Interagency Partnerships

1. Interagency Partnerships February 2013

2. Intergency Partnerships: Goals & Strategies • Goals • Healthy development and growth for the children of the Commonwealth • Long term learning success, including reading proficiency for all children by 3rd Grade • Strategies • Establish a coordinated system of care for children and families • Ensure that all state agencies & state agency partners that touch young children & their families have policies and staff that support the healthy growth & development of children • Approaches across agencies • Screening • Cross-agency training • Data sharing

3. Young Children Served by EEC’s Partners • Total number of children under the age of 6 in Massachusetts: 443,000 (2010 U.S. Census) • DCF • Serves 1,300 children <3 y.o. in placement, 1,000 children 3-5 y.o. in placement • Serves 5,300 children <3 y.o. not in placement, 5,200 children 3-5 y.o. not in placement • DHCD currently serving 3,000 children under the age of 6 in its Emergency Assistance (shelter) program • DMH • CBHI conducts avg. of 112,000 behavioral health screenings/yr. for children <3 y.o. • CBHI conducts avg. of 50,000 behavioral health screenings/yr. for children 3-6 y.o. • DPH • Early Intervention providers serve 31,000 children under the age of 3 annually • WIC serves 40,000 infants and 117,000 children ages 1 – 5 annually • Growth and Nutrition Clinics serve 1,000 children birth – 6 annually

4. Race to The Top Early Learning Challenge: Leadership Retreats • 1st Leadership Retreat held 5/14/2012 – “Fulfilling the Promise: Building Strong Inter-Agency Partnerships for the Success of Young Children” • Purpose: Engage state leadership and initiate planning • 55 participants from 16 state agencies • Discussion topics: • Universal engagement of families and communities • Workforce development • Assessment and screening • Strengthening inter-agency data systems. • Outcomes/Recommendations: • Advance cross-agency data sharing by adopting a universal informed consent form • Begin work on creating cross-agency professional development opportunities for staff at state agencies that serve children & families w/ children

5. Race to The Top Early Learning Challenge: Leadership Retreats • 2nd “Fulfilling the Promise” Leadership Retreat held 10/24/2012 • Purpose: Move cross-agency collaboration forward • 46 participants from 16 state agencies • Discussion topics: • Identification of common principles and practices across agencies that are aligned with supporting the positive development of children. • Use of states' early learning standards for child development and learning outcome goals • The role of state services to families and children to support children's growth • Outcomes/recommendations: • Begin creating & rolling out cross-agency professional development opportunities for staff at all partner agencies, starting w/ topics such as brain development & impact of early relationships. • Explore formal connection or joining of EOHHS Family Access/Resource Center initiative with Race to The Top-related work

6. Accomplishments to Date • Planning for cross-agency professional development underway – first 3 training opportunities being developed, rollout begins spring 2013 (DPH, EEC, DCF, DMH, ORI, DHCD & DTA participating in planning process) • DCF and EEC have held three regional meetings bringing together regional & local DCF and EEC staff with Supportive child care providers; State-wide pool of Supportive child care slots now in development • Series of joint trainings held for staff from DHCD’s homeless shelter providers and homeless child care providers

7. Collaboration on Cross-Training • EEC collaborating w/ Dept. of Public Health (DPH), Dept. of Mental Health (DMH), Dept. of Children and Families (DCF), Dept. of Transitional Assistance (DTA) & Office for Refugees and Immigrants (ORI) • Goal: Develop & roll out a suite of professional development opportunities for front-line staff serving young children and their families, so that staff are better equipped to support families’ efforts to help their children develop, learn and grow • Training topics include: • Building Capacity to Support the Early Learning and Development of Massachusetts’ Children • Social and Emotional Competence of Children • Concrete Support in Times of Need

8. Collaboration with DCF: Areas of Focus • Embed early childhood developmental knowledge and support throughout DCF & its networks • Enhance parents’ understanding of their child’s development through access to screening • Enhanced procedures for connecting DCF-served families w/ young children to needed services and supports • Provide access to behavioral health evaluation and services when there are concerns • Improving access to/utilization of Supportive child care

9. Collaboration with DHCD: Areas of Focus • Embed early childhood developmental knowledge and support throughout DHCD and its provider networks, including HomeBASE • Enhance homeless & formerly homeless parents’ understanding of their child’s development through access to screening • Support access to high-quality early education for homeless and formerly homeless families

10. Collaboration with DMH: Areas of Focus • Joint oversight of the Early Childhood Mental Health Program • Expand capacity of the Mass. Child Psychiatry Access Project MCPAP • Provide training and education to EEC licensors, CFCE staff, and CCR&R staff on mental health issues in children: • Recognizing signs of possible mental health issues • Intervention strategies for non-clinical/first responders • Access to specialized community resources

11. Collaboration with DPH: Areas of Focus • Provide leadership & assistance in embedding health guidance and support across multiple programmatic systems • Support creation of universal system of social-emotional screening for children birth – 5 with linkages to community resources • Help child care providers access annual health care practices consultation required by QRIS • Support families & children transitioning from Early Intervention to Special Education

12. Appendix

13. DCF: Key Collaborative Efforts • Race to the Top/Early Learning Challenge Grant • Integrating early childhood development and brain science across DCF programs, policies, practices and professional development • Early Education and Care • Enhancing collaboration with EEC to maximize access to Supportive Child Care • Early Intervention • Automatic referrals to Early Intervention for all children under 3 who are subject of a “supported” allegation of abuse and/or neglect • Family Resource Centers • Joint Procurement with Department of Mental Health • Caring Together • Cross-Over Youth • Collaboration with the Department of Youth Services to improve services to children served within child welfare and juvenile justice

14. DCF A LOOK FORWARD: 2012 – 2015 OUR TRANSFORMATION JOURNEY FOCUSES ON IMPROVEMENTS INNOVATIONS INTEGRATION

15. DCF: Highlights of Improvements & Innovations • Strengthen Basic Core Practices (Home visits, visits with children in foster care, interviewing children) • Managing with Data • Kinship First • Fatherhood Engagement • Placement & Educational Stability • Child & Family Wellbeing • Family Engagement/Family Voice in Policy and Management (Senior staff, management meetings, Area Boards) • Massachusetts Child Trauma Project

16. 2008 – 2011 DCF Accomplishments: Better Responses / Better Results Our RESPONSES are BETTER. • Implemented Integrated Casework Practice Model • Implemented Differential Response • Implemented Short Term Stabilization track • Implemented standardized Risk Assessment Tool • Improved core functions and incorporated innovations • Established Clinical Approaches: Safety Organized, Trauma – Informed, Solution Focused Practices

17. 2008 - 2011 DCF Accomplishments: Better Responses / Better Results Our RESULTS are BETTER. (FY 2011 compared to FY 2009) • Fewer Children in Foster Care – More than 2,000 fewer children in the foster care system • Child Safety – Absence of Repeat Maltreatment improved from 88.6% to 92% • Fewer Child Victims – Fewer Child Victims entering Care 4,662 to 3,406 a 27% decrease • Kinship First – The number of children placed with kin increased from 20% to 26% • Fewer Children in Congregate Care – The number of children in congregate care decreased from 1,769 to 1,510 a 15% decrease • Improved Reunification Rate – A 17% improvement in the number of children entering care within the past twelve months who reunified within 12 months

18. Massachusetts Department of Children and Families: 2011 Demographic Profile 51A Reports 80,875 % Investigations Supported 60% % Initial Assessments with Finding of Concern 45% Average # New Cases per Month 1,361 Average # Cases Closed per Month 1,436 Youth >18 voluntarily Signing back into Care 1,634 Children <18 in Caseload 34,954 Children < 6 12,906 Children 6 >12 10,181 # Clinical Cases 19,390 # Adoption Cases 1,805 Children <18 in Placement 7,355 % of Child Caseload in Placement 21% % < 6 32% % 6 <12 21%

19. How DHCD is Collaborating Across Agencies to Support Education of the Child/Whole Child Development • EEC • Referrals to homeless child care slots for families living in shelters/hotels • Training for shelter and child care providers on developmental needs and risk factors for young homeless children • Ages and Stages Questionnaire training for shelter providers • DPH • F.O.R. Families (Follow-Up Outreach Referral) – Home visiting and service referrals for DHCD-served families living in hotels • DCF outreach and health & safety assessments • Connections made to open cases • Identification of cases where intervention may be needed • ESE – Notification to school departments of families entering hotels with children who are age 2 and older • Horizons for Homeless Children • Playspace Programs in shelters, hotels, local state agency offices

20. DHCD: How Services Provided by and its Provider Network Impact Children • Families with children who face a housing emergency are provided with temporary shelter and stabilization services • Some shelter providers offer parenting classes and other child-focused activities to promote better outcomes for children • DHCD’s Div. of Housing Stabilization (DHS) is working to engage fathers in their children’s development whenever possible

21. DMH’s Collaborative Efforts to Support Education of the Child/Whole Child Development – Existing Initiatives • MCPAP—Massachusetts Child Psychiatry Access Project • Regional children’s mental health consultation teams • Support pediatric practices in meeting the mental health needs of their patients • CBHI—Children's Behavioral Health Initiative • Part of MassHealth, the Commonwealth’s Medicaid program • Specialized behavioral health services for families and their children with significant behavioral, emotional, and mental health needs • Pediatric Screening for mental health has increased from 15% to 67% in 4 years • Department of Children and Families • Consultation for preschool children in supported DCF care • Clinical Consultation by DMH psychiatrists • Connections to mental health systems of care when necessary and appropriate • Design of shared delivery system for residential services to be implemented May, 2013 • Interagency planning & care coordination for challenging youth with serious mental health issues

22. DMH’s Collaborative Efforts to Support Education of the Child/Whole Child Development – NewInitiatives • EEC’s Early Childhood Mental Health Consultation Program • Technical assistance • Program monitoring • Mental Health Training and Consultation • Massachusetts Child Psychiatry Access Project (MCPAP) and CBHI service teams • Trainings for Early Education Program Staff • First series: Statewide training program for preschool teachers Developing skills for working with parents who have mental health and substance abuse issues • EEC’s Coordinated Family and Community Engagement Programs, Child Care Resource and Referral grantees, Licensor’s, and other EEC staff • Statewide Community Crisis Intervention Project • Involving DMH’s PPAL—Professional Parent Advocacy League

23. Young Children (<6 y.o.) Served by DMH • Primary Diagnoses: • Attention Deficit/Hyperactivity Disorder (ADHD) • Post-Traumatic Stress Disorder (PTSD) • Primary Age Range: 4 to 5 y.o. • Primary Services Provided and Supported for Young Children • Child Psychiatry Consultation • Case Management • Individual and Family Flexible Supports to DMH clients and to their siblings, including respite for families • Therapeutic After School Programs • Parent/Professional Advocacy League (PPAL): Group & Educational Forums for Parents • Residential Services (limited)

24. DMH: How DMH Impacts Children • Services and Supports for children with serious emotional disturbance and their families • Practice Improvements and Research and Training at a systemic level • Parent Support to any parent whose child is experiencing mental health challenges • Clinical Consultation to staff at other child serving agencies

25. DMH: MCPAP Phone Consultations with Primary Care Practicioners

26. DMH: CBHI Data CBHI utilization by children 12 and under during FY11 Behavioral Health Screenings for children <13 y.o. 1/1/2008 – 6/30/2011