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Family Success: Achieving Outcomes by Promoting Accountability. Presenters: Bret Stockton, Director of Business Development Catherine Adams: Business Development Manager. Workshop Overview: Video Introduction Youth Villages’ Overview Increasing Family Accountability

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Presentation Transcript
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Presenters:

Bret Stockton, Director of Business Development

Catherine Adams: Business Development Manager

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Workshop Overview:

Video Introduction

Youth Villages’ Overview

Increasing Family Accountability

Intensive In-Home Services: Intercept

Intercept Outcome Data

Questions/Answers & Discussion

youth villages mission and values
Youth Villages’ Mission and Values

OUR MISSION

Youth Villages helps children and families live successfully.

OUR VALUES

Kids needs come first…Always.

Children are raised best by their families.

We provide a safe place.

We strive to achieve positive, lasting results.

We are committed to our staff.

We are each responsible for providing the highest level of service to our customers.

We constantly improve our performance to achieve excellence.

We create new programs to meet the needs of children, families and the community.

We do what we say we do.

quick facts
Quick Facts

Youth Villages’ Daily Program Census as of 7/31/11

The Youth Villages Specialized Mobile Crisis program in Tennessee received 9,862 calls in FY 2010 and conducted 6,921 face-to-face assessments. Across the state, over 65% of these youth were diverted from hospital placement.

Youth Villages’ Mentoring Program currently has over 325 mentors.

goals of intensive in home services
Goals of Intensive In-Home Services:

Achieve long-term, successful outcomes for youth in the home

Empower families to be accountable to and for their children and to resolve problems independently whenever possible

Ensure services rendered focus on providing families with the resources needed to address current and future mental health and behavioral issues

Reduce the overall cost of services through reduced overall length of stay per youth and treatment in the least restrictive environment

Decrease number of unnecessary out-of-home placements

Prevent disruptions from home-based setting resulting in placement in detention centers or hospitals

Increase the number of youth served by reducing the overall cost per youth

Provide cost effective, successful services to states and localities

Increase service capacity to ensure that all children and families have access to the most appropriate level of service they need

recommendations for promoting accountability
Recommendations for Promoting Accountability:

Before any child is committed to state custody, or if necessary at the moment the child is committed to state custody, families should be assigned an intensive in-home service provider.

States should build in a mechanism to intensely monitor every single child who is entering custody, to ensure that all appropriate efforts are being made to provide the most appropriate service(s).

States should marshal all resources needed to do whatever it takes to resolve family problems so that children can safely stay or return home if at all possible, and monitor to ensure that resources are properly used to their fullest extent.

youth served july 2000 through may 2011 youth served by program
Youth served July 2000 through May 2011Youth Served by Program

Youth may be served in multiple programs.

in home services programs admissions by fiscal year october 1994 through march 2011
In-Home Services ProgramsAdmissions by Fiscal Year October 1994 through March 2011

Youth may have multiple admissions to the program.

* Represents the first three quarters of the fiscal year

Fiscal Year – July 1 to June 30

history of promoting family accountability
History of Promoting Family Accountability

History of providers’ role in promoting accountability: Take responsibility for outcomes

Philosophical change: Seeing families as the solution

Reasons families don’t accept responsibility and accountability: What is the fit?

Role of alignment: Can’t speak about families in the ways that you wouldn’t speak to them

organizational practices for promoting family accountability
Organizational Practices for Promoting Family Accountability

Emphasize our accountability

Describe what accountability looks like for each family, identify what stands in the way of that, then hold ourselves accountable for addressing those things.

Eliminate language like “resistant” or “not ready for change.”  If the family just needed to be told what to do, we wouldn’t be needed.

Often need to do non-traditional things to earn trust and communicate a non-judgmental relationship.

Address alignment as a developmental target with staff.

why treatment in the home is necessary
Why Treatment in the Home is Necessary

Natural Environment - Resolve problems in the natural environment.

Present Focused - Address current behaviors relating to:

Family Peers School Individual Community

“Fit” - Understand the fit.

Family Responsibility - Encourage the family to take responsibility.

Generalization - Develop long-term solutions in the community.

Realistic Setting - Teach youth to function in realistic setting.

Effective Treatment – Treatment based on research is most effective.

Research - Research indicates that restrictive out-of-home placements may do more harm than good.

Engage Entire Family – Need to treat entire family.

intercept program overview
Intercept Program Overview

Youth Villages developed the Intercept Program to serve a broader population of youth and families

Serves youth from infant to age 17

Utilized with a combination of child welfare, mental health, and juvenile justice systems

Currently serving AL, FL, GA, MA, MS, NC, NH, OR, and TN

Ability to divert youth from placement, thus keeping families together safely

Ability and experience in transitioning youth home from out-of-home placements (detention, RTC, acute hospitalizations, foster homes, etc.) even after extended time out-of-home (more than 3 months)

program key components
Program Key Components

Youth Villages' Intercept program offers the following: 

Extremely high levels of staff training and supervision

Intensive services conducted in the child's home and community by a single Intercept family intervention specialist

Caseloads of only 4-5 youth/families per Intercept family intervention specialist

Family sessions conducted 3 times per week

24/7/365 on call support to families

Accountability for success is with the Intercept family intervention specialist and program

program key components cont
Program Key Components (cont.)

Average 4-6 months per case for diversion and up to 6-9 months per case for reunification

Involvement in all systems affecting youth and family

Assistance with concrete needs such as housing, healthcare, and employment

Nurturance of long-term support from extended family and other natural support systems

Masters level counselors preferred or Bachelors level with experience working with target population

ongoing evaluation of cases
OngoingEvaluation of Cases

Daily Updates and Red Flag E-mails

Weekly Individual Counselor Development

Critical Event Reviews

Supervisor field visits

Tape reviews

typical youth referral issues
Typical Youth Referral Issues
  • Youth Villages, Inc.
typical parent referral issues
Typical Parent Referral Issues
  • Youth Villages, Inc.
initial and ongoing communication with key stakeholders
Initial and Ongoing Communication With Key Stakeholders

Community Stakeholders:

Case Managers

Current provider (if applicable to reunification cases)

Agency Staff (child welfare, juvenile justice, and/or mental health)

Court Staff (including Judges, GALs, and POs)

Schools (including teachers, principals, guidance counselors)

Mental Health Centers (including psychiatrists)

Communication includes:

In addition to the youth and family, Youth Villages’ Intercept includes key stakeholders in the assessment and treatment planning process.

Youth Villages provides documentation such as monthly updates, detailed assessments, weekly treatment plans, discharge plans, and safety plans.

Youth Villages provides ongoing updates as often as requested.

intervention targets
Intervention Targets

Identification of the primary risk factors associated with referral problems

Services are all-inclusive

Services are focused on strengths of the family & child

Family Members are full partners in the treatment process

Interventions take place within the multiple systems occurring within the natural ecology

intercept program common interventions
Intercept Program:Common Interventions

Work with family to design and implement an individualized safety plan

Work with family to design and implement an individualized behavior plan

Work with family and support network to design and implement a supervision plan

Work with family to meet basic needs (housing, health care, transportation, employment, etc.

Work with family on how to manage medications

Work with family to increase and utilize their support network

Find respite with extended family or other supports, as necessary

Engage stakeholders, including caseworkers and courts to find appropriate relative/support placements when it is necessary to remove a child from the home

intercept specialist characteristics
Intercept Specialist Characteristics

Total Commitment to Model

Intense

Critical Thinker

Creative

Flexible

Open to High Levels of Supervision

Outcome Driven

how intercept can help
How Intercept Can Help

Diversion

Diversion/Stabilization

Assessments on all youth entering care

Adoption Stabilization

Birth to Four

Reunification

Assessments and intensive family searches

Short-term Reunification

Long-term Reunification

Residential Partnerships

intercept program outcomes
Intercept Program

Outcomes

Youth Served July 2006 through December2010

Includes youth served through the Intercept Program in Alabama, Florida, Georgia, Massachusetts, Mississippi, New Hampshire, Tennessee and Virginia.

outcome evaluation process
Outcome Evaluation Process

Research Dept. led by Dr. Sarah Hurley and 14 full time staff

Follow-up surveys administered to all youth/families who received at least 60 days of Youth Villages’ services (a “full dose”) at 6, 12, and 24 months post-discharge.

intercept program demographics youth served july 2006 through march 2011 n 9 461
Intercept ProgramDemographics Youth served July 2006 through March 2011N = 9,461

Gender

Race/Ethnicity

intercept program presenting issues youth served july 2006 through march 2011 n 9 461
Intercept ProgramPresenting Issues Youth served July 2006 through March 2011N = 9,461

90% of youth have multiple presenting issues.

intercept program history of family difficulties youth served july 2006 through march 2011 n 9 461
Intercept Program History of Family DifficultiesYouth served July 2006 through March 2011 N = 9,461

50% of families have multiple difficulties

intercept program admissions by fiscal year youth served july 2006 through march 2011
Intercept ProgramAdmissions by Fiscal Year Youth served July 2006 through March 2011

Youth may have multiple admissions to the program.

*Represents the first three quarters of the fiscal year

Fiscal Year – July 1 to June 30

intercept program admissions by region youth served july 2006 through march 2011
Intercept ProgramAdmissions by Region Youth served July 2006 through March 2011

Youth may have multiple admissions to the program.

intercept program discharge location youth discharged july 2006 through march 2011 n 7 683
Intercept ProgramDischarge LocationYouth discharged July 2006 through March 2011N = 7,683

Only includes youth who received at least 60 days of service; 16.1% (1,469 out of 9,152) of admissions ended prior to 60 days.

*includes placements such as group homes, runaway, foster care and rehab centers

intercept program parent satisfaction at discharge parents surveyed july 2006 through march 2011
Intercept Program Parent Satisfaction at DischargeParents surveyed July 2006 through March 2011

Note: Figures include only youth who received at least 60 days of service.

intercept program success at follow up follow ups conducted through march 2011
Intercept ProgramSuccess at Follow-upFollow-ups conducted through March 2011

Success is defined as living at home with family or living independently.

Note: Figures include only youth who received at least 60 days of service.

intercept program youth reporting no trouble with the law follow ups conducted through march 2011
Intercept ProgramYouth reporting NO Trouble with the LawFollow-ups conducted through March 2011

Note: Figures include only youth who received at least 60 days of service.

intercept program school status follow ups conducted through march 2011
Intercept ProgramSchool StatusFollow-ups conducted through March 2011

Indicates the number in school, graduated from high school, or in GED classes at the time of follow-up.

Note: Figures include only youth who received at least 60 days of service.

intercept program out of home placements follow ups conducted through march 2011
Intercept ProgramOut of Home PlacementsFollow-ups conducted through March 2011

Note: Figures include only youth who received at least 60 days of service.

intercept program youth in state custody at follow up follow ups conducted through march 2011
Intercept Program Youth in State Custody at Follow-upFollow-ups conducted through March 2011

Nearly a quarter (20.7%) of youth were in state custody during enrollment.

Please note: Most youth in parental custody who are admitted to Intercept are at substantially increased risk of placement into state custody, either through the child welfare or juvenile justice system.

Note: Figures include only youth who received at least 60 days of service.

about our response rates
About our Response Rates

Surveys are conducted by research staff via phone with letter surveys to non-respondents.

Please note: Surveys are completed with youth/families who have discharged from YV services altogether. If a youth re-enters YV services, the survey cycle is reset and begins again at their discharge.

Parent Satisfaction surveys are only conducted with families who were involved in the youth’s treatment.

  • Internet search of public records (Lexis-Nexis) is completed to locate accurate contact information
  • While no consensus exists regarding adequate response rates, 40% - 60% has been identified as appropriate for surveys of this type and size1.
  • Rate of re-entry into YV services: 6-Month Follow-up – 5.3% (334 out of 6,339) 12-Month Follow-up – 9.6% (501 out of 5,211) 24-Month Follow-up – 14.2% (432 out of 3,050)

1PWGSC (Public Works and Government Services Canada). (2008). Advisory Panel on Telephone Public Opinion Survey Quality: Standards and Guidelines for Response Rate.

questions answers discussion
Questions

Answers

Discussion

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Contact Information:

Bret Stockton: 901-338-6097

Bret.Stockton@youthvillages.org

Catherine Adams: 901-283-1728

Catherine.Adams@youthvillages.org