Commissioners’ Committee on Cross-Systems Services for Children and Youth

Workgroups

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Commissioners' Senior Staff and Youth & Family Partners Workgroup

The Commissioners’ Committee formed the Senior Staff and Youth & Family Partners Workgroup to facilitate communication between local and regional staff and Commissioners. The Commissioner’s Committee meets quarterly receiving updates from the Senior Staff Workgroup and family and youth partners. The Commissioners are committed to collaboratively develop and implement joint solutions to improve the lives of children, youth and families.

The Commissioners’ Senior Staff and Youth & Partners Workgroup is made up of senior staff from the following state agencies:

and Family & Youth Partners from the following organizations:

The Senior Staff workgroup meets the first Thursday of each month to share information and provide updates on cross-systems work and provide updates on individual workgroups, as well as works to improve communication and public transparency, and share information from regional colleagues. These meetings are very well attended and there is a great deal of enthusiasm and energy among all agencies (Typical Agenda). These meetings provide an opportunity to share information, receive invaluable input from our family & youth partners and communicate with agency Commissioners through their senior staff. This group is a team that works together to fulfill the goals of the Children’s Plan.

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Cross-systems Training Workgroup

The Navigating Multiple Systems Workgroup is working to create a free 13-episode online video series to help train and inform service coordinators, case managers, educators, parents and youth on how to obtain services and supports for children and youth with complex needs and their families from multiple child serving systems. 

This video series will provide presentations on each of New York State’s child serving systems, offering important information about the services and supports each system offers, eligibility requirements and how to apply for such services and supports, among other things. There will also be separate segments for youth and family members that will offer practical guidance on how to obtain emotional and technical support from other youth and families, advocates and other members of the community.

Members of the workgroup include representatives from:

Regulatory Impediments Workgroup

The Regulatory Impediments Workgroup has been charged by the Commissioners Committee to identify state and federal laws and regulations that impede efficient planning between service systems; present obstacles in the development and provision of needed services and supports for children, youth and families; and reduce wasteful state and local practices.

Current members of the workgroup include representatives from the following family and youth organizations and state agencies:

Social Development Workgroup: Strengthening Children’s Social & Emotional Development and Learning

Under the leadership of the NYS Council on Children and Families, state and community agencies, and family & youth partners have joined together to promote the importance of children’s social-emotional well-being. The workgroup is chaired by the Council on Children and Families and composed of the following organizations:

On June 18, 2010, the workgroup held a roundtable discussion with Ben Tanzer, a national, social marketing consultant to gain information on ways to better plan, implement and evaluate social marketing tools and opportunities to achieve an effective, high-quality marketing campaign. The workgroup is investigating the best ways to reach people with positive and helpful messages.

The vision of encouraging a public health approach set forth in The Children’s Plan laid the foundation for representatives of the Social Emotional Development Workgroup to develop recommendations for Social and Emotional Development Consultation in Early Childhood settings. These recommendations have been compiled in a report called, "Framework for Supporting the Social-Emotional Development of Young Children".

Respite Care and Services Workgroup

The Respite Workgroup is co-chaired by the Council on Children and Families and the Commission on Quality of Care for Persons with Disabilities and has members from the following agencies:

Click here to view the April 2011 Respite Report.

Background

Respite care is a very complex issue, particularly when looking at it from a cross-systems perspective, which is imperative to resolve these issues. Although respite is a very complex issue, the Commissioners, Senior Staff, and the members of this workgroup are very committed to finding solutions to the issues surrounding respite care. The workgroup began its work by defining the most common types of respite:

  • Hourly: Typically one on one with a qualified individual.
  • Half or Full Day: Half or full day respite with a qualified individual.
  • Overnight Respite: Respite care away from home in a foster home, IRA, or other arrangement.
  • Emergency/Crisis Respite: An unplanned emergency response is required to prevent further deterioration in family system, or respond to a familial crisis. This typically can last from 1-21 days in a variety of settings.

Initial Findings:

  • Common themes for defining and providing respite among the state agencies exist, but each agency regulates its own programs.
  • An hourly form of respite care is the most available. Few cross-systems serving programs have adequate emergency and crisis respite capabilities.
  • Cross-systems coordination is inconsistent/lacking on the county level; each child-serving system has its own referral pathways, triage efforts, and contracting patterns.
  • For youth enrolled in youth services sponsored programs (OMH, OPWDD, OCFS), planned (overnight) respite frequently takes several months to establish as part of a treatment plan and is barely adequate.
  • Respite availability is not an option for youth not currently enrolled in OMH, OPWDD, OCFS, or DOH programs.
  • The lack of crisis respite may result in children being picked up by law enforcement or presenting in emergency rooms, and consequently, in long-term costs to the child/family and society (i.e. psychiatric care, hospitalizations, PINS petitions, detention, diagnostic placements).
  • There is little cross-systems data available to track the number of units of service being provided, the number of children being served, or the number of homes and slots available at any point in time.
  • With the expansion of community prevention programs such as the OMH waiver and the Bridges to Health (B2H) waiver programs, the demand for planned and emergency respite will likely increase in the coming years.
  • Families who have children enrolled in Health Department programs that offer respite, may have limited access to the service because of availability and proximity to the service.
  • Office of Probation and Correctional Alternatives is in the early stages of assessing respite availability in their system.

Preliminary Recommendations Case Planning Efforts:

  •  All familial resources need to be identified as early as possible when cases are opened. Familial, natural and informal resources should always be considered first when developing respite plans. Treatment plans need to account for the anticipation of crisis situations and proactively use respite as one means to diffuse these situations.
  • Reviews of weather preventive programs are developing appropriate crisis avoidance plans (including respite care) and proactively intervening in an effort to reduce unnecessary psychiatric emergencies should be considered.

System Recommendations:

  • More data are needed to identify the need for emergency and planned respite. These data need to be broken down at both county and system levels. Regional technical assistance teams are a possible data collection resource.
  • NYS programs need to do more to encourage familial, informal and natural support networks that will be available after services end. (Westchester County is an example of a county that has effectively implemented these networks).
  • Ensure the availability of culturally and linguistically competent respite programs.
  • Promote cross-systems training for staff working in respite programs.
  • The provision of respite services needs to include children with a wide range of supervision needs. A range of respite options from familial to group care options should be part of a flexible continuum of services.
  • Funding should be flexible enough to follow youth who need temporary emergency respite placements.
  • Communities should develop protocols to anticipate the needs of children with complex needs (OPWDD & OMH) eligible) and have rapid responses to these youth.
  • Service systems need to develop strategies that allow for emergency respite services such as paying a “per diem” for trained therapeutic foster care to be available for crisis respite placements.
  • Explore the development/replication of mobile crisis teams for children and youth (e.g. Parsons Team).
  • Develop sustainable flexible funding streams to support efforts to provide flexible responsive services to youth and families.
  • Amend state regulations to better serve children with cross-systems needs, i.e., by enabling more flexibility with respect to mixing of ages and populations in planned and crisis respite programs.

Recommended Next Steps

  • Increased training efforts should be focused on the expanded use of familial supports in the provision of respite. Agencies should re-examine the availability and use of flexible funding to support this (e.g., stipend for food)
  • The workgroup needs to further analyze data from the respective state agencies to ensure its accuracy and comprehensiveness. Based on a comprehensive review, further next steps will be identified.
  • The workgroup encourages the use of paying a stipend to ensure emergency/crisis respite resources are available at lower levels of care (e.g. Therapeutic Foster Care)
  • Consider a long-term examination of how funding can follow the needs of youth.
  • Request the Regional Technical Assistance Teams (RTATS)develop cross-systems meetings with regional partners to:
    • Make a full and complete local assessment of the scope of the problem and current available resources;
    • Assist in identifying “best practices” and creative solutions to share with other regions;
    • Make recommendations to the workgroup for local solutions that take into account the current resource challenges.
    • Encourage regional conversations on sharing the costs of higher-end solutions for emergency respite (e.g. using empty residential beds)