

92.75% of families had at least one informal support added at the close of a case

84.75% of school age children improved school performance (i.e. behavior, truancy, and/or homework completion) for three months after services are completed.

Planning adjustments and lessons learned: This contract has been renewed for another year. Expenditures: FY11 Contract Amount: $335,590.00 FY11 Total Expended: $264,731.96

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Project 5) Family Team Meeting (FTM), FSA3-11-001, Lutheran Services in Iowa Description: Provides Family Team Meeting Facilitation for DHS involved families in Cedar, Clinton, Dubuque, Jackson, Muscatine, and Scott Counties. Key Activities: The Performance Measures for this service are:

95% of all Family Team Meetings will result in DHS case manager and supervisor approved DHS case plan

95% of the Family Team Meetings will have a case plan notes disseminated to the DHS case manager within 5 working days after the meeting date.

80% of the time contact with the referring DHS staff and the family will be completed within 3 working days of the receipt of the referral.

90% of the Initial Family Team Meetings held within 5 working days of the receipt of the referral

90% of Subsequent Family Team Meetings were held no more than 35 and 100 calendar days, respectively, of the receipt of the referral

100% of the time billing and reporting timeframes will be met Progress in reaching desired outcomes:

99.5% of all Family Team Meetings resulted in DHS case manager and supervisor approved DHS case plan

96% of the Family Team Meetings have case plan notes disseminated to the DHS case manager within 5 working days after the meeting date.

99% of the time contact with the referring DHS staff and the family will be completed within 3 working days of the receipt of the referral.

69.5% of the Initial Family Team Meetings held within 5 working days of the receipt of the referral

96% of Subsequent Family Team Meetings were held no more than 35 and 100 calendar days, respectively, of the receipt of the referral

100% of the time billing and reporting timeframes were met

Planning adjustments and lessons learned: This contract is a DHS contract has Scott County Decategorization funding assigned to it. The only performance measure not met this year was the percentage of the Initial Family Team Meetings being held within 5 working days of the receipt of the referral. DHS has worked with LSI to address this performance measure and has chosen to renew the contract. LSI was required to begin tracking the number of meetings per county; during the last two quarter of FY11 they had 295 meetings in Dubuque, 34 in Jackson, 129 in Clinton, 277 in Scott, 212 in Muscatine, and 45 in Cedar. Expenditures: FY11 Contract Amount: $411,258.00 FY11 Total Expended: $411,258.00

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Project 6) School Facilitator, DCAT3-11-153, Mississippi Bend AEA Description: The purpose of this contract is to provide a School Facilitator at Edison Academy. The School Facilitator is a social service specialist with expertise in the educational setting. The School Facilitator is a member of the team that provides services to students and their families in an Alternative School setting. The School Facilitator provides services which include: consultation, networking with community agencies and educational program design. Key Activities: The Performance Measures for this service are:

90% of youth will have no new involvement in the child welfare system six months after services begin

90% of youth will have no new involvement in the juvenile court system six months after services begin

90% of youth had their information captured on the Youth System of Care document

75% of all youth will have a post graduation transition plan

75% of youth will have at least one informal support added by the end of the school year

60% of youth will show improvement in school performance (i.e., behavior, truancy, and/or homework completion) for three months after services are completed

60% of all youth will be on track to graduate as determined by Edison Academy. Progress in reaching desired outcomes:

It is unknown at this time the % of youth who have had no new involvement in the child welfare system six months after services begin

It is unknown at this time the % of youth who have had no new involvement in the juvenile court system six months after services begin

9.8% of youth had their information captured on the Youth System of Care document

73.6% of all youth will have a post graduation transition plan

21% of youth will have at least one informal support added by the end of the school year

It is unknown at this time the % of youth showed improvement in school performance (i.e., behavior, truancy, and/or homework completion) for three months after services are completed

70% of all youth will be on track to graduate as determined by Edison Academy.

Planning adjustments and lessons learned: This contract was only for one year and ended June 30, 2011. Both Mississippi Bend AEA and the Scott County Decat Board expressed an interest in continuing this service. A new contract has been developed to continue services for FY12, but with slightly

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different performance measures as it was determined some of the FY11 performance measures did not coincide with the contractual work required. Expenditures: FY11 Contract Amount: $20,000.00 FY10 Total Expended: $17,289.19 Project 7) Elevate Project, DCAT3-11-165, Quad City Arts Description: Provides supportive art services to the Davenport elevate chapter. Key Activities: The Performance Measures for this service are:

100% of events will be developed, coordinated, and implemented along with the Davenport elevate Chapter Facilitator

100% of reports will be turned into the Scott County Decategorization Coordinator on time

80% of elevate participants will indicate that the project allowed them to share their story through artistic expression

80% of elevate participants will express satisfaction overall with the program. Progress in reaching desired outcomes:

100% of events were developed, coordinated, and implemented along with the Davenport elevate Chapter Facilitator

100% of reports were turned into the Scott County Decategorization Coordinator on time

85% of elevate participants indicated that the project allowed them to share their story through artistic expression

89.2% of elevate participants expressed satisfaction overall with the program.

Planning adjustments and lessons learned: This contract was only for one year and ended June 30, 2011. Expenditures: FY11 Contract Amount: $4,999.00 FY11 Total Expended: $3,993.32 Project 8) Scott County CPPC, DCFS-08-040, Scott County Decategorization Description: This contract provides leadership and coordination of activities to implement the Community Partnership for the Protection of Children initiative in Scott County. As of FY 2010, this contract also provides leadership and coordination of activities to implement the Transitioning Youth Initiative / Iowa Youth Dream Teams in Scott County.

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Key Activities: The Performance Measures for this service are:

CPPC o All four strategies will be implemented during the contract period

Shared decision making board will meet at least quarterly with 80% of attendance of all members

Family Team Meetings will be increased by 15% from the previous year

At least, one neighborhood networking activity will be undertaken in the contracting period

At least one activity aimed at changing practice or policy will be undertaken in the contract period

Transitioning Youth Initiative / Iowa Youth Dream Teams o A shared decision making board will be established to meet on a monthly

basis with 80% attendance of all members. o The Iowa Dream Team Coordinator along with the help of the shared

decision making board will plan a community outreach event. o The Iowa Dream Team Coordinator along with the help of the shared

decision making board will host a training session for Iowa Dream Team Facilitators

Progress in reaching desired outcomes:

CPPC o Shared decision making board met in August, November, January, March,

May, and June with an average of 48.5% members in attendance o There were 277 DHS FTM during the third and fourth quarters and SCK

hosted a Family Team Meeting training on October 27th, 28th, and 29th o Six neighborhood networking activities were undertaken in the contracting

period. o Three activities were aimed at changing practice or policies were

undertaken in the contract period.

Transitioning Youth Initiative / Iowa Youth Dream Teams o The Iowa Dream Team Coordinator established a Shared-Decision

Making (SDM) Team for the Transitioning Youth Initiative, which met in October, December, January, February, March, April, May, and June with an average of 76% of its members in attendance

o The Iowa Dream Team Coordinator along with the help of the SDM Team planned a community outreach event which occurred on June 11, 2011

o The Iowa Dream Team Coordinator along with the help of the SDM Team started planning for a training session for Iowa Youth Dream Team Facilitators to occur in August 2011.

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Planning adjustments and lessons learned: The Shared decision making board has doubled in membership and increased member attendance, Scott County Kids has brought on a new coordinator to assist with increasing attendance to 80%. Scott County Kids has developed a system for tracking community based family team meetings during FY11 and it will be implemented during FY12. This contract was increased to provide Disproportionality training throughout the service area, the training was found to be insufficient and the Decategorization board chose not to go through with the training during FY11. Expenditures: FY11 Contract Amount: $69,000.00 FY11 Total Expended: $17,487.60 Project 9) Decategorization Coordination, DCAT-07-028, Scott County Kids Description: Provide Decategorization Coordination and Support Services for the Scott County Decategorization Project. Key Activities: The Performance Measures for this service are:

100% of board meetings conducted by Decategorization staff shall be conducted by the State of Iowa open meeting laws.

100% of contracts will be implemented according to DHS contracting guidelines as they are published at the time the contract is written.

95% of bills will be submitted to Bi-State Regional Commission within 5 business days upon receipt by Scott County Decategorization unless there is an error on the bill that the Decategorization Coordinator is resolving prior to submission to Bi-State Regional Commission.

Progress in reaching desired outcomes:

100% of board meetings conducted by Decategorization staff were conducted by the State of Iowa open meeting laws.

100% of contracts were implemented according to DHS contracting guidelines as they are published at the time the contract is written.

100% of bills were submitted to Bi-State Regional Commission within 5 business days upon receipt by Scott County Decategorization unless there was an error on the bill that the Decategorization Coordinator is resolving prior to submission to Bi-State Regional Commission.

Planning adjustments and lessons learned: This contract has been renewed for another year. Expenditures: FY11 Contract Amount: $151,230.00 FY11 Total Expended: $131,292.56

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Project 10) Victim Restitution, DCAT3-11-008, 7th Judicial District Description: The Judicial Branch will act as the employer of record and perform the payroll functions for the juveniles enrolled in the Seventh Judicial District Juvenile Court Services Victim Restitution Program. Key Activities: The State Court Administrator will perform all payroll functions within the time required by law and submit monthly payment vouchers and supporting documents. The Judicial Branch acted as the employer of record and performed the payroll functions for the juveniles enrolled in the Seventh Judicial District Juvenile Court Services Victim Restitution Program. Progress in reaching desired outcomes: N/A Planning adjustments and lessons learned: There were no adjustments made to this contract. Expenditures: FY11 Contract Amount: $27,000.00 FY11 Total Expended: $20,539.98 Project 11) Scott County Children’s Mental Health System of Care Commission Description: Scott County Decategorization entered into a Memorandum of Understanding with the Iowa Department of Human Services, Child Health Specialty Clinics, Center for Disabilities and Development, and Community Circle of Care in Dubuque, Iowa to provide technical assistance for developing a System of Care in Scott County. Key Activities:

Provide technical assistance for community stakeholders, providers, and individuals

Assist with developing System of Care values

Share lessons learned with the community regarding experiences in North East Iowa

Hire and supervise staff hired through the grant process and provide necessary tool and supplies to perform their duties (i.e. Technical Assistance Coordinator, Parent Coordinator, and Youth Coordinator)

Provide analysis of children’s mental health delivery service system

Progress in reaching desired outcomes:

Providing technical assistance for community stakeholders, providers, and individuals

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Assisting with developing System of Care values

Sharing lessons learned with the community regarding experiences in North East Iowa

Hired and supervises staff hired through the grant process and provide necessary tool and supplies to perform their duties (i.e. Community Planner, Family Systems Coordinator, and Youth Coordinator)

Provides analysis of children’s mental health delivery service system Planning adjustments and lessons learned: None to report at this time. Expenditures: FY11 Contract Amount: $620,000.00 FY11 Total Expended: $620,000.00

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Attachment A:

FY 2010-Making or Breaking Community Agencies

Factors of Agency’s capacity to effectively provide service to clientele

Data recorded and analyzed by:

Scott County Kids

On March 5, 2010, 40 community stakeholders (38 adults and two children) attended a

community forum facilitated by Scott County Kids to review community planning priorities for

children and youth in Scott County, Iowa. The attendees were representatives from a variety

Scott County health and human agencies, community programs/agencies, non-profit agencies

and state organizations. The group discussed how the current social and economic climate has

highlighted local agencies’ abilities to ‘do more with less’. Human service providers have

reported significant increases in demands for their services. At the same time, agencies receiving

state of Iowa funding experienced the reductions in FY 09 and FY 10 unprecedented 10% mid-

year across the board budget reductions and reduction in Medicaid reimbursements for mental

health services and health care.

These significant and sustained decreases in funding continue to erode community agency

capacity and resilience. Agency leaders are faced with increasingly difficult decisions to balance

agency survival with fulfilling their missions to serve vulnerable populations, which are

increasing in numbers. The discussion participants articulated a new level of seriousness about

these reductions. The question becomes, “How resilient are our agencies at this point?” If

resiliency is the ability to spring back from and successfully adapt to adversity, we need to

carefully consider the resiliency of our essential safety net organizations.

These reductions create a significant ripple effect in the community. For example, as funding to

Department of Human Services and Juvenile Court from the State of Iowa decreases,

community based agencies experience new demands and dimensions of need. More

specifically, agencies providing community-based programming face not only an increase of

people seeking services, but also much more complex needs that were previously addressed by

state funded agencies. This new population of clientele forces agencies to internally struggle

with competing priorities between adhering to their agency’s core mission and contemplating

mission drift by serving - or for the first time - not serving clients.

The figure on the next page demonstrates the multiple and accumulating factors that impact

agencies capacity and resilience as described by to our community agencies.

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1. Increased number of people who are experiencing: food insecurity, exhausted funds to pay

bills, lack of reliable transportation, substance abuse challenges, and increased wait times for

subsidized child care and housing. Increase number of people who are: uninsured or

underinsured and cannot pay for health and mental health treatments, teen and adults

displaced and/or homeless, children who are diagnosed with a form of Autism and/or have a

mental health diagnosis.

2. Increased cost: gasoline for transporting clients, health insurance for staff, building costs, and

office supplies. With over extended staff, the time to train new staff has decreased

productivity and increased staff cost.

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Another discussion topic for the group was the shortage of mental health care for children and

youth in our region. The group suggests there are opportunities for improved coordination and

communication but there is also a work force issue.

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When the strained agency meets a complicated mental health service delivery system there are

unintended consequences of marginalizing both community members seeking services and

agency staff. As agencies adapt and continue to adjust to the instability and reduction of funds, it

promotes the mentality to ‘do more with less’ resources, staff and ability to access services.

Increase usage of

higher level care

and more

expensive services

for children and

families

Increased

risk for

vulnerable

children and

youth

OU

TC

OM

E

Battling root

causes

related to

poverty…

Parents wanting their

child’s behaviors

‘fixed’

Decreased

options for

out of home

placements

Increased service

need for

adolescences

Increased

child abuse

rates

Less

protective

workers for

children and

youth

Inconsistent

funding

FACTORS

‘Free’ programming is not free

to the agency

Ethical and moral

practice modalities

Overwhelmed

agencies

Programs set up to meet

funding criteria but not for

sustainability

Disenfranchised and

disorganized people

Language,

cultural, and

immigration

differences

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Participants’ Recorded Solutions:

Establish consistent and stable funding sources

o Scott County Kids-Decategorization will work with legislators and

DHS to address internal spending barriers

Decategorization amendment to expand timeline for spending

allocation from one year to two years

o As a community seek to diversify and leverage funds by collaborating

on similar projects, applying for comprehensive grant or philanthropic

funds, and sharing funding opportunities between agencies

Local legislators need to be aware of the continuum of community needs

o Strategize and begin planning late summer for upcoming legislative

session

As a community, we need to continue raising awareness for mental

health services and impacts on children/families

o Throughout the community, continue open and honest communication

about mental health services and the complications when services are

unavailable

Maximize utilization of existing mental health services for target

population

o Invest in and promote use of United Way 211 system

Promote community programs that engage families, effectively treat

target population and their specific challenges, and collaborate with

agencies

o Continue to have community forums for agency dialogs

o Scott County Kids will create an email distribution list and share

agency updates and community information

Encourage children, youth and families to have fun by connecting them

with programming/services from: Parks and Recreation, Library, free

or reduced cost summer programs

o Share community opportunities with families that strengthen their

relationships and experiences

22

ATTACHMENT B:

23

ATTACHMENT C: Scott County Children’s Mental Health System of Care Initiative

Focus Group Preliminary Feedback: 8/22/11

Focus Groups Since 6/1/11:

19 Focus Groups

210 Participants

113 People who want to do more than a

focus group

Community Identified Priorities:

Family Navigators;

Universal Release of Information;

Professional Development/Education for

Families, Providers and the Community

The Common Themes:

Quotes:

- “We need someone to give resources and make them more accessible for us; someone to help

us figure out what to do and where to go.” –Parent, Family Resources DV Shelter Focus

Group, 6/20/11

- “We need a resource or support for parents with children with mental health needs. Someone

who’s been through it and knows what it’s like.” – Staff, Bethany Focus Group, 6/7/11

- “It’s hard for me to know if my two year old has ADHD, or is he just being a two year old. I

think we need access to more education about mental health in general.” – Parent, Family

Resources DV Shelter Focus Group, 6/20/11

- “It would have been great to be served in my community, rather than being locked-up at a

residential facility 120 miles away.” – Youth, AMP (Elevate) Focus Group, 6/23/11

**Contact Ryan for detailed data and feedback from focus groups**

ryan.bobst@scottcountyiowa.com 563-326-8221 x 8593

Website: http://www.scottcountykids.org/system_care.php

Public Charter Comments: http://scottcountykids.wordpress.com/system-of-care-project-charter/

Scott County’s Current Strengths Scott County’s Current Weaknesses

Variety of services compared to other

communities; Quality services;

Passionate people; People are open to

ideas and diversity

Lack of prevention/early intervention

services; Services aren’t always the

most appropriate; Lack of

communication; Few culturally

sensitive services; There is no “go to”

person to help families and providers

navigate the system

Opportunities Threats

Family Navigators; Community wide

MOU for universal shared release of

information; Professional development

for families, providers and community

members; Collaboration to achieve

shared goals; Enhance the utilization of

existing mental health resources

through increased knowledge and

awareness

Community worries about current lack

of sustainable/stable plan and network

for mental health services in general;

Apathy; Competitive nature of service

providers; Not engaging the entire

community in the change process

24

Attachment D:

DECATEGORIZATION: BUILDING CAPACITY AND ACHIEVING OUTCOMES

CAPACITY

OUTPUT Promotes community

planning, collaboration

and Decategorization

Board Governance

CAPACITY

OUTPUT DECAT

ACTIVITIES

ACHIEVING

Redirect and utilize funding

toward preventative, family,

neighborhood, and community

based services

CAPACITY

OUTPUT Tailoring services to

the individual needs

of children and

families

CAPACITY

OUTPUT

Reduce reliance on

out of home

placement and out of

community

placements

CAPACITY

OUTPUT

OUTCOME

S

Develop a service system that

more accurately reflects the

needs of the children and

families within the community

served.