Transcript Southern Region Substance Abuse and Mental

A Successful Approach to Family
Care and Collaboration
Patricia “Shannen” Davis, MSW, CAP (SPI)
Silvia Quintana, LMHC (DCF)
Islem Pardinas, MSW (Our Kids)
Larry Allen, LCSW, MBA(SFBHN)
 To
prevent and divert children from entering
the Dependency System.
 To assess family needs in an effort to
promote wellness.
 To engage families in accepting community
services.
Referral Sources
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Child Protective Services
Family Intervention
Specialist
Our Kids Intake
Providers
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Substance Abuse
Treatment Providers
Mental Health Treatment
Providers
Co-occurring Treatment
providers
Dependency Full case
management agencies
Domestic Violence
providers
Infant Mental Health
Provider
Safe at Home/Parents as
Partners/ Family
Empowerment Program
 The
following services are co-located at the
DCF Service Centers:
100 Opa Locka Blvd. Miami, FL
401 NW 2nd Ave. Miami, FL
12195 Quail Roost Drive, Miami, FL
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Child Protective Investigation (CPI)
Family Intervention Specialist (FIS)
Our Kids Intake (OK)
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On August 1, 2008, The Family Intervention
(FIS) Program operated by Spectrum was
embedded within each of the CPI locations
North, Central and South as was intended by
the legislators when the positions were
authorized.
The FIS program also adopted the best
practice model approved by SAMHSA called
Screening Brief Intervention Referral and
Treatment (SBIRT) that incorporates
Motivational Interviewing as part of the
engagement techniques.
Call comes into the Hot Line where CPI
suspects Substance Abuse and/or Mental
Health need for services
CPI will contact FIS if suspected substance
abuse or mental health are identified in the
family.
FIS will make contact with family within 72
hours for assessment. FIS makes referrals to
the community and SAMH system of care as
appropriate.
 Total
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individuals assessed: 5,525
Parents: 3126
Kids: 2399
 Families
Assessed: 1,512
 24% of Parents assessed received a positive
drug screen
 24% of Parents referred needed Services
100.0%
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
n=748 Average LOS: 38 days
Needed Services
Referred to
Who have
Provider and had treatment service
appointment
in SFBHN**
**Note: This data reflects only those individuals who received
services through SFBHN funding. If other services were received
through any other funding source, this data is not reflected here.
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If based on GAIN, drug/alcohol test, and
client interview no services are needed FIS
reports findings to CPI.
If Services are needed:
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FIS continues to assess, engage, and link the
family to services
FIS reports weekly to CPI on status of family and
referrals
FIS provides results on ongoing engagement to
CPI at the end of 21 days including recommended
services and linkage status to providers.
 FIS,
Child Protective Investigator, Child
Protective Investigator Supervisor, Our Kids,
Children Legal Services will staff case as
needed.
 FIS and Our Kids full case management
agency if warranted will continue to engage
and transition family into case management
and other SAMH provider services.
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Spectrum Program is the FIS provider. They
have been trained and use:
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Screening, Brief Intervention Referral and
Treatment Model (SBIRT)
Motivational Interviewing
Solution Focused Case Management
Global Assessment of Individual Needs (GAIN)
Quick
Family Centered Practices being used by CPI,
FIS and OK are: Structured Decision Making
and Trauma Informed Care
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Mental Health Services
Substance Abuse Services
Domestic Violence- Victim or Perpetrator
Children’s Mental Health
Full Case Management
Crisis Intervention
Intensive in-home services
Other Community Services
 Quarterly
staffing focuses on persons who
have dropped out of treatment, appropriate
levels of care, appropriateness of referral
and is really an in depth qualitative review
from hotline to termination of supervision.
 Quarterly meetings at the hubs focus on
system issues as well as provide updated
educational information.
 South
Florida Behavioral Health Network,
SAMH, Our Kids, DCF/CPI units, will be
responsible for Data tracking.
 Data collected includes: Referral, linking,
treatment completion, drop out from
treatment, recidivism rate, referrals to
dependency court.
 The
Southern Region’s Substance Abuse and
Mental Health (SAMH) Program Office
entered into a contract with South Florida
Behavioral Health Network on October 1,
2010 to oversee the Substance Abuse and
Mental Health System of Care.
 System
of Care development and
management
 Utilization Management
 Network Management and sub contractual
relations
 Continuous Quality Improvement
 Technical Assistance and Training
 Data Collection Reporting and Analysis
 Planning
Acute
Treatment
Support
Services
• Detoxification
• Crisis Stabilization
• Addiction Receiving Facilities
• Outpatient
• Intensive Outpatient
• In Home-On Site
• Residential
• Comprehensive Community Service Teams
(CCST)
• Wraparound (Flexible Funds)
• Clubhouses
• Drop-In Centers
 Lead
CBC for Miami Dade and Monroe County
 System of Care development and
management
 Utilization Management and Continuous
Quality Improvement
 Network Management and sub contractual
relations
 Technical Assistance and Training
 Planning
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Dependency Full Case Management service for all case
through 6 Community Providers
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Intake
Foster Care Placement and Licensing
Shelter and Residential Group Care
Level of care assessments
Nurse Case management
Adoptions
Independent Living services
Intensive in-home family preservation services through two
program Safe at Home and Parents as Partners for High
Risk Families where there are safety threats
Case Management through Family Empowerment Program
for moderate to low risk families
Since 2009 Our Kids is using Children’s Research Center’s
Evidence Based structured Decision Making Tool to guide
all service decision.
3500
3000
Number of Children
2500
2000
Family Empowerment
Program
1,446
1500
1000
Court-InParents As Partners
537
1,389
Relative/Non392
Safe At Home
473
Licensed
596
Family Preservation (n=3,308)
Court (n=1,525)
500
0
For purposes of this analysis, cases from other
states and counties (ICPC and OTI) were excluded.
7/27/2011
 Prevention
 Diversion
Services
Services
 Dependency
 If
a family is at risk of becoming involved
with the Dependency System and could
benefit from services based on assessment
and recommendations, referrals will be made
to SAMH providers and other community
providers as needed.
 If
a family is found to need SAMH/CW
services and CPI finds that there are some
risk factors, staffing will be held between
Our Kids intake, CPI, CPIS, CLS and FIS.
 Service recommendations will be made in an
effort to divert the family from the
Dependency System.
 If
a family is found to be at risk and diversion
is not an option the CPI,CPIS, FIS, Our Kids
Intake, CLS will staff the case and make
appropriate treatment and services
recommendation based on assessment as the
case is moved to the Dependency System.
Reporter
Family Intervention Specialists / SAMH Process Map (DRAFT- REVISED as of 11/10/2009)
Call to the Hotline
Hotline
See Prevention
Referral Procedures
Receive and
Process the call
Assess the call
Assign to
Respective
Region
Accept
Substance Abuse
and Mental Health
Providers
Our Kids Inc.
Family Intervention
Specialist (FIS)
Child Protective
Investigations Serv.
Centers
Southern Region
Reject
Accept the report
CPI will continue with
the investigation.
Assign to the
Service Center
NO
NO
Receive and
determine if
SAMH/ FIS
services are
needed
If SAMH/FIS
services are
need
YES
See CPI Process
Map
Complete referral
and submit to FIS
CPI & FIS go
out on the
investigation.
FIS complete
assessment
(GAIN Q)
& drug screen
NO
Is FIS
available
Receive the
referral
YES
assessment (GAIN Q)
& drug screen within 72 hrs
Engage & link
family to service
for 21 days from
the day of referral
If services are
not needed
based on
assessment
(GAIN Q)
Receive status
report from FIS
Receive assessment
and recommendation
report from FIS at the
end of 21 days
YES
For prevention,
diversion and
dependency
cases a
staffing will be
held between
CPI, CPIS,
FIS, and OK
for appropriate
services as
needed
OK will receive
referral to provide
prevention or
diversion services
Provide CPI
with weekly
report on
status of case
Complete assessment
with treatment
recommendations &
status of Family. Submit
to CPI & O.K. (if
applicable) at the end of
21 days
Receive assessment
and recommendation
report from FIS at the
end of 21 days, if
applicable
See CPI Process
Map
CPI and OK staffing to
determine services
recommendations and if
family is engaged in
developing a service plan.
Case is
closed within
60 days by
CPI and FIS
FIS & OK will
continue to
engage &
transition family to
In-Home case
management
services
CPI, FIS, and OK staffing to
determine services
recommendations and if
family is engaged in
developing a service plan
Continue providing
services to family
(mental health,
substance abuse,
domestic violence,
and other services
as needed)
If family YES
drops out of
treatment and
refuse
additional care
NO
OK and
SAMH
provider
will notify
CPI
Treatment and
services are
completed
Narrowing front door
Revision of protocol
Developing a plan to mine data from
FSFN, Medicaid, SFBHN, and Our Kids
databases for Adults and Children