Final Report - RI Department of Children, Youth & Families

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APPENDIX M: CURRENT REALITY COMMITTEE REPORT F. Various State departments operate programs aimed at helping children with mental health and substance abuse problems. For example, MHRH provides an adolescent substance abuse program, and DHS administers CEDARR, EPSDT, and Rite Care. G. The State lacks sufficient mental health and substance abuse treatment providers who can deliver direct services to bilingual clients, while also focusing on incorporating an awareness of cultural issues and differences into individual treatment plans. H. The State lacks a sufficient supply and continuum of mental health treatment options for children and their families post-adoption. I. The State has a significant shortage of child psychiatrists. In addition, most do not practice forensic child psychiatry. The majority require fee-for-service, vastly diminishing their accessibility to most families. J. Pursuant to a contract with DCYF, beginning in January, 2001, Placement Solutions started to review out-of-state and purchase-of-service placements for the purpose of providing recommendations and oversight for the transition of children from out-of-state care to in-state care solely from a clinical perspective. Focus to date has been on establishing standards for “level of care” criteria, with attention to time frames and specific services necessary for a successful family-centered transition. II. Solutions A. The mental health and substance abuse treatment system can be better coordinated throughout the State. Computer technology should be used to organize, streamline and process data, and to manage an information system that is current and easily accessed. A program of public education should be developed and implemented to help fill gaps in knowledge and information among professionals and others regarding the needs of and services for emotionally disturbed children and substance-abusing youth. This educational program should also include information about funding and payment options and procedures, as well as, the impact of the mental health parity law. B. Individual communities and schools must truly own their children. This must be committed to both the early identification of family-related problems and the timely provision of specifically tailored community-based services to prevent disruption of the family and the physical and psychological exit of children from the community and school. C. CIS and less intensive programs, outreach and tracking, and other outpatient mental health and substance abuse treatment options should be available to all children who need this service. D. Cultural sensitivity and the communication needs of non-English-speaking families should be addressed within the context of continuing education training System of Care Task Force Report (January 2003) 160
APPENDIX M: CURRENT REALITY COMMITTEE REPORT programs and workshops for public and private employees servicing diverse populations within the State. In addition, special circumstances, including siblingrelated issues within the system of care, sexual orientation of children or their parents, kinship care, adoption, AIDS, should be appropriately addressed within the context of initial and continuing training, and staff supervision. Toward that end, the Child Welfare Institute should ensure a diverse staff capable of assisting DCYF and community-based providers to address cross-cultural views of family roles, discipline, and other parenting issues. (Recommendations in The Governor’s Commission to Study Children in Foster Care and Adoption Report concerning cultural sensitivity should continue to be implemented.) E. Crisis intervention services must be available on demand. Out-patient psychiatric, individual counseling services and diagnostic assessment must be readily available, accessible and affordable to meet the needs of individuals and families. Waiting lists must be eliminated. I. Current Reality CASSP and Wrap-around Services A. CASSP is a family-centered service system to assist families at risk. It adopts a holistic approach toward treating the family, one that stresses the importance of accurate assessment of symptoms to identify the most effective path toward problem resolution. As a family-centered model, it is designed to create one comprehensive resource system and to fill in gaps that a more fragmented service plan might expose. A vital component of CASSP is the importance placed on wrap-around services. Wrap-around refers to a service approach that focuses on identifying what children and families need, building on their strengths and creating treatment plans that are individualized, comprehensive and flexible. Wrap-around requires that service providers, especially those responsible for case management, recognize that one problem within the family and among family members is usually affected by others; thus services in their totality must address multiple issues. Effective wrap-around services are based in the community closest to the child's home, and incorporate open and frequent communication among service providers (as well as with clients) so that they work in concert with one another. Roles are clearly defined and tasks are well-coordinated. Progress toward achieving goals is closely monitored and necessary changes in the plan are made to reflect the ongoing evaluation of each family member's progress. Rhode Island's CASSP system is effective; however, implementation of the wrap-around model is hindered by a lack of sufficient resources and financial commitment. DCYF has recently hired two coordinators to implement a family-centered system of care model that will hopefully expand and facilitate the type of planning currently done by CASSP. II. Solution A. The CASSP system of care should be a model for expansion within the State. More than lip service must be paid to the notion that an effective system of care is family-focused. The State must devote sufficient resources to wrap-around System of Care Task Force Report (January 2003) 161
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TOWARD AN ORGANIZED SYSTEM OF CARE
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TABLE OF CONTENTS TRANSMITTAL LETTE
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TRANSMITTAL LETTER Hon. Donald L. C
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TRANSMITTAL LETTER With strong stat
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PREFACE The Rhode Island System of
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EXECUTIVE SUMMARY This plan for an
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EXECUTIVE SUMMARY stakeholders have
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CHAPTER 1: OVERVIEW The Rhode Islan
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CHAPTER 1: OVERVIEW SYSTEM STRATEGY
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CHAPTER 1: OVERVIEW the four Region
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CHAPTER 2: COMMUNITY-STATE PREVENTI
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CHAPTER 3: STRENGTHENING DCYF AS A
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CHAPTER 3: STRENGTHENING DCYF C. Re
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CHAPTER 3: STRENGTHENING DCYF 5. $
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CHAPTER 3: STRENGTHENING DCYF (Marc
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CHAPTER 4: FINANCING THE SYSTEM OF
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CHAPTER 5: WORKFORCE DEVELOPMENT Wo
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CHAPTER 5: WORKFORCE DEVELOPMENT Ch
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CHAPTER 5: WORKFORCE DEVELOPMENT ex
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CHAPTER 6: PERFORMANCE MEASURES AND
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CHAPTER 6: PERFORMANCE MEASURES AND
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CHAPTER 7: IMPLEMENTATION CHAPTER 7
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CHAPTER 7: IMPLEMENTATION i. Legisl
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CHAPTER 7: IMPLEMENTATION programmi
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APPENDICES 61
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APPENDIX A: RHODE ISLAND SYSTEM OF
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APPENDIX A: SYSTEM OF CARE TASK FOR
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APPENDIX B: PRINCIPLES OF FAMILY CE
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APPENDIX C: DEFINITIONS, CORE VALUE
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APPENDIX C: CULTURAL COMPETENCY cri
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APPENDIX D: VALUES AND PRINCIPLES F
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APPENDIX E: SERVICE AND PROGRAM COM
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APPENDIX F: DCYF FAMILY SERVICE REG
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APPENDIX G: COMPREHENSIVE CARE NETW
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APPENDIX G: COMPREHENSIVE CARE NETW
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APPENDIX H: COMPARISON CHART OF COM
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APPENDIX I: DCYF RECOMMENDATIONS TO
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APPENDIX J: LISTING OF LICENSED AND
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APPENDIX K: PERFORMANCE MEASURES AN
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Final Report - RI Department of Children, Youth & Families

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