Transformation Through Family-Driven Care

1. Transformation Through Family-Driven Care Presenters: Renee Becker, Family Liaison Riverside County Department of Mental Health, Children’s Services Pam Hawkins, Program Director Advocacy Program United Advocates for Children of California

2. Why do we Need a Definition of Family-Driven Care? • The President’s New Freedom Commission Report Achieving the Promise: Transforming Mental Health in America • Goal 2: Mental Health Care is Consumer and Family Driven • The Mental Health Services Act • Mental Health Services Act Community Services and Supports: Three-Year Program and Expenditure Plan

3. President’s New Freedom Commission ReportGoal 2: Mental Health Care Is Consumer and Family Driven Recommendations • Individualized plan of care. • Involve consumers and families fully in orienting the system toward recovery. • Align Federal programs to improve access and accountability. • Comprehensive State Mental Health Plan. • Protect and enhance rights.

4. MHSAEssential Elements for All Three-Year Program and Expenditure Plans • Client/family driven mental health system for older adults, adults and transition age youth and family driven system of care for children and youth.

5. Why Transform ThroughFamily-Driven Care? • Families know what works for them; • Families know what their limitations are; • Families can keep track of services and change; and • Family and youth comfort and buy-in are necessary for success. Families and youth are the catalyst for transformation because:

6. Why Transform throughFamily-Driven Care? • Family experience is holistic; • Families face the challenges all day and every day; • Families are passionate and will not give up; • Families have credibility; and • Family-Driven Care is culturally competent

7. Developing the Definition forFamily-Driven Care • Steps in the California process. • Steps in the National process.

8. Steps in the California Process • In 2002, United Advocates for Children of California and California Mental Health Advocates for Children and Youth attempted to create a single set of concrete operational definitions for the core values of CSOC. • The purpose was to decrease the significant variance in actual practice that exists across California counties. • California defined family-driven care by implementing a participatory process that was inclusive of a broad-based stakeholder group including youth, family members, advocates, private providers and county providers and administrators.

9. Steps in the National Process • In 2004, the Federation of Families for Children’s Mental Health in collaboration with the Child, Adolescent and Family Branch CMHS/SAMHSA • Development of an expert professional and family panel – culturally diverse, different perspectives, and geographically distributed. • Interviews with recognized leaders in the family movement. • Open forum discussions held at Training Institutes. • Literature review. • Feedback solicited from system of care communities and family-run organizations.

10. National Definition of Family-Driven Care(Federation of Families for Children’s Mental Health) Family-Driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes: • Choosing supports, services, and providers; • Setting goals; • Designing and implementing programs; • Monitoring outcomes; and • Determining the effectiveness of all efforts to promote the mental health and well being of children and youth.

11. 10 Guiding Principles of Family-Driven Care(Federation of Families for Children’s Mental Health) • Families and youth are given accurate, understandable, and complete information necessary to make choices for improved planning for individual children and their families. • Families and youth embrace the concept of sharing decision-making and responsibility for outcomes with providers. • Families and youth are organized to collectively use their knowledge and skills as a force for systems transformation.

12. 10 Guiding Principles ofFamily-Driven Care(Federation of Families for Children’s Mental Health) • Families and family-run organizations engage in peer support activities to reduce isolation, gather and disseminate information, and strengthen the family voice. • Providers embrace the concept of sharing decision-making authority and responsibility for outcomes with families and youth. • Providers take the initiative to change practice from provider-driven to family-driven.

13. 10 Guiding Principles of Family-Driven Care(Federation of Families for Children's Mental Health) • Administrators allocate staff, training, support, and resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and families. • Community attitude change efforts focus on removing barriers and discrimination created by stigma. • Communities embrace, value, and celebrate the diverse cultures of their children, youth, and families. • Everyone who connects with children, youth, and families continually advance their cultural and linguistic responsiveness as the population served changes.

14. 7 Characteristics of Family-Driven Care(Federation of Families for Children’s Mental Health) • Family and youth experiences, their visions and goals, their perceptions of strengths and needs, and their guidance about what will make them comfortable steer decision making about all aspects of service and system design, operation, and evaluation. • Family-run organizations receive resources and funds to support and sustain the infrastructure that is essential to insure an independent family voice in their communities, states, tribes, territories, and the nation.

15. 7 Characteristics of Family-Driven Care(Federation of Families for Children’s Mental Health) • Meetings and service provision happen in culturally and linguistically competent environments where family and youth voices are heard and valued, everyone is respected and trusted, and it is safe for everyone to speak honestly. • Administrators and staff actively demonstrate their partnerships with all families and youth by sharing power, resources, authority, responsibility, and control with them.

16. 7 Characteristics of Family-Driven Care(Federation of Families for Children’s Mental Health) • Families and youth have access to useful, usable, and understandable information and data, as well as sound professional expertise so they have good information to make decisions. • Funding mechanisms allow families and youth to have choices. • All Children, youth, and families have a biological, adoptive, foster, or surrogate family voice advocating on their behalf.

17. Creating the Conditions Necessary for Transformation to Family-Driven Care • Youth and their families receive training on accurate, understandable, and complete information to make informed decisions and treatment choices for improvement in individual care plans. • Providers receive training to change practice modalities to family-driven care. • Administrators allocate staff, training, and support resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and their families.

18. Creating the Conditions Necessary for Transformation to Family-Driven Care • Families and youth take the risk of embracing the concept of sharing decision-making and responsibility for outcomes with providers. • Providers take the risk of embracing the concept of sharing decision-making and responsibility with youth and their families.

19. Creating the Conditions Necessary for Transformation to Family-Driven Care • Families and youth organize to collectively use their knowledge and skills toward transformation for systems change. • Peer support reduces isolation and strengthens family and youth voice. • Change in community attitude removes barriers created by stigma.

20. Support Transformation! • View the change process differently; • Act and interact in new ways; • Feel comfortable with the process of change; and • Own and believe in a new way of working together

21. For more Information: • Renee Becker, Family Liaison • Riverside County Department of Mental Health Children’s Services 9707 Magnolia Avenue Riverside, CA 92503-3609 (951) 358-6858 rbecker@co.riverside.ca.us • Pam Hawkins, Program Director • United Advocates for Children of California Advocacy Program 1401 El Camino Avenue, Suite 340 Sacramento, CA 95815 (916) 643-1534 hawkinsp@uacc4families.org