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Bridging Silos: Building Stronger Systems of Care to Improve Child Outcomes. Grantmakers for Children, Youth and Families Conference October 10, 2012. Bridging Silos: Building Stronger Systems of Care to Improve Child Outcomes. Introductions Why Systems Building? Foundation Case Studies

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bridging silos building stronger systems of care to improve child outcomes

Bridging Silos: Building Stronger Systems of Care to Improve Child Outcomes

Grantmakers for Children, Youth and Families Conference

October 10, 2012

bridging silos building stronger systems of care to improve child outcomes1
Bridging Silos: Building Stronger Systems of Care to Improve Child Outcomes
  • Introductions
  • Why Systems Building?
  • Foundation Case Studies
        • Connecticut
        • Colorado
  • Small-Group Discussion
        • 3-Part Discussion
  • Concluding Comments
introductions
Introductions
  • Judith Meyers
    • President and CEO, The Children’s Fund of Connecticut
  • Deidre Johnson
    • Program Officer, The Colorado Trust
  • Phillip Chung
    • Assistant Director of Research, Evaluation, and Strategic Learning, The Colorado Trust
  • Jennifer Schroeder
    • President, The Implementation Group
why systems building
Why Systems Building?
  • System: “a set of interrelated parts that interact and function together to produce a common outcome” (Coffman & Parker, 2010)
  • Systems building: the process of improving the individual parts, and more importantly, how these parts interact
    • Goal of systems building: improve the continuum of quality care for children and families
the connecticut experience

The Connecticut Experience

Judith Meyers, Ph.D.

President and CEO

Children’s Fund of Connecticut

framework vision of a comprehensive system for children s health
Framework: Vision of a Comprehensive System for Children’s Health

Every child in Connecticut will receive high quality health promotion and prevention services within a family-centered medical home, and will have timely access to community-based services and supports as needed, where needed, to assure optimal development.

children s fund of ct strategies
Children’s Fund of CT: Strategies
  • Develop Framework
  • Fund Communities and Provide TA:
    • Systems Development
      • Community Plans
      • Demonstrations/Replications
    • Practice Change
      • EPIC
      • Workforce Development
  • Research & Dissemination of Findings
  • Policy Reform
child health services building blocks
Child Health Services Building Blocks

Desired Outcomes for School Readiness

.

Family Capacity and Function

Emotional / Social / Cognitive Development

Physical Health & Development

Early Care and Education

Programs

Family Support

Services

.

Care Coordination

Prt C (B-to-3)

Title V

Indicated

Developmental Services

Medical Services

Home –Based Services

Selective

Child

Health

Services

Medical Home

[Accessible, Continuous, Comprehensive, Coordinated,

Family-Centered, Compassionate,

Culturally Effective]

Universal

systems development support for communities
Systems Development:Support for Communities
  • Purpose: Promote full integration of child health in comprehensive community early childhood planning and implementation
    • Grants to communities – Public/Private
    • Provide Technical Assistance
      • Results based accountability frame
      • Information, webinars, intensive support
        • Child Health System Performance
        • Health Related Indicators for School Readiness
        • Inventory of Community Resources resources/
        • How well services are integrated across/embedded in child serving systems
        • Engaging child health provider
        • Accessing and using data
systems development model demonstration replication for key components
Systems Development: Model Demonstration/Replicationfor Key Components
  • Child FIRST (Child and Family Interagency Resource, Support, and Training) - evidence based early childhood home visiting intervention, embedded in a system of care
practice improvement
Practice Improvement
  • Educating Practices in the Community (EPIC)
    • Brings timely information and training to child health professionals to change their practices
    • Sample modules
      • Screening - Developmental/Behavioral Health/Autism
      • Collaborative Health Care
      • Oral health
      • Care Coordination
      • Hearing Loss
  • Early Childhood Mental Health Workforce
    • Infant/toddler mental health competencies
advancing policy reform
Advancing Policy Reform
  • Governance- state and local
  • Standardsthat define quality
  • Research, evaluation and data development
  • Financing sufficient to assure the delivery of high quality programs and practices in a comprehensive manner based on adopted standards; infrastructure support; Medicaid
  • Provider and practitioner support to assure the quality of services and the development of workforce with the capacity to meet the needs (competencies)
  • Public/private partnerships
challenges for funders
Challenges for Funders
  • Collaboration with other funders
  • Lack of alignment across systems
  • Lack of capacity – dollars, experience in systems building
  • Lack of data
  • For rural communities systems change at the local level is difficult to effect without regional collaboration.
  • Engaging health providers
the colorado experience the colorado trust s early childhood health integration strategy

The Colorado Experience: The Colorado Trust’s Early Childhood Health Integration strategy

Deidre Johnson

Program Officer

The Colorado Trust

early childhood health integration
Early Childhood Health Integration

GOAL

To better integrate health

into Colorado’s broader early childhood development system

as a means of improving health outcomes for more than 700,000 children.

colorado early childhood councils
Colorado Early Childhood Councils
  • Introduced in Colorado in 1997
  • Multi-sector partnerships working to coordinate services in local communities:
    • Early Learning
    • Family Support and Parent Education
    • Health
    • Social Emotional and Mental Health
  • Goal: Improve child outcomes by creating a system of care that is more effective and easier for families to navigate.
selected child health outcomes
Selected Child Health Outcomes
  • Access to preventive oral/medical health care
    • Assuring Better Child Health and Development
    • Cavity Free at Three
  • Enrolling children in health insurance
  • Access to a Medical Home approach
  • Immunizations
  • Physicians and dentists accepting Medicaid/CHP+
  • Access to timely, appropriate prenatal care
  • Increased knowledge of the importance of health/wellness
  • Increased number of environments providing early identification and mental health consultation
conceptual framework
Conceptual Framework
  • Context - Improving the political environment that surrounds the system so it produces the policy and funding changes needed to create and sustain it.
  • Components - Establishing high-performance programs and services within the system that produce results for system beneficiaries.
  • Connections - Creating strong and effective linkages across system components that further improve results for system beneficiaries.
  • Infrastructure - Developing the supports systems need to function effectively and with quality.
  • Scale - Ensuring a comprehensive system is available to as many people as possible so it produces broad and inclusive results for system beneficiaries.

~ J. Coffman (2007)

early childhood of la plata county
Early Childhood of La Plata County
  • Developed and implemented the Community Access and Referral Enrollment System (CARES) a sliding fee scale program to increase access to medical, dental and mental health care services by offering discounted care to the underinsured. (www.laplatacares.org)
  • Created an Early Childhood Community Resource Guide – an online, bilingual asset/inventory database of resources available in La Plata County for children from birth to age 8
  • Created a Pediatric Health Care Home Coalition to increase communication and collaboration among medical and non-medical early childhood service providers , decrease duplication and increase early intervention.
phase ii goals
Phase II - Goals
  • Demonstration of effective systems-building activities that further advance health integration accomplishments achieved during the first three years.
  • Active and sustained engagement of health partners.
  • Active and sustained coordination of health integration activities within the Early Childhood Council.
  • Demonstrated planning for sustainability of health integration activities beyond the completion of the Phase II health integration grant.
lessons learned advice for funders
Lessons Learned & Advice for Funders
  • Defining systems, systems building and systems outcomes
  • Dealing with different developmental stages and varying local resources – Grantee readiness
  • Program Implementation vs. Systems-Building
  • Language matters when working across systems
  • Engaging health providers
  • Aligning and collaborating with state level partners
  • Planning and technical assistance – Iterative approach
small group discussion
Small-Group Discussion
  • Part 1 (10 minutes):
    • How integrated vs. silo’d are the systems in the communities you serve?
  • Part 2 (10 minutes):
    • How would you measure success in systems building in the communities you serve?
  • Part 3 (10 minutes):
    • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
    • What are some of the challenges in reaching success indicators?
    • How would you communicate your role in supporting systems building work to both your grantees and your Board?
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part 1 report bac k
Part 1 Report-Back

Part 1:

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part 2 small group discussion
Part 2 Small-Group Discussion

Part 2:

How would you measure success in systems building in the communities you serve?

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part 2 report bac k
Part 2 Report-Back

Part 2:

How would you measure success in systems building in the communities you serve?

part 3 small group discussion
Part 3 Small-Group Discussion

Part 3:

  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?
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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?
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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?
  • Part 2: How would you measure success in systems building in the communities you serve?
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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

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  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?

Part 2: How would you measure success in systems building in the communities you serve?

part 3 report back
Part 3 Report Back

Part 3:

  • As a funder, how can you increase the likelihood the communities you serve will reach the systems building success indicators you described?
  • What are some of the challenges in reaching success indicators?
  • How would you communicate your role in supporting systems building work to both your grantees and your Board?
contact information
Contact Information
  • Judith Meyers, President and CEO of The Children’s Fund of Connecticut ([email protected])
  • Jennifer Schroeder, President, The Implementation Group ([email protected])
  • Deidre Johnson, Program Officer, The Colorado Trust ([email protected])
  • Phillip Chung, Assistant Director of Research, Evaluation and Strategic Learning, The Colorado Trust ([email protected])
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