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State Executive Council Retreat Summary

COMPREHENSIVE SERVICES FOR AT-RISK YOUTH AND FAMILIES ACT
STATE EXECUTIVE COUNCIL
RETREAT
AIRFIELD CONFERENCE CENTER
WAKEFIELD , VA

 APRIL 26-27, 2005

DRAFT SUMMARY

MEMBERS PRESENT: Jane H. Woods, Secretary, Office of Health & Human Resources; Woody Harris, Local Government Representative; David Canada, Local Government Representative; Greg Peters, Private Provider; Lee Goldman, State and Local Advisory Team; Cindi Jones for Patrick Finnerty, Department of Medical Assistance Services; Lelia Hopper, Office of Supreme Court; Vickie Johnson-Scott for Commissioner Anthony Conyers, Jr., Department of Social Services; Jeff Lake for Commissioner Robert Stroube, Department of Health; Doug Cox for Superintendent JoLynne Demary, Department of Education; Tim Howard for Jerrauld C. Jones, Department of Juvenile Justice; and Ray Ratke for Commissioner James Reinhard, Department of Mental Health and Mental Retardation and Substance Abuse Services. (see Attachment 1)

MEMBER ABSENT: Brenda Sookins Wright, Parent Representative

GUESTS PRESENT:

• Trudy Ellis: State and Local Advisory Team - Parent
• Chris Spanos: Virginia Association of Counties (VACo)
• Janet Areson: Virginia Municipal League (VML)
• Anne Smith: Virginia Association of Local Human Services Officials (VALHSO)
• Mike Farley: Virginia Coalition of Private Providers Association (VCOPPA)
• Natalie Elliott: CSA Coordinators Network
• Catherine Hancock: State and Local Advisory Team – DMAS
• Kim Barnes: State and Local Advisory Team – VDH
• Judge Nelson Durden: Juvenile & Domestic Relations District Court – 8 th Judicial District
• Cynthia Cave: State and Local Advisory Team – DOE
• Mike Farley: Virginia Coalition of Private Providers
• James Howard: State and Local Advisory Team – Greene County DSS Director
• Michael Mastropaolo: Court Service Unit – 15 th District
• Shirley Ricks DMHMMRSAS
• Arlene Belfield: Richmond Behavioral Health Authority
• Wayne Turnage: Governor’s Office/DMAS
• Patricia Winter: Western Tidewater Health District
• Therese Wolf: State and Local Advisory Team – DSS
• Kim McGaughey: Office of Comprehensive Services
• Alan Saunders: Office of Comprehensive Services
• Brenda Rivers Office of Comprehensive Services

RESOURCES:

• Jolie Bain Pillsbury: Facilitator, Sherbrooke Consulting, Inc.
• Sheila Pires: Presenter, Human Service Collaborative
• Carol Obrochta: Presenter & Consultant

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DAY ONE - APRIL 26, 2005

WELCOME

The State Executive Council’s (SEC) retreat convened at 1:00 p.m. on April 26. Secretary Woods welcomed and thanked the participants for their continued commitment to the Comprehensive Services Act (CSA). The Secretary spoke via phone, expressing her regret that she was unable to participate due to an emergency, but would attend the second day. Kim McGaughey shared that some of the people who created CSA met at Wakefield many years ago to develop the vision by combining the work of various workgroups comprised of over 200 leaders across the state. Again, we convened a meeting at Wakefield to build upon the accomplishments with CSA over the past few years and to take CSA to the next level.

INTRODUCTIONS & PURPOSE OF RETREAT

Greg Peters introduced the facilitator, Jolie B. Pillsbury (see Attachment 2 ). Greg expressed his appreciation to the Annie E. Casey Foundation for its financial support of the national facilitator and experts. He also recognized the colleagues he worked with on the retreat planning committee (Ray Ratke, Cindi Jones and Kim McGaughey).

Jolie presented the purpose of the retreat which was developed by the planning committee and Secretary Woods. She stressed that the draft SEC’s Mission and Strategic Directions serve as the foundation for the work of the retreat (see Attachment 3 ). The purpose of the retreat was to build on this foundation and for participants to:

Have an increased understanding of:

• Effective strategies used by other states and communities in implementing effective systems of care that are relevant to Virginia ;
• Practical ways to involve families;
• Early data on CSA children & services from the automated data base; and
• Next steps for developing a feasible action plan.

To provide input to the SEC on:

• Mission , vision, and principles of the Comprehensive Services Act (CSA)
• Strategic directions and priorities to achieve the mission of CSA; and
• Roles and contributions to the mission of CSA by the SEC, State and Local Advisory Team (SLAT), and the Office of Comprehensive Services (OCS).

PARTICIPANTS’ DESIRES FROM RETREAT:

The participants introduced themselves giving their names and affiliations. They briefly stated what they hoped to accomplish at the retreat, with some participants including desires for CSA. Some reoccurring themes included: return to the original vision/intent of CSA; increase emphasis on early intervention and prevention; strengthen state and local partnerships; take action; and improve communication (see Attachment 4 ).

PRESENTATIONS

Cindi Jones introduced Sheila Pires and Carol Obrocta (see Attachment 5 and Attachement 6 ). She shared that there were two purposes of this session: 1) to provide participants a common understanding of the systems of care framework with an overview of effective components, particularly those that are relevant to Virginia ; and 2) to keep focused that our work impacts the lives of real children and their families.

Ms. Pires presented “Creating Effective Systems of Care with Families: Lessons Learned Across the Country.” She briefly provided examples of systems of care in a few localities and states with outcomes (Wraparound Milwaukee; the Dawn Project in Marion County Indiana; Mental Health Services Program for Youth in three counties in Massachusetts ; and statewide system in New Jersey). (See Attachment 7) Discussion followed, particularly on the importance of clearly defining the target population which drives all other aspects of the program.

Carol Obrochta shared her experiences as a family member and briefly, her learnings as a professional working with family resource networks across the country.

SHARING “WHAT IS MOST IMPORTANT” AMONG STAKEHOLDERS

Greg Peters introduced the purpose of this session as developing a better understanding of common themes and different perspectives among stakeholder groups on four questions: 1) what we are doing well with CSA and/or in creating a system of care in Virginia; 2) what we need to improve; 3) what impact we want to have for children, families and communities; and 4) what vehicles we want to use to get there. Greg thanked participants who sent in their thoughts before the retreat
(see Attachment 8 ).

Jolie assembled five stakeholder groups: Parents and Private Providers; Departments of Health and Medical Assistance Services; Courts and the Departments of Juvenile Justice and Mental Health, Mental Retardation and Substance Abuse Services; Office of Comprehensive Services and the Department of Social Services; and Local Government and Education. After discussion, the groups then combined into larger groups to share their perspectives on questions. Each group reported out. (See Attachment 9 )

Jolie summarized some common themes that had emerged thus far: 1) more clearly define the target population; 2) implement a consistent system of dedicated case management; 3) focus on basic tenets of law and provide state level policy guidance that is uniform and consistent; 4) take a long term view related to the impact of unserved children as they become adults; 5) value of prevention; 5) importance of including families; 7) importance of data; 8) how to coordinate the development of DMHMRSAS’ systems of care and CSA to strengthen and complement both efforts, rather than creating two parallel systems.

She also summarized some of the outcomes desired by participants: best outcomes for children and families; developing productive adults over the long term; healthy families; keeping children in communities; reducing recidivism across all systems; improving academic achievement; having someone accountable for each child.

INPUT ON MISSION , VISION & PRINCIPLES

Ray Ratke introduced this session as building upon the conversations of other states’ experiences with Ms. Pires and on “what is most important” to CSA stakeholders. The purpose was to provide input to the SEC on its mission, vision and guiding principles by building upon work already done, rather than starting from scratch. The Code provides a strong foundation for CSA’s statutory intent. The SEC now wanted input on its mission statement developed a year ago that it will finetune at its next meeting in June.

Jolie asked participants to review the documents listing the statutory intent for CSA, the SEC’s mission statement, other draft mission statements, and guiding principles that were excerpted from multiple sources: the CSA statute, the SEC’s strategic plan, SEC challenge workgroups reports, OCS’ staff brainstorming, and the national system of care model. The longer version included the specific wording from each entity. (See Attachment 10 ) The shorter version synthesized the themes and eliminated duplication. (See Attachment 11 ) Jolie asked each participant to indicate on the documents those elements they supported, were uncertain about, and with which they disagreed.

DAY TWO – April 27, 2005 - The Session convened at 8:45 a.m.

SUMMARY OF INPUT ON MISSION , VISION & PRINCIPLES

Kim McGaughey briefly summarized findings from the documents submitted by individual participants to provide input to the SEC on mission and principles. Overall, there was widespread support among participants on the overall concepts and many phrases in the documents, with some participants indicating personal preferences for specific phrases. There was only a sprinkling of phrases that multiple people stated they disagreed with:

• The use or placement of the phrase “cost effective” in the SEC’s mission statement– 14 people;
• The SEC to “direct the system of services” in its mission statement - 15 people, with 9 people suggesting “provide leadership;”
• Choice of the words “family-driven” in the principles - 7 people suggested “family-focused” or “family-centered;”
• “Advocacy” for children in the principles – 7 people were uncertain, some participants suggested clarification of advocating “who” and “for what”

CSA CHILDREN, SERVICES & OUTCOMES

Secretary Woods introduced Wayne Turnage, stressing the extraordinary value and long term contributions of the CSA data set. Wayne presented an overview of the “Comprehensive Services Act: Early Data From the Automated Data System.” He presented: the goals and structure of the CSA Data System; information on CSA children, including demographics, source of referral, funding by eligibility category; reasons children come to CSA; risk levels and service patterns; cost of CSA services; preliminary outcomes; and conclusions. (See Attachment 12 ) Extensive discussion followed.

INTERWEAVING THE PROPOSED WORK & IDENTIFYING PRIORITY THEMES

Greg Peters introduced the next session, acknowledging the hard work being done by many groups on ways to improve CSA. The purpose of this session was for participants to reflect on the proposed work and the retreat discussions to identify common themes for the SEC to consider as it prioritizes the work.

Kim McGaughey noted the document “Interweaving the Proposed Work” that listed under major themes the work and recommendations proposed by various groups: the SEC challenge workgroups, General Assembly directives and requests, various study requests, State and Local Advisory Team (SLAT), and the CSA coordinators regional network. Major themes in this document included: family involvement; best practices, technical assistance and training; coordination of policies and practices across child serving agencies; utilization management; continuum of services; funding; state support to ease administrative burdens; data, outcomes and quality improvement; communication; coordination of all state children’s services across agencies; and custody relinquishment. (See Attachment 13 )

Jolie asked participants to break into four groups to discuss the proposed work and identify themes for the SEC to consider as it prioritizes its work. Each group reported out and suggested priority themes (see Attachment 14 ).

After extensive discussion, Jolie observed that many participants in the group wanted to tackle how to define the target population. She suggested that the group was proposing a way to begin tackling the conversation in the future if the SEC chose to do so: 1) gather and analyze the facts on what children the agencies are currently serving by combining data across all the child serving systems; 2) look at the CSA statute and the original legislative intent; 3) do a gap analysis; 4) look at the realities of the agencies; and 5) assess all sources of funding across departments.

Trudi Ellis, SLAT parent representative, offered five suggestions for increasing involvement of family members on various committees: 1) offering meeting times at the beginning or end of the day, or in the evenings; 2) supporting logistics, such as offering child care during the meetings; 3) providing transportation or reimbursement of travel costs; 4) providing training or glossaries describing language used among professional; 5) assigning new family members a mentor whom they may ask questions; and 6) increasing visibility of the need for family participants to serve on committees.

CSA STRUCTURE: GETTING ORGANIZED FOR ACTION

Cindi Jones shared that there was a strong statutory basis for CSA’s infrastructure with the SEC, the Office of Comprehensive Services (OCS) and SLAT. The SEC wanted input on the roles of these entities and how to use them most effectively. OCS provided information on the statutory responsibilities. (See Attachment 15) Jolie asked participants to break into four groups: SEC members, SLAT members, OCS, and key stakeholders. Each group then brainstormed the roles for each of these four groups. (See Attachment 16 )

NEXT STEPS FOR THE SEC

SEC members suggested next steps:

• OCS develops decision briefs from the retreat with options for the SEC to consider at it’s June 15 th meeting
• SEC finalizes mission, vision and principles
• SEC identifies priority themes/strategic directions to address
• SEC charges SLAT and OCS with responsibilities
• OCS proposes action plan to address themes/directions
• Future SEC agendas driven by themes with actions taken at each meeting

The SEC will develop the framework for its action plan at the June ’05 meeting. Participants suggested that the SEC include timelines for tracking accomplishments.

Cyndi Jones, Greg Peters and Ray Ratke thanked the participants for their commitment and passion to CSA as evidenced by the work over the past two days. Ray Ratke thanked Kim McGaughey and Brenda Rivers for their work on the retreat. He thanked Jolie Pillsbury for her skilled facilitation.

The meeting adjourned at 1:30 p.m.

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