The Technical Assistance Network for Childrens Behavioral Health (TA Network)

TANetwork@ssw.umaryland.edu January 9, 2014

HSC Human Service Collaborative

Accountability Solutions, LLC

Comprehensive Community Mental Health Services for Children and Their Families Program: Program Partners
The Technical Assistance Network for Childrens Behavioral Health The TA Network (The Institute for Innovation & Implementation at the University of Maryland, School of Social Work, [i.e. The Institute]) National Technical Assistance Center for Childrens Mental Health at Georgetown University (Georgetown National TA Center) National Indian Child Welfare Association (NICWA) ICF International (ICF Macro) Westat Caring for Every Childs Mental Health Campaign Technical Assistance Team (Vanguard and NASMHPD) The Research and Training Center for Pathways to Positive Futures: Supporting Successful Transitions for Youth and Young Adults with Serious Mental Health Conditions The Learning and Working During the Transition to Adulthood Research and Training Center

The TA Networks mission is to develop effective service systems and establish a skilled and wellprepared workforce that can expand and sustain community-based systems of care across the United States to benefit all children and youth with behavioral health needs and their families.

Introducing the TA Network

The Institute is the lead entity on a contract from the Substance Abuse and Mental Health Services Administration (SAMHSA) to establish and maintain the Technical Assistance Network for Childrens Behavioral Health, or The TA Network Partnership among University of Maryland Baltimore, School of Social Work (UMB SSW) and 10 other universities and organizations The TA Network provides technical assistance to the Child, Adolescent, and Families Branch (CAFB) of SAMHSA and Childrens Mental Health Initiative (CMHI) grantees across the nation

TA Network Core Partners

Accountability Solutions, LLC., led by Kelly Hyde; The Center for Community Learning, Inc., led by Myriam Monsalve Serna, Catalina Booth, and colleagues; The Center for Health Care Strategies, Inc., including Kamala Allen, Dayana Simons, and colleagues; The Family-Run Executive Director Leadership Association (FREDLA); Human Service Collaborative, including Sheila Pires, Ira Lourie, and Cliff Davis; The National Federation of Families for Childrens Mental Health, led by Sandra Spencer; Portland State University, including Janet Walker, Nancy Koroloff, and Susan Richardson, which co-hosts the National Wraparound Initiative (NWI), the Research and Training Center for Pathways to Positive Futures, and Reclaiming Futures programs; The University of South Florida, College of Community and Behavioral Sciences, Department of Child and Family Studies, led by Mario Hernandez and Kathy Lazear, along with their colleagues, including Mary Armstrong, and others; The University of Washington, including Eric Bruns, which co-hosts NWI and hosts the Wraparound Evaluation & Research Team; and Youth M.O.V.E. (Motivating Others through Voices of Experience) National, led by Lacy Kendrick Burk

Key Staffing Roles

Project DirectorMichelle Zabel (mzabel@ssw.umaryland.edu) Co-Deputy Project DirectorsMarlene Matarese (mmatarese@ssw.umaryland.edu) and Denise Sulzbach (dsulzbach@ssw.umaryland.edu) TA Support Coordinators/Policy Analysts Becky Bertell Lieman (rlieman@ssw.umaryland.edu) Therese Hackford (thackford@ssw.umaryland.edu) Ryan Shanahan (rshannahan@ssw.umaryland.edu) Business LeadsEmily Goldman, Administrative Manager (egoldman@ssw.umaryland.edu) and Andrew Lee, Accounting Analyst (alee@ssw.umaryland.edu) Multi-media DirectorMeredith Waudby (mwaudby@ssw.umaryland.edu) Events & Communications Jennifer Floam (jfloam@ssw.umaryland.edu) and Adam McGrath (amcgrath@ssw.umaryland.edu) Institute Coordinator Stephanie Foster (sfoster@ssw.umaryland.edu) The TA Tuesday Telegram & Quarterly TA Network Newsletter TANetwork@ssw.umaryland.edu Main phone number at The Institute: 410-706-8300

Key Staffing Roles: Defined

Technical Assistance Support Coordinator (TASC) The role of the TASC is to support both grantees and TA providers, serving as the administrative liaisons for each grantee state or community. Grantees will also have access to our Rapid Response TA System through which grantees can pose questions and seek help via e-mail or telephonically. TASCs are one point of contact through which Rapid Response TA requests will be triaged to the appropriate TA Network partner or consultant for the most up-todate response.

Key Staffing Roles: Defined

Systems Coach (SC)The role of the SC is to provide sitedriven TA and assist grantees in developing TA Plans and tapping into specific content expertise from our TA Network partners and Consulting Pool Clearinghouse as well as peerto-peer opportunities. The SCs are assigned based on their experience and expertise and may shift over time as new needs arise. The SCs will ensure that the TA process is determined by the grantees and will consistently assist the sites in identifying areas of need to support scaling up and building capacity. For example, if a grantee requests monthly coaching calls, then the SC will coordinate and lead these calls. The SC will be available primarily for virtual consultation but may also be involved in on-site TA provision.

Key Staffing Roles: Defined

Content Expert (CE)The role of the CE is to serve as an expert in a specific area of focus. CEs will function in two primary roles. Grantees who do not choose to have a Systems Coach will be assigned to a CE as their primary contact around content specific TA requests. The CE will be available as needed and will also draw on additional CEs as needed depending on the grantee TA needs. CEs will also be utilized from the Consultant Pool Clearinghouse and may join coaching calls, participate in on-site consultation and/or respond to content specific rapid response requests. In some cases, we are drawing on CEs who have an existing relationship with a grantee to ensure coordination and maximize resources.

Our Consultant Pool

The TA Network has an expert consulting pool of roughly 150 individuals, and the number continues to grow. Consultants have experience in a wide variety of topic areas and have practiced in all parts of the country and surrounding territories.

Our Experts By the Numbers

Specialty Area
Cultural and Linguistic Competence Behavioral Health: Mental Health, Substance Abuse & Co-Occurring Disorders Child Welfare Juvenile Justice Education Primary Care Youth Driven Care, Youth Organization Development and Sustainability Family Driven Care, Family Organization Development and Sustainability Policy, Systems Design, Financing & Sustainability Evidence-Based Practices Program Development Transition Aged Youth Health Care Reform/ Managed Care Workforce Data Link/ Health Information Technology Trauma Early Childhood Continuous Quality Improvement & Data Military Developmental and Intellectual Disabilities Rural Communities Faith-Based

Number of Experts
33 39 20 13 9 5 17 20 39 30 22 8 22 30 10 7 6 25 3 4 6 2

Technology Enhanced Technical Assistance

Website The Technical Assistance Reporting System (TARS) Online TA Plan Video Repository Online Training Center Interactive Map of Behavioral Health Best Practices Consultant Pool Repository Searchable Resource Library Social Media/iTunes University/YouTube Channel Online Newsletter Online Learning Communities (Beginning with a focus on CLC) Video Coaching Platform CQI online survey, including needs assessment and IOTTA

Technology and Online Resources

Overall Strategic Approach & Products
Staff a centralized website that will allow grantees to access dynamic, individualized training, and technical assistance Develop a web-based platform to house the array of existing resources, featuring a robust search function to help users filter by keyword, topic area, organization, etc. to easily find relevant tools and resources Assess existing relevant training and technical assistance resources across childserving systems Create additional field driven online curriculum, train the trainer curriculum, and certifications Research federal legislation and regulatory activities and national trends, and identify relevant information to include on the website Generate state snapshots that detail the current state and regional landscape related to children's behavioral health issues, accessible via an interactive map Provide information detailing current federal landscape related to childrens behavioral health issues

State and Community Information Exchange (SCIE)

Purpose: To assist the TA Providers funded by SAMHSA CAFB to be responsive to grantees needs and to provide States and Communities with the most efficient use of technical assistance resources 1st SCIE was sent out 11/8/13 (due 11/22) and was designed to support the grantees ability to reflect on and identify priority areas of focus and TA needs over the next 4-6 months Responses will help the TA Network identify:
Work that is currently underway Key priorities in the short-term Type of technical assistance grantees anticipate needing

SCIE will be re-issued every 4-6 months to continually adjust TA to meet unique needs of each State and Community

SCIE Data
Results from the Fall 2013 Survey Total Number of completed survey responses: 64 Number of grantees represented: 67 (91%) Number of grantee states/territories represented: 37 (95%)

SCIE Data
Figure One: Graph of Mean Ranks of Preferred TA Methods (1 = Least Preferred, 9 =Most Preferred)
8 7 6 Respondents 5 4
CMHI

3 2 1
Access to online Access to specific Assignment of a Assignment of a Monthly scheduled Online discussion resources, technical expertise coach with specific point person to TA Planning Calls forums on webinars and (through content expertise contact with particular topics trainings consultant pool) as requests for TA needed (not a coach) On-Site TA and Rapid response (via consultation email) to specific TA needs with linkage to resources and consultants to contact directly Peer-to-Peer Learning Opportunities

Implementation Planning All Grants

TA Preference

SCIE Data
Table Two: Top Five TA Needs Cited in Response to the Question: What are your priority areas of focus over the next four to six months where you anticipate needing technical assistance?
TA Need Sustainability CMHI 28 (93%) 0 Planning Implementation 2 (10%) Total Respondents 30 (47%) States Represented* CA, DE, FL, ID, IL, GU, MA, MD, MI, MS, NC, NM, NY, TN, TX, VT, WA DC, DE, FL, IL, KY, MI, NC, NY, OH, TN, TX, WA CA, DE, FL, NC, NY, OH, PR, TX, VA CO, FL, ID, MD, NM, OK, PR, VA, WA CO, DC, DE, GU, KY, NY, PA , VA

Financing

11 (39%)

5 (25%)

16 (26%)

Youth & Family Engagement

9 (32%)

0 0 0

3 (15%) 2 (10%) 3 (15%)

12 (19%) 9 (13%) 8 (12%)

Wraparound 7 (23%) Implementation/Expansion Family Support Organizations/Peer Support Capacity 5 (17%)

*Note: Multiple grantees within a state may have cited the same TA need.

SCIE Data
TA Requested from Partners at the Childrens Campaign Total number of respondents requesting TA: 37 (58%) Types of TA requested included:
Access to resources/materials/toolkits (35%) Access to general social marketing TA (32%) Sharing successes and activities across communities (13.5%) Early dissemination of National Campaign theme and content (8%) Expanding audiences (5%)

Areas of Focus
Cultural and Linguistic Competence Youth Organizations & Leadership Family Organizations & Leadership Wraparound Care Coordination Systems and Finance Juvenile Justice Child Welfare

Cultural and Linguistic Competence (CLC)

Center for Community Learning and University of South Florida

Cultural and Linguistic Competence (CLC)

Overall Strategic Approach & Products
Provide technical assistance and training to system of care grantees based on the needs of the Branch, system of care communities, TA network partners, coaches and subject matter experts. Provide meeting facilitation and training to the CAFB (e.g., Project Officers) and broader SAMHSA communities to enhance staff development. Provide networking opportunities to system of care grantees, Branch staff and partners, TA Network staff, coaches and subject matter experts, and others on- and off- site (with technology emphasis).

Cultural and Linguistic Competence (CLC)

Deliverables
Work closely with the CLC Coordinators and representatives from the SOC State Expansion and Community grantee sites. Provide resources centered around CLC such as: CLC Primer, Online CLC certificate course, CLC-focused web events, 24/7 web-based CLC resources and FAQ topical library developed and maintained through a structured review process, and peer-topeer technical assistance exchange.

Cultural and Linguistic Competence (CLC)

Deliverables
Work closely with Andy Hunt to plan and coordinate activities (e.g., every other month following Branch staff meeting, every other month forum open to SAMHSA partners, e.g., Knowledge Cafs, Brown Bag Lunches). Work closely with national partners (e.g., NICWA conference, LGBTQI2-S National Workgroup, Georgetown University TA Center, Vanguard Communications, ICF Macro and Westat, ACF, etc.). Complete major initiatives such as the development of a process for and implementation of peer-to-peer exchange, content specific serial learning communities and discussion times, and Office Hours with facilitated topical discussions.

Youth Organizations & Leadership

Youth M.O.V.E. National

Youth Organizations & Leadership

Overall Strategic Approach & Products
Develop an Online Learning Community, email distribution list, Social Media tools i.e. Facebook, Facebook group, Twitter, Tumblr, YouTube, podcasts, and the Youth M.O.V.E. National website. Promote peer learning opportunities for youth chapters and youth groups with similar interests and purpose by connecting these groups and creating chances for them to learn from each other. Provide guidance and models for statewide and local youth leadership group structures to ensure expanding capacity within the state for youth organizations. Provide guidance on Chapter Purpose Areas to guide development of visions missions, and strategic plans. Host quarterly chapter calls and discussions. Develop resources and disseminate resources including Chapter Development Toolkits. Participate as a partner in the White House Dialogue for Childrens Mental Health.

Family Driven Care Organizations and Leadership

 Provide TA to SOC grantees around issues of family involvement and operationalizing family-driven care Provide TA and resource development in the following areas: Identifying the strengths and needs in area of family engagement Identifying strengths and needs in the area of family voice and familydriven care Implementing family-driven practices and developing assessment tools to help grantees determine where they are on the continuum of a family-driven care Family involvement in child welfare and juvenile justice populations

Provide TA, including online training opportunities, on the use of Parent Support Providers including: Developing and sustaining a core group of Parent Support Providers using the National Parent Support Provider Certification process Core domains and competencies of Certified Parent Support Providers How the Affordable Care Act can aid in the sustainability of Certified Parent Support Providers Provide support and TA on the use of social media for awareness and sustainability activities Develop and manage a listserv and monthly calls with Lead Family Contacts to offer general TA and support

 Conduct an initial survey of family-run organizations, conduct data analysis and develop a skills matrix to identify a) areas of expertise, b) materials and products, c) identify gaps and needs Assess the needs of family leaders and family-run organizations looking at varying stages of maturity for organization readiness to empower family-driven care Provide TA to SOC grantees on family-run organizations models of family organizations, financing, business practices, organizational development Compile a resource bank of materials and developing new materials and training to support family leaders and build the capacity of family-run organizations

 Develop a leadership training, including a boot camp for new Executive Directors of family-run organizations Develop assessment tools, including self-assessment, to measure key family-run organizations performance indicators with focus on capacity and sustainability Strengthen the ability of family-run organizations to provide peer support through recognized certification, licensing and accreditation bodies Compile pertinent child welfare and juvenile justice resources and identify subject matter experts within the family-run organizations community to develop family partnership within and across child-serving systems Implement a communication process for sharing information across family-run organizations

Wraparound Care Coordination: National Wraparound Initiative (NWI)

Portland State University, University of Washington (UW), Accountability Solutions, LLC., and University of Maryland Baltimore

Accountability Solutions, LLC

National Wraparound Initiative (NWI)

Overall Strategic Approach & Products
Support grantee efforts to implement high-quality wraparound. Inform grantees about and provide access to NWIs large, multimedia library of resources Produce webinars and newsletters. Provide TA about NWIs fidelity and accountability tools for wraparound. An announcement regarding the process for grants to get this TA is forthcoming Connect grantees to in-depth TA on wraparound when this need is identified. Create needed products, such as Wraparound remote video coaching, An external fidelity and implementation review process, and A handbook summarizing state implementation and fiscal models.

The NWI website: www.nwi.pdx.edu

Systems and Finance

Center for Health Care Strategies, Human Service Collaborative, and University of Maryland Baltimore

HSC Human Service Collaborative

Systems and Finance

Overall Strategic Approach & Products
Provide TA on the organization and financing of delivery systems and on sustainability and expansion Provide Rapid Response to questions related to financing, Medicaid, Title IV-E, block grants and funding structures like single payer systems, braided funding Hold periodic Office Hours on topics related to the organization and financing of systems Conduct webinars and develop issue briefs Develop a toolkit on Social Return on Investment (ROI):
o o o o o How to analyze Medicaid data How financing is organized in States (e.g. role of Medicaid vs. Mental Health Authority); How to do and use a ROI analysis How to develop case rates How to establish systems to link Big Data - state administrative data across systems

Systems and Finance

Overall Strategic Approach & Products
Develop a series of resources related to Psychotropic Medication Monitoring based on 8/24/2012 CMS Informational Bulletin on Collaborative Efforts and Technical Assistance Resources to Strengthen the Management of Psychotropic Medications for Vulnerable Populations and 11/21/11 State Medicaid Directors Tri-Agency Letter on Appropriate Use of Psychotropic Medications among Children, specifically: o Why is this important, what should we monitor (identification of indicators agreed to by 6 state national quality collaborative) and how do we define the quality indicators

o Consultation models & how to finance them

o Red flag systems & informed consent structures

Systems and Finance

Overall Strategic Approach & Products
Create a series of resources on customizing care coordination using wraparound based on the 5/7/13 Joint CMS and SAMHSA Informational Bulletin on Coverage of Behavioral Health Services for Children, Youth and Young Adults with Significant Mental Health Conditions, including: o Descriptions of states/counties using CMEs or wrap teams within supportive organizations and systems, o Care coordination ratios, o Rate methodologies and financing structures, and o Fidelity and outcomes.

Juvenile Justice Reclaiming Futures

Portland State University Reclaiming Futures

Juvenile Justice Reclaiming Futures

Overall Strategic Approach & Products
Reclaiming Futures model convenes cohorts of local teams to work on systems integration and responding more effectively to needs of youth in juvenile justice with MH conditions and substance abuse. Work includes: Working directly with a cohort of assigned communities using adapted Reclaiming Futures model Major focus on systems collaboration, use of effective approaches/interventions, youth and family voice Providing coaching and link grantees to more in-depth TA as needed Creating needed products based on community needs including development of products to help jurisdictions identify effective strategies for establishing linkages between the juvenile justice and mental health systems Providing technical assistance that includes youth and parent participation initiatives that expand and enhance family involvement in the development and delivery of these mental health services

Child Welfare
University of Maryland Baltimore, University of South Florida, and Human Service Collaborative

HSC Human Service Collaborative

Discussion & Questions