2010 Impact Report to the Community Impact is Ingham County’s System of Care, a partnership of child- and family-serving agencies working in cooperation to provide coordinated services for children with Serious Emotional Disturbance (SED) and their families. The main goal of Impact is to build and enhance home- and community-based services for young people with SED who are at risk of out-of-home placement and their families.
14-month Calendar
Child and Adolescent Functional Assessment Scale (CAFAS) The eight domains that CAFAS measures are school, home, community, behavior toward others, moods/emotions, self-harmful behavior, substance use and thinking. Scores range from 0 to 240, with scores of 50 and above indicating SED. Youth with scores of 80 and above meet the criteria for Impact services, meaning they have SED with a risk of out-of-home placement.
CAFAS Scores, 2007–2010 October 2007– September 2008 October 2008– September 2009
October 2009– September 2010
75% 31% 83% 32% 78% 29%
Proportion of youth improved
Impact System of Care’s results with SED youth are still the best in Michigan.
Proportion no longer SED at exit
175 youth were active in services in FY 2010. Impact has served 566 youth since 2006. Outcome 1 Maximized functioning of children with SED and their families. “Impact is a model for other programming for youth. It gets everyone dealing with children to come together to think holistically about the lives that we’re touching. I really like the direction we’re heading with Impact.” – Brian McGrain Ingham County Commissioner
“Impact’s results are still excellent. Variability from year to year could be due to case mix, which could be caused by differences in family resources or the extent of trauma the youth has experienced. Impact’s results are much better than those for the average youth referred for SED services in Michigan. The average Impact youth has statistically significant Improvement.” - Kay Hodges Ph.D., Author of the CAFAS tool
NOVEMBER 2009 SHINING STAR WINNER
Cristy Brooks
Client Service Specialist, Wraparound
“I am better at handling daily life as a result of Impact services.”
66% 71% 84% 75%
“My child is better at handling daily life as a result of Impact services.”
47% 62% 54% 56% 24
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Percentage of caregivers and youth who say they agree or strongly agree. Source: Longitudinal Outcome Study
DECEMBER 2009 SHINING STAR WINNER
Erin Hamel
Juvenile Court Officer, Ingham County Circuit Court Family Division
“I have the tools I need, and therapy helps me deal with my anger.” - Josh Lawrence, former Impact youth
“Josh and I are doing fine. His behavior and how he treats me has improved,” -Suzanne Lawrence, mother
Longitudinal Outcome Study Impact System of Care uses data from the Longitudinal Outcome Study (LOS), the largest study of children’s mental health in the world, to help track the outcomes of its services. Caregivers and youth 11 years and older who voluntarily join the LOS are interviewed when they begin receiving Impact services. Then, every six months for up to three years, they are asked about their experience with Impact and whether they see improvement in their lives as a result of receiving services.
Outcome 1 Maximized functioning of children with SED and their families.
New Year Brings New Plans The Impact initiative was funded in 2005 by the federal Center for Mental Health Services to create a System of Care for children and youth with serious emotional and behavioral needs. This month marks the beginning of the final year of the six-year project.
JANUARY 2010 SHINING STAR WINNER
Sharla Henson Family Counselor, Highfields, Inc.
“The quality of work by Impact gives not only our children a second opportunity, but adults as well.” - Don Vickers, Ingham County Commissioner
Impact’s plans for the next year include: •
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Garner support for and commitment to realigning resources Once the Substance Abuse and Mental Health Services Administration (SAMHSA) funding ends in September, we will need funding to continue the vital components of the Impact System of Care. Support the development of the Impact Learning Center We will sustain local learning opportunities as well as share technical and training expertise with communities outside Ingham County. Continue to promote a research base We will submit articles for publication in professional journals to highlight the work being done in Impact. Share our Family Guidance Service Model Now that a replication guide for the Family Guidance Service Model (FGS) of HomeBased Services is complete, we will assist other communities as they establish their own programs using the FGS model.
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“We are continuing on a positive trajectory of sustaining the System of Care in the absence of the federal grant. I really think the collaborative relationships and service coordination will continue after the federal grant funding ends.” – Sara Deprez, Juvenile Programs Director, Ingham County Circuit Court Family Division
A companion training manual is being developed as we work with Monroe County. Continue great work by moving toward Wraparound fidelity A Michigan Wraparound Fidelity Index is being patterned after the national Wraparound Fidelity Index and will be used locally. Enhance capacity to support more youth and families in services Promote and maximize the use of waivers to support more youth and families connecting with needed services. Therapeutic Foster Care Begin using Therapeutic Foster Care homes as a community-based alternative to residential placement. Pursue new funding sources Pursue National Institute of Health funding and other grant opportunities.
FEBRUARY 2010 SHINING STAR WINNER
Megan Dean Juvenile Court Officer, Ingham County Circuit Court Family Division
“There has been a significant improvement in how frontline staff collaborate, which has led to a higher quality of services and supports for youth and families, which ultimately leads to better outcomes.” - Sara Deprez Juvenile Programs Director, Ingham County Circuit Court Family Division
Outcome 2 Reduced need for out-of-home placements.
“Impact has been a successful partnership for our youth and families in Ingham County and has helped to reduce our residential/out-of-home placements by meeting the needs of youth in their own home and community.” –William Collette, Chief Judge, Ingham County Circuit Court
DHS has saved millions Ingham County Department of Human Services (DHS)has reduced the monthly average number of youth in foster care from 784 in May 2008 to 595 in September 2010 by providing families protective services with Impact supports while youth remain in their homes. That’s a savings of $1.2 million per year in the foster care daily rates alone.
“While there is a financial benefit, the real benefit is to the families because we are keeping so many more children at home.” - Randy Rauch, DHS director
Outcome 3 Efficient use of resources.
Residential placement budget cut The Ingham County Circuit Court Family Division will be able to face large cuts to its residential placement budget due to better in-home and community services such as Impact.
The Impact System of Care is helping Ingham County save money in tough economic times.
“With the Impact System of Care, we have a more professional, proficient way to assess and provide services for the youth with SED. In the past two years, it has become a more acceptable and widespread resource.” - Maureen Winslow, Deputy Court Administrator
Community Mental Health Increases Capacity The realignment of resources allows CMH to increase capacity to serve more youth in their homes.
“We had a huge capacity problem before Impact, unable to serve many children, adolescents and their families who would have benefited from the Impact package of services. Now, as a result of this innovative financing package, we’ve closed a large segment of this gap.” - Robert Sheehan, Executive Director, Community Mental Health Authority of Clinton, Eaton and Ingham counties
MARCH 2010 SHINING STAR WINNER
Rachelle Baerman-Skief Mental Health Therapist, Community Mental Health
“This approach to treatment also saves the county thousands of dollars annually by keeping children here in our community instead of sending them hundreds, if not thousands, of miles away to an out-of-state residential care facility.” – Rebecca Bahar-Cook, Ingham County Commissioner
of the 128 youth in Child Protective Services remained in their homes in 2009.
94%
Impact supports youth and family involvement LADDER OF YOUTH PARTICIPATION
Impact has developed three categories of mechanisms for youth and family participation intended to support the evolution of youth and family involvement. Involvement Category 1 This category of involvement supports and encourages youth and family members to be champions and advocate for children with mental health needs. It includes joining work groups, public speaking, attending conferences, attending or co-facilitating learning opportunities and reviewing materials and processes to ensure they are in youth- and family-friendly language and formats. Involvement Category 2 This category of involvement includes service delivery by family members and/or youth through funded positions, including the Family Advocate Support program, parent mentors and data collection and evaluation.
“They were a lifeline to me because I had gotten to the point of giving up; I was so stressed out. You don’t know what you can do for yourself. They showed me my voice was important and to share my voice in such a way that people would listen.” – Impact parent
Involvement Category 3
LADDER OF CAREGIVER PARTICIPATION
This category of involvement gives youth and family members opportunities with partner agencies – Ingham County Department of Human Services, Ingham County Circuit Court Family Division, Community Mental Health Clinton-Eaton-Ingham and the Association for Children’s Mental Health.
Outcome 4 Increased participation of families and youth in the development of the System of Care.
APRIL 2010 SHINING STAR WINNER
Nate Gundrum Juvenile Court Officer, Ingham County Circuit Court Family Division
“Having (Ingham County) youth, their families, Community Mental Health, Department of Human Services and the Circuit Court Family Division all working together to find realistic solutions to youth behavior is fantastic.” - Rebecca Bahar-Cook, Ingham County Commissioner
Outcome 5 A unified, family-driven, youthguided and culturally and linguistically competent system of care for children with SED.
MAY 2010 SHINING STAR WINNER
85% 81% 77% 69%
67%
Moniqua Chaffin
82%
Client Service Specialist, Wraparound
75%
65%
“I HELPED CHOOSE MY CHILD’S SERVICES.”
Percentage of youth and caregivers who say they agree or strongly agree that they are satisfied with services received.
67% 71% 70% 89%
“I HELPED CHOOSE MY SERVICES.”
Satisfaction with Impact System of Care services remains very high, especially among caregivers.
43% 27% 60% 40%
6 mo. 12 mo. 18 mo. 24 mo.
Source: Longitudinal Outcome Study
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Percentage of caregivers and youth who say they agree or strongly agree. Source: Longitudinal Outcome Study
The proportion of caregivers and youth who believe that they have been treated with respect is very high. youth
78%
caregivers
91%
80%
6 Months
90%
91%
97%
12 Months
85%
18 Months
89% 24 Months
The percentage of youth and caregivers who agree or strongly agree that providers treated them with respect. This information from the Longitudinal Outcome Study is an important measure of Impact’s unified, family-driven, youth-guided, and culturally and linguistically competent system of care. “We’ve always been treated with respect (by the Child and Family Team). It is not pity, not judgment; it is respect and it is admiration. They often say, ‘Keep doing the good work. You have a hard job and it is obvious you are working hard at it.’ It is really clear that they care about our kids and our family.” —Impact parent
JUNE 2010 SHINING STAR WINNER
Leon Williams Juvenile Court Officer, Ingham County Circuit Court Family Division “I believe it is fundamentally important that our Ingham County Impact team continues to be a local and national leader in developing and implementing a culturally and linguistically competent System of Care to ensure that the rainbow of families we serve are provided the very best tools and support available to help foster success for them. Our Impact System of Care team always makes Ingham County proud of the excellent work that it does.” - Debbie De Leon, Ingham County Commissioner
IMPACT VALUES
Y O U TH - G U I D E D FA MI LY- D R I VE N A C C ES S I BL E A ND H I G H - Q U A L I TY S E R VI C ES I ND I VI D U A L I ZED C A R E C O O R D I NATE D C A RE C O L L A BO RATI VE C A RE C U LTU R A L LY A ND L I NG U I S TI C A L LY C O MPE TENT S ERVI C E S Outcome 5 A unified, family-driven, youth-guided and culturally and linguistically competent system of care for children with SED.
The University of South Florida and Michigan State University recently completed a study of Impact’s Family Guidance Service (FGS) that deemed the home-based model ready for replication in other Michigan communities.
A Replication Guide for the Family Guidance Model of HomeBased Services was published in August and will be used for statewide training by the Impact Learning Center.
“The results of the evaluation confirmed our initial impressions that the home-based services program was indeed an excellent program with a strong theory of change and set of values, with a highly cohesive and skilled team, and with a structure and treatment model that yielded positive results for children and youth with very challenging problems, and their families,” Robert Friedman, Ph.D., and three other guide authors wrote in the preface. “We were particularly impressed by the strong support for the program expressed by diverse stakeholders, including youth, parents, and staff from various agencies, and by the strength-based approach used by the program.”
Friedman is co-author with Beth Stroul of “A System of Care for Children and Youth with Severe Emotional Disturbances,” a monograph on Systems of Care which has been widely used across the country to plan service-delivery systems.
“When staffs [from different partner agencies] are gathered together, you can’t tell who works for whom—it appears seamless.” – Bob Sheehan, Executive Director, Community Mental Health Authority of Clinton, Eaton and Ingham counties
JULY 2010 SHINING STAR WINNER
Ted Sinnaeve Senior Mental Health Therapist, Community Mental Health
Impact Family Guidance Service is a model for home-based support.
WHO FUNDS THE SOC LOCALLY? CEI–Community Mental Health Ingham County Department of Human Services Ingham County Circuit Court–Family Division
Cross-agency collaboration activities focus on rich learning opportunities The Impact Learning Community offers training and consultation in areas that promote best practices, with the goal of improving outcomes for youth and families receiving services. Midmanagers of partner agencies meet monthly for the Managers’ Luncheon to develop crossagency relationships and discuss collaborative work and problem solving. Monthly Front-Line Staff Luncheons also promote cross-agency relations and allow for networking and collegial conversation.
A third cultural proficiency training module was added this year to address agency culture and rapport building with families. Staff and family members serve as facilitators for the three training modules. Other learning opportunities offered by the Learning Community are strength-based training, change management and a Michigan Leadership Institute.
Outcome 5
“O to rg th ge an in e f the izat i te a r io – n m res mil to ns Ju in ts y W s d w aid com Co rap tin .” of ith in t he th g H m a Ta Se eal mu rou te, fa e m rv th ni nd ily ic C ty F es hi M a ld e cil re nt ita n’ al to s r,
r, ce it ffi rcu t O Ci on ur ty isi Co un Div le o y ni C il ve am am Ju gh t F In our C
al lf am ili e co r Ju s.” – m eso “Ne ve C mu ur tw ni hr ni ce o le is ty s rk In Co tine he in t of gh u r S lp he Fa Ci am t O aye ing m rcu C ffi rs ily it ou ce , D Co nty r, iv u isi rt on
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as g )h tin ct d ea pa an t tr s (Im le o es s, ab n in ng ar pt am bus isti t x ur ye e I c . o ac ce ing n e Co tw re ur do f a ty st o so f o .” pu nty pa m re y o re ss e u e e a ad wa mo ine , D Co sion s w i th e n om r w is bu slo ham Div “I c sp e it be ide a n re; ing Win Ing ily w as o do n r, m it ym of ree ato t Fa an y u tr ur s a a w M ini Co – t dm i A ircu C
W he th I e as m, mp n a re sis ca ac ske lie ta re t m d f n g e w Im th p alo and ce, ive an ha er ac n n gu rs s t t e t m e. o id sa o to Y t a i h ea ou fe nc d fo elp nt th elin e, r t a pe sa g he nd op id ir h le fa el m p ily .
0 01 ar t 2 St us g ug in r A in ne Sh in W
s fit r ne he be get the l he to at ve .” f t ng s – r le aff r, s o ki el e st o t es or lev nag ine irec rity a tl o m en w ll ar of a -m n D th a w e at le ro es u gh f c “A valu ed idd ng rvi th A n-In v l d ro , m mo Se ea to an mp vel d a n’s l H -Ea s i ’ le an ldre nta ton ha ors hi e lin ct ,C yM C re ay it di W un Al mm Co –
he y l t tl al en als gs nd go rin pe lar s.” t b de mi da ha in si en s t rk on ag es wo s al f, , oc at cu u kie ist pr th fo ivid -S ap m s to d an er ea em er f in rm Th tal “T st th o e h sy ge ad l Ba alt en ’s e yM n to te e H e s h in ac tal nit ildr u R – en m Ch M om lth s C a ce e H ervi S
Outcome 6 Increased community knowledge of the System of Care and decreased stigma.
“Impact System of Care is a nationally recognized partnership that provides complete services for children and families by coordinating child service organizations, teachers, communities and much more. My colleagues on the Board of Commissioners and I are proud to support this valuable program!” — Dale Copedge, Ingham County Commissioner
SEPTEMBER 2010 SHINING STAR WINNER
Liz Evans
Client Service Specialist, Wraparound
“Impact’s commitment from community stakeholders, coupled with its strong leadership and commitment to system of care values, clearly points to the probability of continued success beyond the term of the Federal (grant),”
– Gary Blau, Ph.D., chief of the Child, Adolescent and Family Branch, said in the letter that accompanied the Substance Abuse and Mental Health Services Administration (SAMHSA) site-visit report.
“What Impact has done for Ingham County is phenomenal. The fact that Impact helps the whole family right here in the community is a healthier option for far, far less money per day with far better outcomes.” —Deb Nolan, Ingham County Commissioner
Impact provides youth and families with a variety of opportunities to participate in and make decisions about their care. The Impact website and the following meetings provide valuable resources:
Opportunities for Youth and Family Involvement
OCTOBER 2009 SHINING STAR WINNER
Kristin Mikesel Caseworker, Ingham County Department of Human Services
Speak Your Mind A monthly forum for youth to share experiences and make their voices heard. It is for high school-aged teens who are, or have been, involved in mental health, special education, juvenile justice or child welfare services. Speak Up, Speak Out Impact youth share their stories through their youth speaker’s bureau. They meet regularly to hone their publicspeaking skills and prepare for speaking engagements. Family Council Parents, grandparents, aunts, uncles, adoptive parents, foster parents and other caregivers meet every two weeks to provide one another support, encouragement, resources and connection. The council also provides a forum for letting the child-serving agencies that make up Impact know what is working well and what needs improvement.
Federal site visit results in high praise The site-visit team commended Impact leadership for having: •
Community stakeholders who are highly committed to the success of the initiative;
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Decentralized planning that has resulted in greater specificity and accountability; and
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Family members and youth who assist in the decision-making throughout all aspects of the System of Care;
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A structure that is understood by all System of Care participants.
Impact was started with a six-year SAMHSA grant in 2005. Federal representatives visit periodically to track the progress of the initiative. The report was based on the October 2009 visit. The site-visit team observed Impact work group meetings and held discussions with Impact families, youth, staff and community partners. Team members also attended the annual Report to the Community luncheon.
Impact receives national recognition
Technical Assistance Partnership certificate of appreciation For providing leadership and technical assistance to other communities as they develop their own Systems of Care.
Silver Achievement Excellence in Community Communications and Outreach (ECCO) Award For internal communications, including Impact’s orientation video, redesigned brochure and newsletter and the 2009 Report to the Community. The orientation video and other materials may be viewed at impactsystemofcare.org.
Bronze Honoring Excellence in Evaluation (HEE) Award For data use and dissemination in the development of the Impact family orientation video.
“Impact continues to make great strides and has emerged as a leader in Michigan as well as in the nation,” Bethanie Parrish, project officer, from Substance Abuse and Mental Health Services Administration (SAMHSA) sitevisit report.
Happy holidays to all of our Impact System of Care partners.
Outcome 1 Maximized functioning of children with SED and their families. “Impact’s results are much better than those for the average youth referred for SED services in Michigan. The average Impact youth has statistically significant improvement.” – Kay Hodges, Ph.D., author of the CAFAS tool
Outcome 2 Reduced need for out-of-home placements. “Impact has been a successful partnership for our youth and families in Ingham County and has helped to reduce our residential/outof-home placements by meeting the needs of youth in their own home and community.” – William Collette, Chief Judge, Ingham County Circuit Court
THIS ANNUAL REPORT TO THE COMMUNITY PROVIDES AN OVERVIEW
Outcome 3 Efficient use of resources. “While there is a financial benefit, the real benefit is to the families because we are keeping so many more children at home.”
OF PROGRESS TOWARD THE INITIATIVE’S SIX OUTCOMES.
– Randy Rauch, Ingham County Department of Human Services Director
Outcome 4 Increased participation of families and youth in the development of the system. “They showed me my voice was important and to share my voice in such a way that people would listen.” – Impact parent
Outcome 5 A unified, family driven, youth guided, and culturally and linguistically competent system of care for children with SED and their families. “We’ve always been treated with respect. It is not pity, not judgment; it is respect and it is admiration.” – Impact parent
Outcome 6 Increased community knowledge of the System of Care and decreased stigma. “We were particularly impressed by the strong support for the program expressed by diverse stakeholders, including youth, parents, and staff from various agencies.” – Robert Friedman, Ph.D., Director of the Research and Training Center for Children’s Mental Health at the University of South Florida
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