Presented by Denise M. Pietrzak, MSSA, LISW-S Family & Children First Council

1. Service Coordination in Cuyahoga County Presented by Denise M. Pietrzak, MSSA, LISW-S Family & Children First Council

2. What is Service Coordination? • Service Coordination is a process for systems and community providers to assist families with planning, organizing, and linking to services or resources that will meet their child’s and family needs.

3. What is the purpose of Service Coordination? • Service coordination prevents multi-system involved children and their families who may be in crisis from falling between the cracks-due to intake/eligibility or funding barriers.

4. Success Story: Justin • Kids like Justin have complicated needs • 14 years old, stands 6’2”, nearly 200 pounds • lives with maternal grandmother, who works full-time, and step-grandfather • multiple diagnoses: Executive Functioning Autism, ADHD, Bi-Polar Disorder & Obsessive Compulsive Disorder • dealing with the usual teen hormones, plus his disability and mental health concerns • requires 24-hour supervision and at times his behaviors became violent • His family’s quality of life had diminished. His grandparents were locking themselves in their bedroom at night with the family dog in fear that Justin would have a behavioral crisis and harm them while they were sleeping. • Service Coordination Team met about Justin, and coordinated resources from the family members, Cleveland Clinic, Positive Education Program, and Board of Developmental Disabilities: • 30-day residential stay to stabilize him, a mentor to build a positive relationship with him, weekly team meetings to support him, and continuing behavior-management resources in the home

5. Three goals of Service Coordination: • No Wrong Door – Families are identified and linked to the appropriate systems and services no matter what door they enter. • Lead system – A system or community provider is designated as the lead to help families work with all of the members of the team. • Coordinated Plan – Different plans will be coordinated and in sync with each other.

6. Why is Service Coordination Necessary? Some children and families get services from many providers. Service Coordination: • Streamlines services to families • Promotes shared responsibilities • Reinforces collaborative values • Encourages accountability in achieving goals within a parent-driven process • Identifies gaps and barriers in available services and resources • Offers a formalized process with written procedures and establishes a format to resolve questions or conflicts

7. Who Can Benefit from Service Coordination? • Families that are not system involved, but have a need.* • Families who need assistance with navigation to get their needs met across systems. • Families who are experiencing difficulties moving smoothly through the system processes. *There are eligibility criteria for some systems/programs.

8. Who Can Benefit from Service Coordination? (cont) • Families whose wishes differ from what the system is offering. • Families whose needs outweigh the resources of one or more system. • Families who have encountered barriers within or between a system which may impede or disrupt the process. • Families who are having difficulty accessing needed services or supports. • Families who are involved with multiple systems and whose children are at risk of placement outside their home.

9. Service Coordination also helps: • Assist multi-system involved children/youth who are at-risk or recommended for placement • To minimize the use of out of home placements when other alternatives are available. • To maximize cross-system efficiency by utilizing resources to reimburse short term placements. • To assist with needed treatment assessments • To help with stabilization • To help youth transitioning to the community from placement

10. Service Coordination:Can be requested or suggested through: • Your community • Child and family serving public systems of the county • Contacting the Family & Children First Council

11. Service Coordination in Your Community Families who engage with the Neighborhood Resource Specialists are usually families who: • Are not system involved • Have a need that does not warrant system involvement. • Typically has a one-time-only emergency or basic living need, such as an appliance or a rental payment.

12. Service Coordination in Public Systems • Families who present to the systems are generally receiving multiple services from multiple systems. • During their Service Coordination Family Team process, the team may encounter gaps in or barriers to services. • Each of the child-serving public systems has a liaison. The direct service workers or their supervisors or managers can contact the liaison to assist with the resolution of the system gap/barrier so the Service Coordination Family Team can continue to access the resources needed.

13. Service Coordination and Family & Children First Council • Families who present to the FCFC Service Coordination Program Officer are routed to the appropriate community agency or system for assistance.

14. Systems and their Liaisons • Michael Scherer or Linda Torbert, Alcohol, Drug Addiction & Mental Health Services Board of Cuyahoga County • SCT child system utilization gatekeepers • Maura Coyne Lipinski, PEP Connections- Mental Health • Maureen Dee, Catholic Charities- Alcohol and Drug • Adrienne Waugh, Cuyahoga County Employment and Family Services • Eugenia Cash, Cleveland Metropolitan School District • Kerry McAllester, Cuyahoga County Board of Developmental Disabilities • Mary Denihan, Child Support Enforcement Agency • Arlyce Nichols, Department of Children and Family Services • Lori Mago, Help Me Grow • Van Ward, Juvenile Court • Bonita-Rosalyne McKay, Starting Point • Karen Ols, Tapestry System of Care Revised 05/2011

15. Role of the Liaison • Assist in the development of internal procedures needed to implement the Service Coordination Plan (SCP), and in training staff to participate in cross-system activities. • Liaisons provide an internal interpretation to agency staff regarding the SCP and the collaborative process. • Liaisons work with System Executives, and other staff as appropriate, to keep them informed about the progress, problems, and issues arising from SCP implementation. .

16. Role of the Liaison (cont.) • The contact point in one’s own system to resolve cross-system issues related to individual cases. • Assist supervisors/staff who are having problems accessing services from another system; initiate contact with liaison (s) in other systems. • Work with other system liaisons to resolve multi-system issues that have not been resolved at the direct service worker or supervisory levels. • Serve as consultant to the case planning process in an emergency. • Advise family teams about their system’s service continuum for short or long-term care.

17. Role of the Liaison (cont.) • Assist with navigation and linkage between the liaisons and staff from other systems. • Liaisons facilitate access to resources within their own systems as appropriate • Attend regularly scheduled Service Coordination Team Liaison meetings and participate in the functions of the Service Coordination Team.

18. Role of the Liaison (cont.) • The liaison’s position is a unique position within each of the systems. • Liaisons do not provide direct services to children or families. • They float in and out of existing family teams to assist staff from their own system to overcome barriers or resolve problems that are preventing the team from moving forward.

19. Service Coordination in Cuyahoga County • Each county in Ohio is responsible for developing its own Service Coordination mechanism. • The Service Coordination process differs among counties throughout Ohio. • In Cuyahoga County, Service Coordination is NOT: • A regularly scheduled meeting of all system representatives to review cases and allocate funding for children recommended for residential treatment. • A funding source for residential placements. • A mechanism to insure families are meeting system expectations.

20. Service Coordination in Cuyahoga County • In Cuyahoga County Service Coordination is a family-driven process designed to bring services and supports to children and families in a manner that includes family participation at every level.

21. For more information: Denise M. Pietrzak, MSSA, LISW-S Program Officer 4 Family & Children First Council Office: 216-443-6115 Fax: 216-698-2870 dpietrzak@cuyahogacounty.us