1 Scott County Children s Mental Health System of Care Commission Operating Guidelines Purpose: The purpose of this document is to orient the Scott County community to the role, leadership, and governance structures of the Scott County Children s Mental Health System of Care Commission (The Commission). The Commission is a standing committee, and will serve as a leadership force for the Scott County Children s Mental Health System of Care (SCSOC). Background: Youth with mental health challenges: Are more likely to drop out of school 1 Are more likely to be arrested 1 Are more likely to be involved in the juvenile justice and child welfare systems 1 Have low levels of employment 1 Are more likely to experience poverty and homelessness 1 Have parents who are stressed and frequently miss work 2 Cost the US an estimated $247 Billion annually 3 The Scott County Children s Mental Health System is: Fragmented 4, 5 4, 5, 6 Inaccessible Siloed 5 Confusing 5 Overwhelmed 5 These growing concerns led to a Memorandum of Agreement between: 1 National Federation of Families for Children s Mental Health, 2010 2 Journal of Emotional & Behavioral Disorders, 1997 3 National Federation of Families for Children s Mental Health, 2011 4 QCHI mental health subcommittee- Hearts and Minds, Scott County Health Department Community Survey 2010, Quad City Vitality Scan 2007 and 2010, and Scott County Decategorization Annual Plan 2009 and 2010 5 Children s Mental Health Focus Groups, Summer 2011 6 Scott County Decat Community Forum, 2010
2 Funding: Planning funds were provided to the Commission and SCSOC by the Scott County Decategorization Program. Roles: It is the role of the Commission to: (1) Promote SCSOC values and principles; (2) Research, recommend, and design the SCSOC; (3) Provide governance and oversight of SCSOC staff, community panels, and activities that develop; (4) Promote a sustainable SCSOC. Vision: The children of Scott County will have accessible, effective and equitable resources to optimize their mental and behavioral health. Project Scope: The purpose of the Commission is to research, recommend and design a mental health system of care that is inclusive of family driven and youth guided, community based, and culturally and linguistically competent. The Commission will provide oversight, governance and promote sustainability and continuity following the implementation of the mental health system of care. System of Care Defined: A spectrum of effective, community-based services and supports for children and youth with or at risk for mental health or other challenges and their families, that is organized into a coordinated network, builds meaningful partnerships with families and youth, and addresses their cultural and linguistic needs, in order to help them to function better at home, in school, in the community, and throughout life. Core Values: Systems of care are: Family Driven & Youth Guided, with the strengths and needs of the child and family determining the types and mix of services and supports provided; Community Based, with the locus of services as well as system management resting within a supportive, adaptive infrastructure of structures, processes, and relationships at the community level; Culturally & Linguistically Competent, with agencies, programs, and services that reflect the cultural, racial, ethnic, and linguistic differences of the populations they serve to facilitate access to and utilization of appropriate services and supports and to eliminate disparities in care. Guiding Principles: Systems of care are designed to: Ensure availability and access to a broad, flexible array of effective, community-based services and supports for children and their families that address their emotional, social, educational, and physical needs, including traditional and nontraditional services as well as natural and informal supports. Provide individualized services in accordance with the unique potentials and needs of each child and family, guided by a strengths-based, wraparound service planning process and an individualized service plan developed in true partnership with the child and family.
3 Ensure that services and supports include evidence-informed and promising practices, as well as interventions supported by practice-based evidence, to ensure the effectiveness of services and improve outcomes for children and their families. Deliver services and supports within the least restrictive, most normative environments that are clinically appropriate. Ensure that families, other caregivers, and youth are full partners in all aspects of the planning and delivery of their own services and in the policies and procedures that govern care for all children and youth in their community, state, territory, tribe, and nation. Ensure that services are integrated at the system level, with linkages between childserving agencies and programs across administrative and funding boundaries and mechanisms for system-level management, coordination, and integrated care management. Provide care management or similar mechanisms at the practice level to ensure that multiple services are delivered in a coordinated and therapeutic manner and that children and their families can move through the system of services in accordance with their changing needs. Provide developmentally appropriate mental health services and supports that promote optimal social-emotional outcomes for young children and their families in their homes and community settings. Provide developmentally appropriate services and supports to facilitate the transition of youth to adulthood and to the adult service system as needed. Incorporate or link with mental health promotion, prevention, and early identification and intervention in order to improve long-term outcomes, including mechanisms to identify problems at an earlier stage and mental health promotion and prevention activities directed at all children and adolescents. Incorporate continuous accountability and quality improvement mechanisms to track, monitor, and manage the achievement of system of care goals; fidelity to the system of care philosophy; and quality, effectiveness, and outcomes at the system level, practice level, and child and family level. Protect the rights of children and families and promote effective advocacy efforts. Provide services and supports without regard to race, religion, national origin, gender, gender expression, sexual orientation, physical disability, socio-economic status, geography, language, immigration status, or other characteristics, and ensure that services are sensitive and responsive to these differences. Logic Model: The Commission developed a workplan based on system of care values and principles; as well as community input through focus group participation: Action Steps Outputs Outcomes Indicators Conduct process mapping Contribute to community needs assessment process To increase the knowledge of the community about the strengths and needs of the various systems interfacing in children s mental health Pre- and Post-test surveys/evaluations of key stakeholders and their knowledge of perceived and real community strengths and needs
4 Facilitate focus groups Initiate Family Navigator Pilot Project Organize a directory of children s mental health services Promote professional development Create community driven panels Report findings, recommendati ons, and designs of system of care Pursue sustainable system of care for children s mental health Contribute to community needs assessment process Colocation in primary care provider practice Directory based on insurance needs, treatment availability, and location Trainings, meetings, opportunities for collaboration 3 Panels that consist of a Youth Panel; Family Panel; and Provider Panel Reports, maps, assessments, focus group and survey responses and any other data or material collected Grants, funding stream changes, collaborative and innovative partnerships all with To increase the participation of family, youth, and provider stakeholders in the development of a system of care To increase family participation in children s mental health services To increase the referrals made by primary care providers to mental health providers To increase the knowledge and skills of primary care providers and mental health providers on how to manage children s mental health issues in a collaborative and integrated manner. To increase meaningful community participation in the development of a system of care for children s mental health To increase the knowledge of the community and funders regarding the cost of not implementing a children s mental health system of care in Scott County To sustain the independent functioning of a children mental health system of care in Scott County. Number of family, youth, and provider stakeholders participating in planning process by attending meetings and providing information. Evaluate no-call/noshow rates of families participating in the pilot (experimental group) and the rates of families who do not participate in the pilot (control group) Track the number of hits on the directory and gather data from providers where they found referral information Utilize Community Integration Model adapted from SAMHSA to identify baseline level of integration and then provide interventions and then reevaluate level of integration postintervention Establish and maintain panel meetings with consistent, active, and meaningful participation The number of reports and the number of hits/references in news articles The dollars raised through partnerships and grants; the number of stakeholders invested; the number of
5 the goal of promoting sustainability funding stream policy changes Membership: The Commission consists of a maximum of 15 voting members. Members of the Commission shall represent a cross-section of disciplines and advocates involved in systems that interface with children and children s mental health. Desired representation includes: o o o o 4 Standing Positions 7 th Judicial District/Juvenile Court (1) Department of Human Services/Child Welfare (1) Scott County Kids (1) Scott County Decategorization (1) 3 Panel Chairs Youth Panel Chair (1) Family Panel Chair (1) Provider Panel Chair (1) 3 Necessary Disciplines Education (1) Health (1) Primary Care Provider (1) 5 Community Stakeholders Deemed by the Commission to have specialized and unique knowledge and skills in children s mental health (5) Beginning in State Fiscal Year 2013 (July 1, 2012), the following members will have staggered terms and be up for renewal: o Youth Panel Chair (1) o Provider Panel Chair (1) o Health (1) o Community Stakeholder (2) The next renewal period will begin in State Fiscal Year 2014 (July 1, 2013), the following members will have staggered terms and be up for renewal: o Family Panel Chair (1) o Education (1) o Primary Care Provider (1) o Community Stakeholders (3) Excluding the 4 standing positions, Commission seats will then stagger utilizing the aforementioned formula every two years to ensure sustainability. Informal members of the Commission are members who serve at the pleasure of the Commission, for time limited participation, but have no voting abilities. Individuals, such as business leaders, political leaders, and advocates may be requested to assist the Commission with specific issues.
6 Commission members may designate an annual alternate to have voting privileges in the absence of a respected Commission member. Members commit to a minimum of two year participation on the Commission. Terms for non-standing Commission members are limited to three terms of two year increments for up to six total years served. Non-standing Commission members who complete six years must have at least one year prior to applying to the Commission to start new terms. Any member may resign from the Commission by submitting a written notice submitted to the Chair of the Commission one month in advance of resignation. The attendance policy for the Commission is that each member is expected to attend monthly meetings on a regular basis. Each Commission member can miss no more than two meetings in succession without an excused absence or s/he will be asked to resign. Excused absences are granted by the Chair of the Commission. Selection of Membership: Commission members will be selected through an application-based process. Each applicant for membership will complete an application form. The SCSOC staff will process applications and make formal presentations at Commission meetings. Qualified candidates will be selected on the basis of leadership skills, knowledge of children s mental health issues, community service interest and experience, communication skills, collaborative approach, and visionary attitude. Commission members will be representing diverse community interests or stakeholder groups. Following presentations of applicants, a Commission member will make a motion to accept the applicant into membership. The motion must be seconded and unanimously approved for the applicant to obtain membership status. If there is no motion to approve the applicant, or an applicant does not receive a unanimous vote, then the applicant will be respectfully declined from membership to the Commission. The SCSOC staff will inform the applicant via written notice as to the decision of the Commission on their status. The notice will be sent within one week of the decision. Applications will be received from both individuals seeking a Commission seat as well as those recruited by current Commission members. There is no appeals process for an applicant that has been denied admission to the Commission though denied applicants will be encouraged to continue to attend meetings and participate as community members. Meetings: Meetings of the Commission take place once a month, on the third Friday from 12:30pm-2:30pm at: Scott County Administrative Center 600 W 4 th St Davenport, IA 52801 All meetings are open to the public. Meeting notes will be recorded for all Commission meetings by SCSOC staff.
7 Agenda are sent to public posting and Commission members one week in advance of the Commission meeting by SCSOC staff. Meetings are subject to change to allow for maximum attendance and participation. Compensation: There is no compensation for attending Commission meetings. However, a stipend (gift card) and child care reimbursement may be available to parent representative(s) to offset child care costs. Stipend amounts to be determined each year. Orientation: Commission members will be oriented by reviewing the following materials: Operating Guidelines Memorandum of Agreement Project Charter Previous Commission Minutes and Agenda Any Financial Documents Available Any Other Documents Provided by the Commission or SCSOC Staff Structure: The following structure will be provided for the development of the SCSOC:
8 Chair/Vice Chair The Chair of the Commission is the person who served as the Vice Chair in the previous year. The Chair is appointed unanimously for a one-year term. A Vice Chair is elected by unanimous consent of the Commission membership every year. The Vice Chair serves as Acting Chair in the Chair s absence. Nominations and self-nominations can be made for these positions. Community Panels There are three standing community panels that operate under and report to the Commission via Committee Reports and SCSOC Staff: Youth Panel, Family Panel, and Provider Panel. Community members, who are not Commission members, are welcome to join Community Panels in accordance with each panel s governance structure. Each panel will democratically elect a Chairperson that will have voting privileges on and report directly to the Commission at monthly Commission meetings via the Committee Report either in person, through panel secretaries or through SCSOC Staff. It is the responsibility of all Community Panels to maintain collaborative relationships with the full Commission. All communications on behalf of the Commission are made only with the approval of the Commission and SCSOC staff.
9 Establishing New Committees: When the Commission receives a request from a group or individual to form a formal relationship with the Commission, i.e., community groups, governmental agencies, contracted services, etc., or when a standing Community Panel requests to extend or modify its work plan, the Commission will review the request to determine how and/or where the work plan of the requesting group would fit into current Commission work plans and if the group s goals are congruent with the Commission s Scope. The Commission will apply the following criteria in its evaluation: Level of relevance to the Commission s scope and activities, Resources that promote/advance the work of the Commission, and Probability of success. After evaluating the request, the Commission will make one of the following determinations: Establish a new Standing Committee, Incorporate the group as a subcommittee of a Standing Committee, Establish a new Ad Hoc Committee, or Deny the request. Decision-making Process: Recommendations and decisions will be made by Parliamentary Authority. The steps for Parliamentary Authority are: 1) The issue/agenda item is discussed as fully as possible within time constraints. 2) If consensus of all present is not possible, options are to table the item until the next meeting and try for consensus again or 3) To call for a vote. A quorum of 51% of Commission members must be present to have a vote. 4) A motion should be made and seconded with a simple majority carrying the decision. Commission staff will not vote. Those having a conflict of interest shall not vote (refer to conflict of interest section). 5) A 2/3 majority is required for changes made to by-laws or organizational changes. 6) Approved recommendations will be forwarded to the appropriate party. Assigned staff and/or appropriate Commission member will implement decisions. Responsibilities of Chair: 1. Provide leadership to the Commission in developing and implementing a clear vision and strategic direction. 2. Serve as the primary liaison between the Commission and staff.
10 3. In conjunction with staff, structure meetings and develop agendas that result in task achievement. 4. Chair the meetings of the Commission. 5. Continually monitor group dynamics and leadership development needs. 6. Serve as a primary and visible representative in the community. 7. Coach and mentor the Vice-Chair for the role of Chair. Skills, Abilities and Attributes of Chair: 1. Strong facilitation skills. Ability to keep the group focused, promote dialogue and insure inclusive participation. 2. Ability to develop and nurture new leaders to the group. 3. Provide strength-based leadership, providing positive energy. Responsibilities of Vice-Chair: 1. Perform duties of the Chair when the Chair is unavailable. 2. Observe group dynamics and discuss observations with Chair. 3. Participate in leadership decisions, as requested by the Chair. 4. Prepare to assume the role of Chair. 5. At the request of the Chair, perform other tasks and duties. Commission Member Responsibilities: 1. Be knowledgeable in and promote the Commission s scope, values, and work plan goals. 2. Notify the Commission if (1) any issues of the community committees/projects diverge from the Commission s scope and/or work plans, (2) policy issues are advanced, or (3) resources are allocated. 3. Discern and declare conflicts of interest whenever they arise, and consult with the Commission as needed. 4. Participate in the development, implementation and evaluation of the SCSOC. 5. Attend Commission meetings regularly and participate actively. 6. Actively participate in Commission issues by providing constructive input and innovative resolutions to problems. 7. Serve as a positive and effective representative in the community. Look for opportunities to connect to the community. Provide relevant information from the community back to the Commission. 8. Represent your system s take on children s mental health to the Commission. 9. Put the interest of the Commission above any personal or business interest. 10. Assure that the needs and interests of the community are represented in the plans developed and decisions made by the Commission. 11. Contribute to rigorous discussion and debate about important Commission decisions and support those decisions once they are made. 12. Provide individual expertise and contacts as needed or requested. 13. Participate in Getting To Outcomes processes 14. Complete and update community needs assessment through an inclusive process 15. Hold and participate in regular forums to form, report on, and update goals with community member input
11 Conflict of Interest: Members of the Commission, and its Community Panels, whose vote on a Commission matter could have direct financial influence, whether for gain or loss, on themselves, their employer or their family, are seen as having a potential conflict of interest, and shall declare such a potential conflict prior to the vote, and shall abstain from advocating for a voting position or casting a vote on such matters. Commission members will be required to sign a Conflict of Interest Statement annually. Recognition: Special thanks to the following agencies and groups for the formatting and content ideas and framework: County of Fresno (California) Mental Health Advisory Board Early Childhood Council, Multnomah County (Oregon) System of Care Guilford County Community Collaborative (North Carolina) System of Care Orange County (New York) System of Care