2009 Provider Expo

A Celebration of Working Together to Strengthen

Communities

Integrated System of Care Developer

• Care Management Care Management ProvisionProvision– Dawn Project, Indiana

1997– Cincinnati, Ohio 2002– Rockville, Maryland 2005– Baltimore City, Maryland

2006– Baltimore County,

Maryland 2007– St. Mary’s County,

Maryland 2007– Harford County, Maryland

2008– Washington, DC - fall 2008

• System of Care SupportSystem of Care Support– Youth Emergency Services

1998– Back to Home, 1999– Child Abuse Hotline 2004– Full Purpose Partnership

2004– Reception Center 2007

• Training and ConsultingTraining and Consulting– TA Center 2003– National Consulting -

ongoing

LEGEND

Eastern Region

AL

FL

SC

TN

KY

IN

OH

NC

PA

ME

VA

NY

CT

WV

MD NJ

VTNH

MA

DE

RI

- USA Eastern Region

MI

GA

300235

150

120

20

Indianapolis – Indiana (1997)

Cincinnati – Ohio (2002)

Rockville – Maryland (2005)

Baltimore City – Maryland (2006)

St. Mary’s – Maryland (2007)

Washington DC (2008)

Choices Care Management Choices Care Management

•Over 220 Employees

•$38 Million Annual Budget

•Over 1000 youth served in Child Family Teams daily

•Working across ALL child serving systems – 60% CW

CFT meetings every 30 days

Authorize all of the care

Access Provider Network

Families driving the Plan

60 minute meetings

Crisis Plan within 24 hours

PLAN

Case ManagerSchool

FamilyJuv Probation

Child WelfareMental Health/Substance Abuse

Care Coordinator

Individualized Care Plan

Single point of Communication

FAMILIES DON’T FAIL--PLANS DO

System of Care

Core Values:• Community Based• Child centered and Family focused• Culturally Competent

Guiding Principles:• Comprehensive – a broad array• Individualized – not a cookie cutter approach• Coordinated both at the system and service delivery

levels• Involve families and youth as full partners• Emphasize early identification and intervention

Care Coordination

Family Involvement

Cultural Competence Communit

y Based

Treatment

&

Supports

System of Care Process

A System of Care is…

• One Stop Shop for all human service systems

• NO WRONG DOOR for children and families across ALL systems

• A Place where I’d send my family

With the values and principles guiding the process

Parallel Processes across Child Serving Systems

• Child Welfare – state reforms include “child family teams”, family group conferencing

• Juvenile Justice – restorative justice uses a team approach,

• Mental Health – wraparound team process• Education – IEP – Individualized Educational

Plans – team based• Developmental Disabilities – person centered

planning team

National Trends

TEAMS

5 Dysfunctions of a TeamPatrick Lencioni tells us:• Not 5 distinct issues• Interrelated and interdependent• One link broken, the teamwork disintegrates

Teams that DIDN’T work

Characteristics of why they didn’t work

Teams that DIDN’T work

• 1 leader, no others• No trust amongst

them• Designated leader

doesn’t lead• No plan for follow

through• No understanding of

mission• No sense of humor

• No communication• Lack of empathy• No compromise• Lack of self-esteem• Lack of hard work• Not even participation• Unrealistic goals

Teams that DID work

• Consistency• Broad group with

common purpose• Time limited, short

concise• Share the load• Assistance, resources• Role clarity• Humor

• All work together• Compromise• Motivated• Single purpose• Follow through• Respect, sharing• Dedication• Equals, understand• Food

Stages of Team Development

Stage Theme Task Goal Goal

Forming Awareness Commitment: Acceptance: Resolving dependency

Storming Conflict Clarification Belonging: Resolving feelings

Norming Cooperation Involvement Support: Increasing team cohesion

Performing Productivity Achievement Pride: promoting interdependence

Adjourning Separation Celebration & closure

Satisfaction: encouraging comments

When looking at the stages

• Each stage is predictable and every team goes through each stage

• Each stage is manageable by the leader. It offers a plan for leadership

• Knowledge of the stages helps both the leader and members understand what is happening in the team and why

LEARN FROM THE PEOPLEPLAN WITH THE PEOPLE…

WHEN THE TASKIS ACCOMPLISHED

THE PEOPLE ALL REMARKWE HAVE DONE IT

OURSELVES- Lao-tzu

Team basketball clip

Collaboration vs. Clobberation

“CLOBBER”ation is…

clob·ber   (klŏb'ər) clob·bered, clob·ber·ing, clob·bers Slang

• To strike violently and repeatedly; beat or maul.

• To defeat decisively

• To criticize harshly

• Final answer (my add-on)

Dictionary.com, 2009

Collaboration

Col*lab`o*ra"tion\, n. The act of working together; united labor.

col·lab·o·rate  

1. To work together, especially in a joint intellectual effort.

2. To cooperate treasonably, as with an enemy occupation force in one's country.

Dictionary.com, 2009

Collaboration

Winer & Ray, 2000 from the Collaboration Handbook definition:

“Collaboration is a mutually beneficial and well-defined relationship entered into by two or more organizations to achieve results they are more likely to achieve together than alone.”

Factors that Make or Break Collaboration

• Ideology

• Leadership

• Power

• History

• Competition

• Resources

Winer & Ray, 2000

Foundation for Successful Collaboration

• Mutual agreements

• Common goals and missions

• Win-Win for all

• Mutual satisfaction

• Hard work and effort

Change Imposed is Change Opposed

When YOU choose to ChangeYou Gain!

Softball

Collaboration

The elements necessary for successful

collaborative efforts:

ColLABORation

Labor – hard work

CollabORATION

Labor – hard work

Oration – talking together

CoLLABoration

Labor – hard work

Oration – talking together

Ball – having fun, successes

ColLABoration

Labor – hard work

Oration – talking together

Ball – having fun, successes

Lab – new learning, experiment

ColLaboRATIon

Labor – hard work

Oration – talking together

Ball – having fun, successes

Lab – new learning, experiment

Trail – new ground together

ColLabORATIon

Labor – hard workOration – talking togetherBall – having fun, successesLab – new learning, experimentTrail – new ground togetherTailor - individualized, unique

COLLAborATIONLabor – hard workOration – talking togetherBall – having fun, successesTrail – new ground togetherLab – new learning, experimentTailor – individualized, uniqueAllocation – the funding will follow

“It has never been done this way before”

“You can’t do it that way”

“We don’t operate that way here”

STEPS ON THE LADDER OF CHANGE

PARTNERSHIP

Active Resistance

Passive Resistance

Tolerance

Compliance

Commitment

YOU THEM

PTP: AM I PART OF THE SOLUTION OR PART OF THE PROBLEM?

Building a Collaborative Community

• CooperationCooperation– Shorter term informal relations, sharing info – one

way; no risks (low intensity)

• CoordinationCoordination– More formal relationships and understanding of

missions – no money shared or pooled

• CollaborationCollaboration– Durable and pervasive relationship with full

commitment to a common mission; jointly share results and rewards – show me the $$ (high intensity)

Collaborative Features

• Public and Private Human Service agencies

• Community steering committees or consortiums

• Multiple public funders• Local community mental health and health

centers• School districts• Family support network involvement

Community Communication Method

• Consortium meets monthly• Payers/Referrers/Providers meet monthly• Agency Board & Clinical Workgroup meets monthly• Semi-annual focus groups with referring agencies• Supervisors meet bi-weekly with Manager• Supervisors facilitate weekly Peer review• Supervisors meet with CC’s 1:1 daily • Supervisors meet quarterly with Referring Supervisors• CC’s & Supervisors meet with Psych MD’s• Mandatory all staff training weekly• CC’s hold Service Team meetings < 30 days• Director available for consults daily

Community

Supervisors

Line Staff

FAMILY

Service Coord.

Service Team Reps.

Community Agencies

PTP: SHOULDN’T WE KNOW THE DX OF EVERYONE INVOLVED?PTP: SHOULDN’T WE KNOW THE STRENGTHS OF EVERYONE INVOLVED?

Culture of Care Values

Planning

Organizations(lead and partner agencies)

Hospitable System (Policy and Funding Context)

Effective, Collaborative

Supportive

PEOPLE ARE MUCH MORE LIKELY TO ACT THEIR

WAY INTO A NEW WAY OF THINKING THAN

TO THINK THEIR WAY INTO A NEW WAY OF ACTING

HBR – 5/2005

Cross System/Community Collaboration

• Shared Community Vision – “what is your community’s shared vision?”

• Educational opportunities

• Surveys – focus groups

• Job shadow cross system

• Meetings – sharing

• Share opportunities, consultants, etc.

Sustainability

• Value driven system in community– Emphasized strengths based– Family Driven– Community Teams – shared risks

• Collaboration from community & program partners– Delivering a cost effective & quality product– Helping our referral partners do their job better

• Training– Cross training – we provide strengths based training

and they provide system specific– Regular, ongoing and then situational/as needed

Teamwork

As your PARTNER, we promise to…

Put your needs first in every situation

Add value to your personal leadership

Recognize we serve a common goal

Tailor our services to meet your need

Never take for granted the trust placed in us

Embody excellence in everything we do

Respect everyone’s uniqueness

The Great Mullah

• 3 Brothers & 17 camels

• Oldest = 1/2• Next = 1/3• Youngest = 1/9

It doesn’t work – how do we do this?

• With 18 camels

• Oldest = 9• Next = 6• Youngest = 2• TOTAL = 17

And the Mullah walked away with his camel

Collaboration is when…

Everyone shares a little to receive a lot

www.ChoicesTeam.org