Day 1. Day 2. CCASSC Agenda Day 1 & 2. CCASSC Action Minutes Dec County Fiscal Letter Hal Budget Report

Transcription

1 Day 1 CCASSC Agenda Day 1 & 2 CCASSC Action Minutes Dec County Fiscal Letter Hal Budget Report Continuum of Care Reform Overview Document Pathways to Well-Being Document Whole Person Care Document Donna DeRoo Power Point Presentation on QI Donna DeRoo PDCA Roadmap Day 2 RFA Link CCTA Report Out Field Advisor Flyer CCTA Report Out Fed Case Review Flyer CCTA Report Out Advanced Analytics Flyer BAA Training System Study (John B. Cullen)

2 CCASSC AGENDA February 18-19, 2016 Sea Venture Hotel 100 Ocean View Avenue Pismo Beach, CA Thursday, February 18, :00 Noon Director s Roundtable Welcome New Members/Introductions 2016 Budget Update Update on State budget & current fiscal issues. Hal Hunter, Deputy Director, Kings County County Roundtable Issues Homeless/Housing Services AB403/CCR Pathways (Katie A.) Shared Training Plan Whole Person Care Noon 1:00 PM Lunch 1:00 1:30 PM Welcome & Introductions (redux) Review 12/15 Action Minutes Additional Agenda Items? 1:30 1:45 PM Update: Poverty White Paper & CSAC Presentation with SJVPH Directors Patty Poulsen 1:45 2:45 PM Presentation: Performance Management & Quality Improvement (PMQI) Donna DeRoo, Assistant Director, Central California Center for Health and Human Services 2:45-3:15 PM Discussion and Potential Partnership: Central Valley Health Policy Institute (CVHPI) Leadership Institute and CCASSC Donna DeRoo, Assistant Director, Central California Center for Health and Human Services San Joaquin Valley Public Health Consortium 3:15 3:30 PM Break 3:30 4:00 PM CCR Implementation Support Needs: Needs Assessment David and Patty 1

3 4:00 4:15 PM Future Meetings 4:15 ADJOURN Friday, February 19, :30 9:00 AM Breakfast Dates/locations reviewed Topics (CYC; additional RFA, CCR and/or CPM presentations?) CCASSC AGENDA February 18-19, 2016 Sea Venture Hotel 100 Ocean View Avenue Pismo Beach, CA :00 9:20 AM CCASSC Research Update Patty Poulsen 9:20 10:00 AM Presentation: Merced County s All Dads and All Moms Matter programs. Scott Pettygrove, Director, Merced County HSA 10:00 10:30 AM University/CalSWEC Reports CalSWEC Fresno State CSU, Stanislaus CSU, Bakersfield 10:30 10:45 AM Break 10:45 11:45 AM Updates RFA CCTA APS Training IHSS Training BAA Training System Study (John Cullen) Noon ADJOURN 2

4 CCASSC Action Minutes December 10-11, 2015 Pismo Beach, CA In attendance: Day 1: S. Pettygrove, D. Foster, J. Rydingsword, H. Hunter, S. Bugay, K. Harwell, M. Sawicki, R. Ringstad, J. Webb, L. Collins, C. Kothari, M. Miller, D. Neira, P. Poulsen, K. Woodard, S. Pearl, C. Utez, D. Murphy. Day 2: V. Rondero Hernandez, J. Webb, L. Collins, C. Kothari, M. Miller, D. Neira, P. Poulsen, K. Woodard, S. Pearl, C. Utez, D. Murphy 1. Confirmation of 2016 Chair-elect and 2016 Vice-Chair (2017 Chair elect): o Delfinio Neira (Fresno County) is the 2016 Chair o Chevon Kothari (Mariposa County) is the 2016 Vice-Chair CCASSC Budget: o Santa Barbara s decision to withdraw from CCASSC beginning the 2016 membership year was discussed. D. foster submitted a draft 2016 budget for consideration with a reduction in operating costs to offset the loss of Santa Barbara s membership dues ($11, reduction). No decision made as to whether budget reduction should be adopted vs. use of the annual surplus. ACTION: Final decision on how to manage loss of S.B. County revenue will be made at the February 2016 meeting. 3. Opportunities to Expand/ Develop CCASSC: o Considerable discussion about the future of CCASSC and how it can learn and grow from successes learned by other consortia (SACHS and BASSC). Most urgent need seems to be development of a Leadership Academy/ Institute, something which both SACHS and BASSC have in place. Other opportunities to learn from BASSC are of interest. ACTION: It was suggested that an invite be extended to Trent Roher (SF County) to join us at a 2016 meeting. His dual roles as BASSC Chair and CWDA President give him great insight into how to sustain and grow University/Agency/Consortium partnerships. ACTION: Jim Rydingsword and David Foster will work on a formal invitation for Trent. ACTION: Jim & David will solicit questions/agenda items prior to Trent s visit to the group. 4. Linkages/Eligibility Engagement Training: o David Foster indicated CCTA has an existing curriculum used with eligibility staff in Madera County as part of Linkages. ACTION: David will locate curriculum and provide outline/learning objectives to CCASSC members.

5 5. April Meeting location: o Chevon Kothari offered Mariposa County to host the April 2016 meeting. ACTION: Stephanie Pearl will work with Mariposa staff on logistics. 6. Core 3.0 Presentation by Joanne Pritchard (CCTA): ACTION: Joanne Pritchard will provide Stephanie Pearl with the latest copy of the Core 3.0 Implementation Guide and Time Frames for her to distribute to the group. ACTION: Joanne will provide Stephanie with 3.0 Team Contacts and 3.0 County Lead contacts for her to distribute. Please add/delete as needed and let Joanne /David know about the changes. 7. APS Training ACTION: Juliet Webb offered to contact the Governor s APS Program Liaison (Lori Delagrammatikas) and invite her to a future CCASSC meeting for discussion about APS issues.

6 February 4, 2016 COUNTY FISCAL LETTER NO. 15/16-45 TO: ALL COUNTY WELFARE DIRECTORS ALL COUNTY WELFARE FISCAL OFFICERS SUBJECT: FISCAL YEAR REVISED PERCENTAGE CALCULATION FOR THE 2011 REALIGNMENT PROGRAMS IMPACTED BY SENATE BILL (SB) 1020 (CHAPTER 40, STATUTES OF 2012) AND SB 1013 (CHAPTER 35, STATUTES OF 2012) AND ADJUSTMENT TO JANUARY AND FEBRUARY 2016 PROTECTIVE SERVICES SUBACCOUNT REFERENCE: GOVERNMENT CODE SECTION GOVERNMENT CODE SECTION CFL NO. 14/15-40, DATED JANUARY 29, 2015 This letter informs counties of the Fiscal Year (FY) revised Protective Services Subaccount percentage distribution pursuant to Government Code section Attachment I displays the FY revised Protective Services Subaccount base percentage distribution. This percentage includes each county s FY Protective Services Subaccount base and the growth distributed by the State Controller s Office (SCO) on December 24, 2015, (refer to website: California State Controller's Office: Fiscal Year ). Attachment II displays the necessary adjustments to the 2011 Realignment revenues required to correct distributions for the months of September 2015 through November These adjustments were reflected in the January 2016 and will be reflected in the February 2016 Local Revenue Fund distribution to counties. Each county s final adjusted distribution percentage has been determined based on a percent to total of the revised base in the amount of $2.1 billion as displayed in Attachments I and II. An additional amount of $32.7 million was set aside for distribution to the San Francisco County Welfare Department, the county designated to receive funding

7 CFL No. 15/16-45 Page Two that will be used to reimburse the state for realigned contracts and services that will continue to be administered by the California Department of Social Services (CDSS) pursuant to Government Code section The CDSS will continue to issue the federal fund advances as previously provided and will remain the single state agency for the administration of federal funding. The Department of Finance (DOF) is required to provide an annual county distribution schedule for the Protective Services Subaccount to the SCO, which is done in coordination with CDSS and County Welfare Directors Association. The DOF provided the revised county distribution schedule for FY , consistent with the overall distribution percentages contained in Attachment I to SCO in December If you have any questions regarding this CFL, please direct them to CDSS2011Realignment@dss.ca.gov. Sincerely, Original Document Signed By: LILIA A. YOUNG, Chief Financial Management and Contracts Branch Attachments

8 2011 REALIGNMENT FY PROTECTIVE SERVICES SUBACCOUNT REVISED BASE ATTACHMENT I FY FY FY FY PROTECTIVE GROWTH PROTECTIVE SERVICES PROTECTIVE SERVICES COUNTIES SERVICES DISTRIBUTED SUBACCOUNT SUBACCOUNT SUBACCOUNT BY SCO ON BASE PERCENTAGE BASE DIST. BY SCO DECEMBER 2015 REVISED REVISED ALAMEDA $79,902, $5,853, $85,756, % ALPINE $796, $68, $864, % AMADOR $1,595, $113, $1,708, % BUTTE $17,139, $1,168, $18,307, % CALAVERAS $2,507, $187, $2,695, % COLUSA $1,512, $108, $1,620, % CONTRA COSTA $44,551, $3,303, $47,855, % DEL NORTE $4,009, $289, $4,299, % EL DORADO $7,318, $542, $7,860, % FRESNO $46,818, $3,242, $50,060, % GLENN $2,865, $222, $3,088, % HUMBOLDT $11,249, $793, $12,043, % IMPERIAL $8,610, $694, $9,304, % INYO $1,467, $116, $1,584, % KERN $56,601, $3,887, $60,489, % KINGS $7,344, $546, $7,890, % LAKE $4,730, $305, $5,035, % LASSEN $3,466, $225, $3,692, % LOS ANGELES $626,615, $44,762, $671,377, % MADERA $6,441, $483, $6,924, % MARIN $6,255, $437, $6,692, % MARIPOSA $1,798, $136, $1,935, % MENDOCINO $10,062, $732, $10,794, % MERCED $14,030, $1,007, $15,038, % MODOC $989, $79, $1,069, % MONO $1,036, $82, $1,119, % MONTEREY $15,960, $1,087, $17,048, % NAPA $5,660, $400, $6,061, % NEVADA $3,342, $227, $3,569, % ORANGE $99,888, $7,245, $107,133, % PLACER $16,527, $1,222, $17,749, % PLUMAS $1,970, $144, $2,114, % RIVERSIDE $107,303, $7,861, $115,164, % SACRAMENTO $100,557, $7,071, $107,629, % SAN BENITO $2,223, $170, $2,394, % SAN BERNARDINO $104,412, $6,981, $111,393, % SAN DIEGO $139,290, $10,314, $149,605, % SAN FRANCISCO $43,151, $2,961, $46,112, % SAN JOAQUIN $38,185, $2,601, $40,787, % SAN LUIS OBISPO $15,592, $1,147, $16,740, % SAN MATEO $19,738, $1,501, $21,239, % SANTA BARBARA $14,901, $1,023, $15,925, % SANTA CLARA $73,832, $5,599, $79,431, % SANTA CRUZ $11,313, $759, $12,073, % SHASTA $13,240, $850, $14,091, % SIERRA $808, $67, $876, % SISKIYOU $3,449, $237, $3,686, % SOLANO $12,748, $912, $13,661, % SONOMA $22,707, $1,518, $24,226, % STANISLAUS $21,470, $1,606, $23,076, % SUTTER $6,210, $431, $6,641, % TEHAMA $5,967, $415, $6,382, % TRINITY $2,222, $181, $2,403, % TULARE $23,225, $1,692, $24,917, % TUOLUMNE $3,381, $229, $3,611, % VENTURA $22,089, $1,530, $23,619, % YOLO $9,719, $608, $10,328, % YUBA $7,184, $520, $7,704, % SAN FRANCISCO-59TH CO $32,721, $0.00 $32,721, % TOTAL $1,970,716, $138,516, $2,109,233, %

9 2011 REALIGNMENT JANUARY AND FEBRUARY 2016 LOCAL REVENUE FUND (LRF) ADJUSTMENTS ATTACHMENT II COUNTIES SEPTEMBER 2015 OCTOBER 2015 NOVEMBER 2015 TOTAL LOCAL LOCAL LOCAL SEPTEMBER REVENUE REVENUE REVENUE THROUGH FUND FUND FUND NOVEMBER RECEIPTS RECEIPTS RECEIPTS LRF RECEIPTS FY PROTECTIVE SERVICES SUBACCOUNT PERCENTAGE SEPTEMBER 2015 OCTOBER 2015 NOVEMBER 2015 LOCAL LOCAL LOCAL REVENUE REVENUE REVENUE FUND FUND FUND REVISED REVISED REVISED JANUARY 2016 LRF ADJUSTMENT FOR SEPTEMBER, OCTOBER & NOVEMBER 2015 PROTECTIVE SERVICES SUBACCOUNT DISTRIBUTIONS FEBRUARY 2016 LRF ADJUSTMENT FOR SEPTEMBER, OCTOBER & NOVEMBER 2015 PROTECTIVE SERVICES SUBACCOUNT DISTRIBUTIONS REVISED A B B - A ALAMEDA $6,737, $6,686, $8,762, $22,186, % $6,756, $6,705, $8,787, $22,248, $62, $0.00 $31, $0.00 $31, ALPINE $67, $66, $87, $221, % $68, $67, $88, $224, $3, $0.00 $1, $0.00 $1, AMADOR $134, $133, $174, $442, % $134, $133, $175, $443, $ $0.00 $ $0.00 $ BUTTE $1,445, $1,434, $1,879, $4,759, % $1,442, $1,431, $1,875, $4,749, ($9,280.75) ($4,640.37) $0.00 ($4,640.38) $0.00 CALAVERAS $211, $209, $274, $696, % $212, $210, $276, $699, $3, $0.00 $1, $0.00 $1, COLUSA $127, $126, $165, $419, % $127, $126, $166, $420, $ $0.00 $ $0.00 $ CONTRA COSTA $3,756, $3,728, $4,885, $12,370, % $3,770, $3,741, $4,903, $12,415, $45, $0.00 $22, $0.00 $22, DEL NORTE $338, $335, $439, $1,113, % $338, $336, $440, $1,115, $2, $0.00 $1, $0.00 $1, EL DORADO $617, $612, $802, $2,032, % $619, $614, $805, $2,039, $7, $0.00 $3, $0.00 $3, FRESNO $3,947, $3,918, $5,134, $13,000, % $3,944, $3,914, $5,129, $12,987, ($12,102.26) ($6,051.13) $0.00 ($6,051.13) $0.00 GLENN $241, $239, $314, $795, % $243, $241, $316, $801, $5, $0.00 $2, $0.00 $2, HUMBOLDT $948, $941, $1,233, $3,123, % $948, $941, $1,234, $3,124, $ $0.00 $ $0.00 $ IMPERIAL $726, $720, $944, $2,390, % $733, $727, $953, $2,413, $23, $0.00 $11, $0.00 $11, INYO $123, $122, $160, $407, % $124, $123, $162, $410, $3, $0.00 $1, $0.00 $1, KERN $4,772, $4,736, $6,207, $15,716, % $4,765, $4,729, $6,198, $15,693, ($23,177.98) ($11,588.99) $0.00 ($11,588.99) $0.00 KINGS $619, $614, $805, $2,039, % $621, $616, $808, $2,047, $7, $0.00 $3, $0.00 $3, LAKE $398, $395, $518, $1,313, % $396, $393, $515, $1,306, ($7,074.34) ($3,537.17) $0.00 ($3,537.17) $0.00 LASSEN $292, $290, $380, $962, % $290, $288, $378, $958, ($4,557.63) ($2,278.82) $0.00 ($2,278.81) $0.00 LOS ANGELES $52,836, $52,439, $68,718, $173,993, % $52,894, $52,496, $68,793, $174,184, $191, $0.00 $95, $0.00 $95, MADERA $543, $539, $706, $1,788, % $545, $541, $709, $1,796, $8, $0.00 $4, $0.00 $4, MARIN $527, $523, $685, $1,736, % $527, $523, $685, $1,736, ($551.99) ($276.00) $0.00 ($275.99) $0.00 MARIPOSA $151, $150, $197, $499, % $152, $151, $198, $502, $2, $0.00 $1, $0.00 $1, MENDOCINO $848, $842, $1,103, $2,794, % $850, $844, $1,106, $2,800, $6, $0.00 $3, $0.00 $3, MERCED $1,183, $1,174, $1,538, $3,895, % $1,184, $1,175, $1,540, $3,901, $5, $0.00 $2, $0.00 $2, MODOC $83, $82, $108, $274, % $84, $83, $109, $277, $2, $0.00 $1, $0.00 $1, MONO $87, $86, $113, $287, % $88, $87, $114, $290, $2, $0.00 $1, $0.00 $1, MONTEREY $1,345, $1,335, $1,750, $4,431, % $1,343, $1,333, $1,746, $4,423, ($8,690.91) ($4,345.45) $0.00 ($4,345.46) $0.00 NAPA $477, $473, $620, $1,571, % $477, $473, $621, $1,572, $ $0.00 $ $0.00 $ NEVADA $281, $279, $366, $928, % $281, $279, $365, $926, ($2,015.71) ($1,007.86) $0.00 ($1,007.85) $0.00 ORANGE $8,422, $8,359, $10,954, $27,736, % $8,440, $8,377, $10,977, $27,795, $58, $0.00 $29, $0.00 $29, PLACER $1,393, $1,383, $1,812, $4,589, % $1,398, $1,387, $1,818, $4,605, $15, $0.00 $7, $0.00 $7, PLUMAS $166, $164, $216, $547, % $166, $165, $216, $548, $1, $0.00 $ $0.00 $ RIVERSIDE $9,047, $8,979, $11,767, $29,795, % $9,073, $9,005, $11,800, $29,878, $83, $0.00 $41, $0.00 $41, SACRAMENTO $8,479, $8,415, $11,027, $27,922, % $8,479, $8,415, $11,028, $27,923, $1, $0.00 $ $0.00 $ SAN BENITO $187, $186, $243, $617, % $188, $187, $245, $621, $3, $0.00 $1, $0.00 $1, SAN BERNARDINO $8,804, $8,737, $11,450, $28,992, % $8,776, $8,710, $11,414, $28,900, ($92,009.78) ($46,004.89) $0.00 ($46,004.89) $0.00 SAN DIEGO $11,745, $11,656, $15,275, $38,677, % $11,786, $11,698, $15,329, $38,814, $137, $0.00 $68, $0.00 $68, SAN FRANCISCO $3,638, $3,611, $4,732, $11,981, % $3,632, $3,605, $4,725, $11,963, ($18,272.97) ($9,136.48) $0.00 ($9,136.49) $0.00 SAN JOAQUIN $3,219, $3,195, $4,187, $10,603, % $3,213, $3,189, $4,179, $10,581, ($21,083.58) ($10,541.79) $0.00 ($10,541.79) $0.00 SAN LUIS OBISPO $1,314, $1,304, $1,709, $4,329, % $1,318, $1,308, $1,715, $4,343, $13, $0.00 $6, $0.00 $6, SAN MATEO $1,664, $1,651, $2,164, $5,480, % $1,673, $1,660, $2,176, $5,510, $29, $0.00 $14, $0.00 $14, SANTA BARBARA $1,256, $1,247, $1,634, $4,137, % $1,254, $1,245, $1,631, $4,131, ($6,134.81) ($3,067.41) $0.00 ($3,067.40) $0.00 SANTA CLARA $6,225, $6,178, $8,096, $20,501, % $6,257, $6,210, $8,139, $20,607, $106, $0.00 $53, $0.00 $53, SANTA CRUZ $953, $946, $1,240, $3,141, % $951, $944, $1,237, $3,132, ($9,067.62) ($4,533.81) $0.00 ($4,533.81) $0.00 SHASTA $1,116, $1,108, $1,452, $3,676, % $1,110, $1,101, $1,443, $3,655, ($20,608.42) ($10,304.21) $0.00 ($10,304.21) $0.00 SIERRA $68, $67, $88, $224, % $69, $68, $89, $227, $2, $0.00 $1, $0.00 $1, SISKIYOU $290, $288, $378, $957, % $290, $288, $377, $956, ($1,265.41) ($632.70) $0.00 ($632.71) $0.00 SOLANO $1,074, $1,066, $1,398, $3,539, % $1,076, $1,068, $1,399, $3,544, $4, $0.00 $2, $0.00 $2, SONOMA $1,914, $1,900, $2,490, $6,305, % $1,908, $1,894, $2,482, $6,285, ($19,915.25) ($9,957.62) $0.00 ($9,957.63) $0.00 STANISLAUS $1,810, $1,796, $2,354, $5,961, % $1,818, $1,804, $2,364, $5,987, $25, $0.00 $12, $0.00 $12, SUTTER $523, $519, $681, $1,724, % $523, $519, $680, $1,723, ($1,362.92) ($681.46) $0.00 ($681.46) $0.00 TEHAMA $503, $499, $654, $1,656, % $502, $499, $654, $1,655, ($1,021.57) ($510.78) $0.00 ($510.79) $0.00 TRINITY $187, $185, $243, $616, % $189, $187, $246, $623, $6, $0.00 $3, $0.00 $3, TULARE $1,958, $1,943, $2,547, $6,448, % $1,963, $1,948, $2,553, $6,464, $15, $0.00 $7, $0.00 $7, TUOLUMNE $285, $283, $370, $939, % $284, $282, $370, $936, ($2,126.37) ($1,063.18) $0.00 ($1,063.19) $0.00 VENTURA $1,862, $1,848, $2,422, $6,133, % $1,860, $1,846, $2,420, $6,128, ($5,692.54) ($2,846.27) $0.00 ($2,846.27) $0.00 YOLO $819, $813, $1,065, $2,698, % $813, $807, $1,058, $2,679, ($19,276.96) ($9,638.48) $0.00 ($9,638.48) $0.00 YUBA $605, $601, $787, $1,994, % $607, $602, $789, $1,998, $4, $0.00 $2, $0.00 $2, SAN FRANCISCO-59TH CO $2,763, $2,742, $3,594, $9,100, % $2,577, $2,558, $3,352, $8,489, ($610,764.76) ($305,382.39) $0.00 ($305,382.36) $0.00 TOTAL $166,175, $164,926, $216,125, $547,227, % $166,175, $164,926, $216,125, $547,227, $0.00 ($448,027.26) $448, ($448,027.26) $448, TOTAL DIFFERENCE

10 California s Child Welfare Continuum of Care Reform (CCR) Overview California Department of Social Services Presented by Sara Rogers December 11,

11 Context for Change: Proportion of children in Group Homes has remained fairly constant despite efforts to reduce it. Poor outcomes for children placed in group homes for long periods of time. Lawsuit settlement increased Group Home rates by 33% with no new requirements Legislative mandate*: Reform Group Homes & FFAs with robust & diverse stakeholder input Legislative report with recommendations Builds on previous reform efforts: SB 933, RBS Reform * Senate Bill 1013 (Chapter 35, Statutes of 2012) Background 2

12 Vision All children live with a committed, permanent and nurturing family Services and supports should be individualized and coordinated System focus is on achieving a permanent family and preparation for successful adulthood When needed, congregate care is a short-term, high quality, intensive intervention that is just one part of a continuum of care available for children, youth and young adults 3

13 Guiding Principles The child, youth and family s experience is valued in: Assessment Service planning Placement decisions Children shouldn t change placements to get services Cross system and cross-agency collaboration to improve access to services and outcomes Recognizing the differences in the probation system 4

14 The Goal: Children in Resource Families Permanent Family Children in Congregate Care 5

15 The Work Ahead Will take a village! CDSS will be collaborating with a wide array of stakeholders in the implementation work CCR Report AB 403 Preparation Policies Rates Outreach Orientations Tools Training Accountability Recruitment Performance measures Pre-Implementation Applications Reviews Licenses Mental Health Certification Data testing Training & TA Implementation: Children & families served differently! Extensions Data collection Monitoring Technical Assistance Policy Revision 6

16 DRAFT Proposed CCR Implementation Framework State/County Implementation Team CDSS, DHCS, CWDA, CPOC, CBHDA, CSAC County Representatives Stakeholder Implementation Advisory Committee Providers, Youth, Caregivers, Tribes, Advocates, Counties, Legislative Staff and others CCR Implementation Workgroups Program & Licensing Rate Structures Oversight Framework Resource Family Approval Training Mental Health Deliverables Program Instructions Regulations ACLs/CFLs Forms Capacity Building Activities Outreach Activities Communication Materials Training Curricula Mental Health Certification Readiness tools Accountability & Oversight Framework Accreditation Process Application review process Provider Performance measures Consumer Survey 7

17 CCR Implementation Timeline 01/ / /2018 Stakeholder Engagement 2016 Legislation 2017 Legislation Initial Policy & Program Development Interim Standards Retention & Recruitment Outreach & Communication Provider & Caregiver Readiness Child Welfare & Probation Readiness 2018 Legislation. Legislative Reports and Updates Retention & Recruitment of Caregivers 2016 Regulations Initial Licensing Rates & Payments Licensure & Rate Setting of Providers Initial Training Ongoing Training & Technical Assistance t Assessment Resource Family Approval - Early Implementation (Cohort 2) Resource Family Approval - Statewide Implementation Oversight & Performance: FFAs & STRTCs Data Measure & Methodology 8

18 Key Strategies Continuum of Care Reform is a comprehensive framework for changing the continuum of services that support children, youth and families across placement settings (from relatives to congregate care) in achieving permanency. Pillars for this framework include: Increased engagement with children, youth and families Increased capacity for home-based family care Limited use of congregate care Systemic and infrastructure changes: rate structures, training, accreditation, accountability & performance, mental health services 9

19 Increased Engagement Child & Family Team Up-front and continuing assessment along common domains Aligns with the practice changes identified in California Child Welfare Core Practice Model (Statewide Practice Model) & Katie A Quality Parenting Initiative (QPI) 10

20 Foster Families Resource Families Resource Family Approval: Foster Family Relative Caregiver Adoptive Family Related and non-related families Training for all families Resource Families still choose the role they play in the system: temporary or permanent Prepared for permanency-no additional approvals necessary Resource Family Foster Family Agencies and residential care providers will also approve resource families. 11

21 Increasing Capacity for Home-Based Family Care Advancing Resource family approval statewide implementation. Additional funding for support, retention, recruitment and training of resource families & relatives for placing agencies ($17.2 million GF) Foster Family Agencies provide Core Services: May provide core services to children in county approved families Updated and expanded training requirements across provider and caregiver categories Approved Relative Caregiver (ARC) Funding Option Program (2014: $30 million investment) 12

22 Reducing Congregate Care Licensed residential care is re-envisioned to provide short term therapeutic care including core services that are designed to transition children quickly to a home setting. Residential care should only be used when intensive 24-hr care is required that can not be provided in a home based setting. Providers must immediately begin planning for a safe transition to a home based setting. Providers must have the capacity to approve resource families and to transition children and youth to a home setting safely (either directly, or through relationships with other providers). 13

23 Core Services FFAs and STRTCs make available core services either directly or through formal agreements: Services shall be trauma informed and culturally relevant Ensure the delivery mental health services (specialty and non-specialty) Transitional support services for placement changes, permanency, aftercare Education, physical, behavioral and mental health supports Activities to support youth achieving a successful adulthood Services to achieve permanency & maintain/establish family connections Active efforts for ICWA-Eligible children 14

24 Oversight, Accountability & Provider Performance Measures National Accreditation Cross Departmental Oversight Framework Evaluate provider performance along common domains Client satisfaction surveys Public transparency of provider performance 15

25 Other Key Elements New provider rate structure: Sunset RCL system (1-14) Create new STRTC rate Create tiered FFA rate structure Multi-year implementation: New requirements take effect 1/1/2017 Provisions for extensions up to two years Additional extensions for providers and longer for those serving probation youth 16

26 Questions and Contact Info Questions can be sent to: Additional information on the CDSS website at: 17

27 Continuum of Care Reform (CCR) Gap Analysis As you think about implementation in your County, make a note of what elements you have in place in these two critical implementation areas: What is in place to engage children, youth, families, resource families: The gaps: 1

28 What is in place to build resource family capacity? The gaps? 2

29 Training Needs Related to Gaps 3

30 INITIAL DRAFT OF TRAINING PLAN 1/13/16 PATHWAYS TO WELL-BEING: REALIZING AN INTEGRATED, CONJOINT TRAINING PLAN Vision: All public and professional organizations, community-based groups, and families shall have access to a uniform series of foundational training resources that support the integration of care provided by multiple organizations and the well-being of children in foster careand their families. Mission: The integrated training plan aims to establish unifyunified the content necessary to understand and provide the core services of an integrated practice model and encourages the conjoint integrated delivery of foundational training regarding the mental health and well-being of children in foster care across all partnering organizations and community-based groups that is developed from shared values, philosophy and evidence-based practices for serving high-risk, high-need children, youth and their families. Comment [LF1]: Applies to children not yet in the foster care system as well and CCR will include probation youth. This will be useful to ensure that partners across the system of care who are involved know what is needed to ensure that foster youth and actually all youth receive care that reflects the state of the art service and that reflects evidence-based practices. Let s establish this once and keep it up! While foster youth are certainly the current impetus, is it really necessary to limit our language in this way? Guiding Principles: The guiding principles for the development of the shared training plan are largely derived from the desired implementation of evidence-based practices across multiple state and communitybased organizations in California. This desire is given extra urgency as the result of the recent settlement of legal actions and legislative changes being implemented across the State. Pathways to MentalBehavioral Health Services Core Practice Model Guide, with additions for the encouragement of conjoint training. The shared training plan aims to address a need for consistency of information regarding policy and practice expectations across all agencies, partners, and families involved in the delivery, monitoring, and receipt of mentalbehavioral health services for children in foster care. Consistency is considered an essential component of fairness in service delivery. Further, the shared training plan seeks to provide access to families and other community partners with the same foundational information about mentalbehavioral health care for children in the foster care system as that received by professional staff to support the concept of equality and shared responsibility for. The combined emphasis on consistency and community education is believed to result in improved well-being outcomes for children. Comment [LF2]: This includes the changes in Child Welfare from the federal audit, the Katie A Settlement Agreement, the transfer of responsibility for 3632 services to education with special tracking of foster youth, and now, CCR. 1

31 To that end, the shared training plan will embrace the following principles for training content and training delivery: 1. Promotion of Cross-System Training Delivery: Promotion of joint trainings and access to training resources for the child welfare and mentalbehavioral behavioral health workforces to enhance shared understanding, skills, values, and collaboration in the case management and service delivery processes. 2. Promotion of Conjoint Training Delivery: Promotion of conjoint training delivery for two or more types of audiences and uniform access to training resources for all agencies, community-based organizations, and families concerned with the well-being of children in foster care in order to promote shared understanding and build trusting relationships. 3. Collaboration: Advancement of collaborative processes between the child welfare and mentalbehavioral health workforces systems and the families with whom they are partnering to create positive outcomes. 4. Teaming: Promotion of team-based approaches among the child welfare worker, mentalbehavioral health provider, family, youth, and other involved organizations and individuals to provide consistent, quality case management and treatment services to address children s mentalbehavioral health needs and to improve their mental healthsafety, permanence and well-being outcomes. 5. Evidence-based Practice: Promotion of the use of evidence-based and evidenceinformed practices within the training plan, with emphasis on values, philosophy and practices that span the context and target populations within specific models. regarding collaboration, teaming, screenings, assessments, and other aspects of case management and treatment. 6. Trauma-informed Practice: Emphasis on skillful responses to the prevalent and pervasive influences of trauma on children s and adults mentalbehavioral health and overall development. 7. Family and Youth Voice/Engagement: Support for the meaningful participation of families and youth in the curriculum development process and in the delivery of training to ensure deep understanding of the youth and family experience in service delivery. 8. Advocacy: Promotion of training and certification for parents, youth, and other partners to assist families with self-empowerment, resiliency, well-being, and navigation through the child welfare and behavioral health systems. Comment [LF3]: Is there a difference between 1 and 2? Coordinating Organizations: The main coordinating organizations for the development and approval of the shared training plan are: California Department of Health Care Services (DHCS) California Department of Social Services (CDSS) Shared Management Structure s Community Team, a group of community representatives operating under the conjoint auspices of the California Department of 2

32 Health Care Services and the California Department of Social Services pursuant to the Settlement Agreement for Katie A. v. Bonta Pathways to Well-Being Workgroup, a subcommittee of the Statewide Training and Education Committee (Pathways Workgroup) DHCS and CDSS will provide oversight of the shared training plan and orchestrate connections for the Community Team and Pathways Workgroup with other state, county, and partnering agencies that have interest in the plan. The Community Team or their designated participants will contribute their expertise and experience as advocates, service providers, and service recipients involved in and concerned about the public child welfare and mentalbehavioral health, or other involved systems within the Integrated Training Plan and content development process. The Pathways Workgroup will contribute their expertise in content development, training delivery, and knowledge of existing training products for topics related to the shared training plan. Goals of the Coordinating Organizations: 1. Develop a shared, integrated training plan that specifies a series of foundational topics for the practice areas of child welfare and behavioral health concerning the mentalbehavioral health and well-being of children in the foster care system and other public systems that serve them and their families. a. Topics will encompass knowledge, skills, and values for professional staff from governmental or community-based organizations, as well as educational materials for parents, youth, caregivers, and other service providers and or community-based support persons that help each of these groups understand and participate in the public child welfare and behavioral health systems as related to children in care, basics of case management, and principles of mentalbehavioral health treatment. b. As applicable, the plan will include recommendations for conjoint audiences, training sequencing, training standardization, and modalities for training delivery. 2. Establish guidelines for collaboration and communication between the Pathways Workgroup and the Community Team for development of the shared training plan. 3. Establish and execute a vetting process for the development of documents that explain and constitute the shared training plan. The vetting process will include identification of stakeholder groups whose comments will be solicited, and provide suggested options by which the members of the stakeholder groups may provide commentary (such as s, focus groups, on-line surveys, etc.). 4. Develop learning objectives for each of the foundational topic areas. 3

33 5. Identify existing, available training materials that cover topic areas in the shared training plan, and promote the sharing of information about such training resources on the websites of the entities represented in the Pathways Workgroup and the Community Team and other proactive methods. 6. Promote the extension of linkages across the websites of the collaborating entities in the Pathways Workgroup, Community Team, and other partners for access to training resources and related information, such as announcements for training events and sources for technical assistance. 7. Identify gaps in the coverage of foundational topics specified in the shared training plan and advocate for resources for the development of training products to fill those gaps. 8. Revise the shared training plan to reflect new training needs. 9. As applicable, issue recommendations to CDSS, DHCS, CWDA, CBHDA, CIBHS, CalSWEC, or other partners regarding goals 1-8. Ongoing Communications Among Coordinating Organizations The Community Team (and/or their designated workgroup) and the Pathways Workgroup each host in-person meetings or web conferences, respectively, on a regular basis. It is expected that the shared training plan will be a focus of attention for each of these groups during their regular convenings. The Community Team and the Pathways Workgroups will each provide one or more liaisons to the other group to communicate updates, commentaries, and other advisements as needed for the development of the shared training plan via in-person or conference call briefings, or by correspondence. Communications from DHCS and CDSS to the Community Team and the Pathways Workgroup can be provided by the DHCS and CDSS members in these groups. Addenda: (Addendum A) Vetting Process A basic outline of the vetting process follows; further details remain to be articulated. It is envisioned that the vetting of the shared training plan and supporting documents would occur at the same time, while the vetting of learning objectives for foundational topics would follow after a longer period of development. The Community Team and Pathways Workgroup will determine when drafts of the shared training plan, learning objectives for foundational topics, and related supporting documents are ready for vetting by partnering agencies and groups, and the timelines involved for the steps of the vetting process and for product finalization. 4

34 The Community Team and Pathways Workgroup will identify stakeholders, content experts, and designated staff from the child welfare and behavioral health training systems from among their respective memberships or from external groups who have interest in reviewing drafts and providing structured feedback to assist in the development of the shared training plan, learning objectives, and related documents. Drafts of the shared training plan, learning objectives, and supporting documents will be made available online to vetting audiences for their review. Feedback from the vetting groups may occur through a variety of structured modalities agreed upon by the Community Team and Pathways Workgroup, such as webinars, focus groups, and online surveys, which are considered most conducive for engaging particular targeted audiences. Explanations about the expectations for participating in the vetting process will be communicated to interested parties in the identified vetting groups. Comments from the vetting groups will be synthesized and serve as the basis for modifying the draft plan and related documents. The Community Team and Pathways Workgroup will determine when the shared training plan and related documents are ready for finalization and dissemination. (Addendum B) Products Related to the Shared Training Plan: Preliminary List of Foundational Topics Explanations of the Shared Training Plan for professional and lay audiences Learning Objectives Inventory of existing, available resources that support the shared training plan Clearinghouse websites with resources for the shared training plan, information regarding sources of technical assistance, announcements for training events, and links to partnering agencies. (Addendum C) Preliminary topic list: This preliminary, suggested list of topics is drawn from the October 2015 Meeting Summary of the Community Team and from feedback received by the Pathways Workgroup from an online survey of attendees of the Final Statewide Leadership Team Convening in August It should be noted that the survey inquired about general training needs at the county and regional levels and was not specific to foundational, conjoint training. Topics recommended by survey respondents are tagged with an asterisk. Child Welfare 101 Title IV-E MentalBehavioral Health 101 5

35 Mental Health Services Act MentalBehavioral Health Systems of Care / Continuum of Care Trauma-informed Practice and Implementation Tools (including screening & assessment)* Early Periodic Screening Diagnosis and Treatment Psychotropic Medications Intensive Care Coordination and IHBS How to increase utilization of IHBS* Medi-Cal Eligibility, Claiming, Billing Practices*, and Collaborative Documentation Consent, Data Sharing, and HIPAA Collaboration* Youth Engagement* Child and Family Teaming and Team Meetings (referrals; facilitation; adversarial relationshipsshared power)* Fiscal Models and Funding Sources Outcomes* Philanthropy & Philanthropic Organizations Potential Audiences for Conjoint Trainings: This list was created by the Community Team at its October 2015 meeting. Behavioral Health Clinicians (in the public and private sectors) Child Protective Services Social Workers (in the public and private sectors) Parent Partners Resource Parents Biological Caregivers Kin Caregivers Youth / Transitional Age Youth (TAY) Foster Family Agencies Family Preservation Providers Short-term Residential Treatment Centers (STRTCs) DHCS/CDSS staff County MentalBehavioral Health and Child Welfare associations Court Partners Judges and Attorneys Court Appointed Special Advocates (CASA) Probation Staff 6

36 Law Enforcement Faith-based Leaders Educational Liaisons/Special Education Local Plan Areas (SELPAs)/Teachers Regional Center Services Managed Care Plans MentalBehavioral Health Plans Prescribers (Physicians) Foundations & Philanthropies Fiscal Counterparts Community Resources Mentors Children s Informal Supports 7

37 Providing Whole-Person Care to Medicaid High-Utilizers in California: Opportunities for County-Based Pilots in California s 1115 Medicaid Waiver Renewal A New Opportunity for California The recent expansion of health care coverage to low-income Californians through the Affordable Care Act has provided unprecedented opportunities both for access to coverage and for enhanced collaboration among providers of historically siloed services to Medi-Cal eligible clients. At the same time, many California counties are taking on increased responsibilities for the provision of services that touch many of our most vulnerable Medi-Cal eligible residents, including those needing behavioral health, social services supports, and those involved with the criminal justice system. Within this context, there is a new opportunity to advance local efforts to improve the health outcomes of some of our most vulnerable populations, to use resources more effectively through a coordinated and more holistic approach across sectors, and to better aligns services for low-income populations. Meaningful local collaboration is already happening today. For example, efforts are now underway to coordinate the delivery of mental health and substance use benefits between Medi-Cal Plans, Specialty Mental Health Plans, and county systems. Other local efforts are focused on enrolling vulnerable populations, such as individuals who are being released from county jails, into Medi-Cal coverage and linking them to a health home. To develop systematic approaches that link service delivery across separate systems of care, focus systems on improving health outcomes while using resources more effectively, and take current local efforts to scale, a programmatic and financing structure for Whole-Person Care is needed. The absence of a systematic Whole- Person Care approach today results in poorer health outcomes for many low-income residents, continued utilization of high-cost services (e.g. emergency room, hospitalization, and incarceration), and a less efficient use of Medicaid funds and other critical resources. With the upcoming renewal of California s 1115 Medicaid waiver, California can build upon and expand current county efforts to test a systematic framework for Whole-Person Care and align payment incentives to ensure effectively coordinated care across multiple local agencies for the highest need patients. Fall 2014

38 Whole Person Care Working Definition The coordination of health, behavioral health and social services in a patient-centered manner with the goals of improved health and well-being for individual and family outcomes and more efficient and effective use of resources. Vision and Framework Our vision is for counties and local agencies to provide Whole-Person Care as described in the definition for the highest need patients their high users of multiple systems that have historically been served by county systems through collaborative leadership and systematic coordination with other public and private entities identified by the county. County agencies will identify these clients with shared data, coordinate their care in real time, and evaluate individual and population progress. Clients will have an individualized care plan and a single accountable, trusted care manager that supports them getting them needed services. Financial flexibility will permit providers across partnering sectors to do what is right for the client and will align incentives for providers to collaborate. These components describe a framework for providing Whole-Person Care. Whole-Person Care County Pilots in California s 1115 Medicaid Waiver Renewal As a centerpiece of California s 1115 Medicaid waiver renewal demonstrating payment reform and delivery system transformation, California should propose authority for development of County Whole-Person Care Pilots that incorporate the Whole-Person Care framework described above. These pilots would test innovative care coordination and collaboration strategies for the targeted Medi-Cal populations, and would allow participating counties additional flexibility in how they allocate resources to best address the issues contributing to the target population s health conditions and current utilization of services across sectors. A key component envisioned to be authorized through the waiver is the ability to use waiver funds for services not traditionally covered in the Medicaid program, such as targeted housing assistance. While counties would have flexibility to test approaches for identifying the target population and range of services and supports provided, all participating counties would be measured against a uniform set of identified outcomes focused on overall improvements in health, well-being, and efficiency. Fall 2014

39 Most people spend more time and energy going around problems than trying to solve them. Henry Ford Donna DeRoo, MPA, ABD (559)

40 December Pilot Performance Management Project with Fresno County (NACCHO) June 2013 CDPH funding to Expand to Madera and Merced Counties January 2014 CDPH to expand to San Joaquin and Tulare Counties June 2015 CDPH Develop and conduct Intermediate Quality Improvement with CDPH Teams November 2015 NACCHO funding to expand to Stanislaus County January 2016 to 2019 CDPH Intermediate Quality Improvement Training and Coaching 2

41 Assess Public Health Accreditation Domains Investigate Inform & Educate Community Engagement Policies & Plans Public Health Laws Access to Care Workforce QI Evidence- Based Practices Admin & Mgmt Governance Standard 9.1 Standard 9.2 Use a Performance Management System to Monitor Achievement of Organizational Objectives Develop and Implement Quality Improvement Processes Integrated into Organizational Practice, Programs, Processes, and Interventions 3

42 Lead IQI project facilitation Provide consultation to CDPH leadership and staff Develop intermediate IQI curriculum Conduct IQI training with five teams Develop an IQI coaching plan Conduct IQI coaching Created the IQI Guidebook for California 4

43 Session 0: QI Introduction Review Session 1: QI Project Initiation Session 2: Current State Assessment Session 3: Root Cause Analysis Session 4: Identify and Select QI Solutions Session 5: Pilot Select QI Solutions Session 6: Analyze and Evaluate Pilot Results Session 7: Adapt, Adopt or Abandon Decision and Hold the QI Gains Session 8: Capstone and Storyboard Presentation 5

44 All about problem solving Removes system inefficiencies Increases our effectiveness Hold ourselves accountable Supports performance-based decision making processes Empowers employees to be agents of change Decreases frustrations Energizes our work Boosts employee satisfaction 6

45 Leadership Commitment Customer Focus Teamwork & Collaboration QI Infrastructure Employee Empowerment Culture of Quality Continual Process Improvement 7

46 Extra work Evaluating processes Looking for bad apples Process and behavior changes do not hold 8

47 Empowers staff to make great strides towards quality Energize our work Removes inefficiencies, improves the process, decreases frustrations Boosts employee satisfaction 9

48 Quality Control Set of activities for ensuring quality in products. The activities focus on identifying defects in the actual products produced. Quality Assurance Set of activities for ensuring quality in the processes by which products are developed. Quality Improvement Focused on improving an existing process, service, or outcomes. Source: ty_assurance_vs_quality_control 10

49 Introduction to QI for Leadership Supervisors & Managers Staff EVERYONE Leading to Intermediate and Advanced QI Training Implement QI Immediately QI projects may vary depending upon the level of QI experience Beginner QI projects: Intermediate QI projects: Advanced QI projects: 1 st year with QI 2 nd Year with QI 3 rd Year with QI 11

50 Large teams Greater difficulty coordinating schedules for meetings Tend to involve lengthy discussions with little consensus Project moves much slower and may stall out Optimal size is 6-12 members Small teams May miss representation from key groups Limits insight into what is really happening with the process and the underlying root causes Can feel overwhelmed by having to accomplish so many tasks with little resource support Small team projects tend to have a lot of do overs due to missing information D 12

51 Team Roles & Responsibilities Team Sponsor Project Lead Team Members Authority in the organization to implement suggested changes, overcome barriers, and allocate resources Understands the implications of the proposed change on the various parts of the system Driver of the project Schedules and facilitates QI meetings Understands the details of the process the team is trying to improve Actively participates contributing ideas and participating in the team processes and decisions. Holds team members accountable to fulfill their roles and responsibilities Prepares summary updates for Sponsor Select cross functional and technical experts that are involved with the process day-in day-out Where the selected process impacts different departments the project should have representation from those departments Accountable to complete their action items on time Show up and participate for all QI team meetings 13

52 The Researcher The Expert The Planner The Team Player The Creative The Leader High Performance Team The Communicator 14

53 15

54 16

55 Standardize the Improvement and Establish Future Plans 10% ACT 50% PLAN Identify an Opportunity and Plan for Improvement Use Data to Check Results of the test CHECK DO Test the Theory for Improvement 20% 20% 17

56 18

57 Maintaining Momentum Leadership QI Champions Staff Project Consistently models PM & QI behaviors Has QI team(s) present their findings during all-hands meetings QI & PM are constant agenda items Early adopters tend to be your QI champions leverage their enthusiasm and desire to continuously improve Support QI teams with the time and space to create significant improvements Leadership Staff are actively involved in QI identification, prioritization, and implementation Support staff as they strive for continuous quality improvement Leadership Pace the QI projects throughout the year to prevent QI saturation and burnout 19

58 Learning Continuous Improvement 20

59 D 21

60 22

61 Program created in 2004: CVHPI s mission to create capacity to address inequities in health in the San Joaquin Valley Cohort 1 in 2005; Cohort 11 completes in May Year-long program 7 day-long seminars; team project; individual support; networking with >250 other graduates Designed for emerging leaders, Graduates have advanced to key leadership roles in population health advocacy, policy and programming throughout the region and state. 23

62 We seek to support the development of population health leaders for the San Joaquin Valley. We help leaders use advanced health policy analysis, development, and implementation tools to advance health equity in the San Joaquin Valley.

63 Practice skills in examining how national, state and local population health and health care policies create and to health and health care challenges in the Central San Joaquin Valley Practice skills in building and supporting community-led initiatives, using the social and environmental determinants of health inequities frame, to improve population health in the region. Sharpen capacity to use state-of-the-art analytic tools to: Explain health and health care inequities; Assess public health and health care initiative; Facilitate multi-sectoral engagement in health improvement Implement and evaluate policy and program change. Explore new models of community benefit leadership that emphasize resource mobilization, values alignment, and collaborative problem solving

64 Cohorts 1 through 9 Session 1 Introductions, Leadership Model and Health Policy 101 Session 2 Multicultural Issues in Health Policy and Leadership Session 3 Health Needs Assessment and Policy Analysis, Strategic Planning and Resource Mobilization, Group Project Identification Session 4 Emerging Issues in Health Policy Analysis and Program evaluation, Group Project Design Session 5 Health Care Access: Financing, Provider Shortages Implications on the Public Health System Session 6 Population Groups and Health Policy: Children, Eldercare and People with Disabilities and Behavioral Health Session 7 Alternative Goals for Health Policy, Assessing Public Views on Health and Health Care, Values Alignment and Program Implementation Session 8 Integrated Health Systems: Financing/Delivery Integration, Health Care and Social Service Integration Session 9 Project Presentations and Graduation 26

65 Cohorts 10 and 11 have been specially designed to support Health Equity Cohort members: San Joaquin Valley Public Health Consortium member staff assigned to lead equity initiatives. Session 1 Health & Health Disparity: Policy Implication Session 2 Multicultural & Race Session 3 Needs Assessment, Strategic Planning & Framework Session 4 Public Health Financing- Implications on the Public Health System Session 5 Chronic Disease, Equity and the Role of Public Health Session 6 Preterm Birth & Children s Health Session 7 Equity Initiatives - STD s and HIV and Public Health Session 8 Goals for Health Policy: Philosophical & Political Science Perspectives Session 9 Project Presentation, Graduation

66 HPLP has not only helped staff build skills and acquire new contacts, it has also improved the professional capacity for the Department as a whole. Kathleen Grassi Director Merced County Department of Public Health

67 Van Do-Reynoso Director of Public Health Madera County Public Health Department Quote

68 David Luchini Assistant Director Fresno County Department of Public Health Quote

69 31

70 PDCA ROADMAP PHASE PLAN DO CHECK ACT STEPS Select Select Improvement Opportunity Assess Assess Situation or Process Identify Identify Root Causes Solutions Generate & Select Solutions Implement Implement Trial/Pilot Run of Solution Analyze Analyze Trial Run Results Draw Draw Conclusions Adopt, Adapt, Abandon Monitor Hold the Gains DELIVERABLES KEY TASKS Identify QI project opportunity Populate the QI Project Charter Develop the problem statement Select team members Develop QI aim statement Determine scope Identify the target QI audience Develop SMART objectives Document potential constraints and risks Establish PDCA milestone dates Develop communication plan for stakeholders QI Charter Document Map out the current process or situation Identify areas for improvement Identify any performance gaps Evaluate baseline data describing the current state If no baseline exists, execute data collection plan to build baseline Confirm baseline data supports quality problem statement Begin to populate Storyboard Current Process Map Baseline Data Update QI Charter Begin Storyboard Identify all possible causes impacting the current process Identify all issues, bottlenecks and redundant loops Drill down into each identified cause and determine the root cause Identify root causes within your control and out of your control Evaluate & prioritize identified root causes Select the root cause(s) that will form the QI project Confirm baseline data validates selected root cause(s) Root Cause Analysis Update QI Charter Update Baseline Data Update Storyboard Generate list of all potential solutions and improvements that address the selected root cause(s) Evaluate and prioritize potential solutions Review best practices to identify potential improvements Select the QI solution(s) that will accomplish our QI aim statement Define the steps required to implement the selected solution Update QI Charter Update Baseline Data Update Storyboard Preparation Populate the QI Pilot Implementation Summary Set the pilot date Finalize SMART objectives Update data baseline for pilot Develop action plans for pilot obstacles and risks Develop pilot communication plan Deliver additional training for pilot Build the QI action plan Implementation Conduct pilot on a small scale Communicate to key stakeholders during pilot Collect, chart, and display data to monitor pilot effectiveness Document benefits, problems, unexpected observations, and unintended side effects QI Implementation Summary QI Action Plan Communication Plan Update Baseline Data Update SMART Objectives Update Storyboard Compare pilot results to QI aim statement baseline data Compare pilot results to SMART objectives baseline data Pilot Data Results Update QI Implementation Summary Update Storyboard Did we achieve the measure of success stated in QI charter aim statement? Did we achieve our stated SMART objectives? Did we eliminate a root cause(s)? Did we encounter unintended benefits? Did we encounter unexpected obstacles? Is our solution scalable? Can we roll it out to a broader audience? Do we need to make any adjustments? Update the QI Implementation Summary Update Storyboard Determine if QI project results are to be Adopted, Adapted, or Abandoned per the PDCA model If Adopt, begin preparations for a broader scale rollout If Adapt, begin preparation for another DO cycle to test a modification to the process If Abandon, go back to the PLAN stage to review initial QI aim, SMART objectives, processes and root cause assumptions CELEBRATE Update the QI Implementation Summary Update Storyboard Take steps to preserve your gains and sustain your accomplishments Anchor the process gains into your quality performance system, internal dashboard, or alternative reporting mechanism Communicate pilot outcomes to key internal and external customers Finalized Storyboard Updated Communication Plan TOOLS QI Project Prioritization Matrix QI Charter Document QI Aim Statement SMART Objective Worksheet Flowchart Cross Functional Process Map Value Stream Map Affinity Diagram Check Sheets Storyboard Affinity Diagram Cause & Effect Diagram 5 Whys Root Cause Analysis Table Multivoting Tool Storyboard Multivoting Tool Tree Diagram QI Implementation Summary QI Action Plan QI Gantt Chart Check Sheets Flowcharts Storyboard Pie Charts Pareto Charts Radar Charts Histograms Run Charts Check Sheets Storyboard QI Implementation Summary Storyboard QI Implementation Summary Storyboard Communication Plan Run Charts Check Sheets Histograms Pareto Charts Quality Perf System Project coordinated by Central California Center for Health and Human Services, California State University, Fresno

71 RFA Update:

72 Central Region Field Advisor And Coaching Training Hosted by Central California Training Academy Field Advisor Training: Monday, March 7, :00 AM 4:00 PM Building Coaching Capacity for Field Advisors: Tuesday & Wednesday, March 8-9, :00 AM 4:00 PM Both Days Fresno Pacific University Merced Campus 3379 G Street, Bldg. P, Room #104, Merced For those individuals who have been identified as a County Field Advisor for the Common Core 3.0, please join us in our 3 day training. o Training Day 1: Field Advisor Training. o Training Day 2 & 3: Building Coaching Capacity for Field Advisors As a Field Advisor, you are required to attend all 3 training days. Please register using the link(s) provided below. Please note you must complete the required Field Advisor elearning module prior to attendance. You will be provided access to the elearning module and receive an with further instructions on how to access the elearning module upon your registration for the 3-day Field Advisor Training. For Further Information Contact your Regional Training Coordinator: Mayko Vang mvang@csufresno.edu Phone # Cindy Friesen cfriesen@csufresno.edu Phone # Register online through Eventbrite at: Registration Deadline: March 1, 2016

73 The Central California Training Academy presents FEDERAL CASE REVIEW TRAINING A four-day intensive overview to support the Case Review Certification Process in California Intended Audience: Selected Case Review staff across California What you ll learn: This workshop will review the new Federal Case Review tool, which is used to: 1) ensure child welfare conformity with federal requirements; 2) determine what is actually happening to children and families engaged in child welfare services; and 3) assist the state and county to enhance capacity to help children and families achieve positive outcomes. This intensive, four-day workshop will prepare staff with the materials needed to successfully conduct the California Child and Family Review (C-CFSR) process. How you ll benefit: Understand the purpose and role of the case reviewer and case review tools Demonstrate the skills required to complete the case review tool accurately Synthesize information from a variety of sources (organizing data in such a way that they can use the information in the tool) Apply the organizational skills necessary for completion of the case review tool Follow-Up Coaching Sessions: Trainees are required to participate in three of the following coaching call dates. Please click on link to register for that date: Tuesday, March 29 from 10:00 Noon Thursday, April 12 from 10:00 Noon Tuesday, April 26 from 10:00 Noon Tuesday, May 10 from 10:00 Noon DATES: March 15-18, 2016 TIME: 8:30am 5:00pm LOCATION: Fresno Pacific University Merced Campus 3379 G. Street, Bldg. P Room # 104, Merced REGISTRATION DEADLINE: March 1, 2016 Please register online at: training-march-15-thru- 18.eventbrite.com/ For questions re: training contact Judy Rutan at jrutan@csufresno.edu or Trainers: David Plassman, M.Div; Kate Acosta, MA & Judy Rutan, MPA No charge for trainings. All trainings are provided to help meet the Federal Review and AB638 Outcomes of Safety, Permanence and Well Being.

74 Central California Training Academy WORKSHOP ANNOUNCEMENT Advanced Analytics for Child Welfare Instructors This session is intended to focus on how child welfare staff might most effectively combine the data resources they have, and the mandates under which they are operating to develop an information management and operations strategy that will allow them to focus on the critical issues in their county child welfare system. In particular, leaders are interested in understanding how to make best of use of their information resources to structure services that both meet their needs, and that are consistent with their county s Self Assessment and SIP (system improvement plans). Topics include Thinking Systematically about Child Welfare: From Investigations to Permanency Effective Communication of Child Welfare Outcomes Developing Baseline Expectations for Innovation Informing Continuous Quality Improvement Evaluating Contract Agency Performance Using Longitudinal Information in the Budget Process We strongly encourage counties to bring a team comprised of leadership, case reviewers, analysts, quality assurance and / or administrative staff, and other child welfare staff who are responsible for monitoring and improving outcomes for child welfare. Professional Credit BBS: Course meets the qualifications for 18 hours of continuing education credit for MFT s and/or LCSW s as required by The California Board of Behavioral Sciences. Our provider number is: PCE 577. BRN: Provider approved by the California Board of Registered Nursing. Provider number is BRN00046 for 18 contact hours. Jennifer Haight is a Senior Researcher at Chapin Hall at the University of Chicago, and a senior staff member of the Center for State Child Welfare Data. She has worked extensively with staff from public and private child welfare agencies to help them use their administrative data more effectively to understand the functioning of their child welfare systems and to facilitate continuous program improvements. A particular focus has been incorporating information about abuse and neglect incidents into analyses of child welfare outcomes. More recently, her work has focused on assisting public child welfare agencies in the development and implementation of performance-based contracting initiatives. Jennifer holds a Bachelor of Arts degree from Grinnell College and a Master of Arts degree from the State University of New York at Binghamton. Daniel Webster, M.S.W., Ph.D., is a senior research specialist and project director at the Center for Social Services Research at the University of California, Berkeley. A consultant for the Annie E. Casey Foundation for the past eight years, he has worked with county and state child welfare staff in California, Oregon, Washington and Alaska. Webster s major fields of interest include child welfare services, the mental health needs of children in out-of-home care and poverty. Date and time March 22-24, :00 am 4:00 pm Location Ventura County Children & Family Services Telephone Road Building, 2 nd Floor 4651 Telephone Road, Ventura, CA To Register online please use the following link: For more information Contact Judy Rutan at (559)

75 Scope of Work Trainer Name: Trainer Address: Trainer Phone: Trainer Date : January 16, 2016 John B. Cullen johnbcullen@comcast.net Dear, John B. Cullen The Central California Training Academy would like to confirm your services for the following county(ies): Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, The total fee for this agreement is: Hourly Rate: Max # of hours: Term: 2/1/16-6/30/16 Introduction and Summary: Bay Area Social Service Consortium (BASSC) Directors and Bay Area Training Academy (BAA) leadership are expressing the imperative to improve focus on the provision of ongoing skill development for our county social services workforce. Several critical issues have been identified regarding capacity building for BAA, including; structure, responsibility for new training, needed subject matter, delivery methods, collaboration and coordination linkages, funding and cost sharing. In addition, there is consensus that a broader scope of in-service trainings are needed but not well planned, developed or delivered in the Bay Area and, like the rest of California, the training that is provided to our workforce varies greatly by county. BASSC County Directors acknowledged that current and future law and regulatory changes, community service delivery expectations, staff retention, and funding challenges, all demand an efficient, effective and equitable In-Service Training Structure in the Bay Area. The BAA offered that it must make changes to its structure, operations, and financing, in order to have the necessary capacity to plan, develop and deliver a broader range of inservice training offerings to member counties. The County Directors within BASSC supported moving forward on a work plan to identify what is needed to improve the capacity of the BAA to provide a broad range of In-Service Training for county staff. Specifically County Directors asked that the initial scope of work focus on capacity building in the Child Welfare and Adult Service program areas, describing a model structure that would ultimately support a broader scope of in-services training requests beyond Child and Adult Services. Purpose: Prepare a report for BAA and BASSC review and discussion with recommendations for a model In-service training structure, operational components, and financial parameters necessary for BAA to address current and future Child Welfare and APS training needs. The model will also address the larger goal of identifying what steps could be taken to improve the overall structure and training delivery system so that county in-service training requests beyond Child and Adult Services can be routinely met. Deliverables: Phase One of this agreement will begin 1/1/16 3/30/16. Hours not to exceed 95 hours within this agreement time period.* Services and deliverables expected in this agreement include: Conducting initial assessments through interviews with key county, state, regional training consortia, university, and other training related partners. Review of training, policies, procedures and fiscal information with key informants A status report to the Bay Area County directors and BAA leadership at the April 7-8, 2016 BASSC meeting 11/14/13