IMPLEMENTATION EVALUATION REPORT Phase One Implementation Katie A

IMPLEMENTATION EVALUATION REPORT Phase One Implementation: Katie A. Strategic Plan

EVALUATION CEO, DCFS, and DMH committed to evaluate the first year of the Katie A. Strategic Plan implementation: A total of 27 focus groups across 3 SPAs (7, 6, and 1) were conducted in November and December of 2009. The data collection process included 23 individual interviews with DCFS Regional Administrators/Assistant Regional Administrators and DMH District Chiefs/Program Heads.

EVALUATION The evaluation explored four specific components: 1) Mental Health Screenings 2) Referrals to Assessments for Children with Positive Mental Health Screenings 3) Assessments for Children with Positive Mental Health Screenings and Linkage to Mental Health Services 4) Mental Health Service Provision

KEY STRENGTHS Mental Health Screening Process Ø Seven elements: • • Easy-to-use screening How-to training Ongoing support Protocols and roles specifying responsibility Checkpoints ensuring completed screening on all children Data-tracking system Cross-system ownership

KEY CHALLENGES Mental Health Screening Process Ø Ensuring that all children with existing cases are screened for mental health needs. Ø Administering the mental health screening tool consistently across different and complex, timelimited situations, including the Medical Hubs.

KEY STRENGTHS Referrals to Assessments Ø Formal procedures Ø Clear roles and responsibilities Ø Referral packet checklist Ø Data-tracking system Ø Coordinators of the Multidisciplinary Assessment Teams and Service Linkage Specialists

KEY CHALLENGES Referrals to Assessments Ø Obtaining the necessary consent for services in a timely fashion. Ø Determining, obtaining and maintaining benefits for certain children in the child welfare system that are Medi-Cal eligible.

KEY STRENGTH Assessment and Linkage Activities Ø Coordinated Service Action Team (CSAT) CSAT is viewed as a structure that has brought greater order, efficiency, and accountability to assessment and linkage services for newly detained cases, nondetained and existing cases.

KEY CHALLENGES Assessment and Linkage Activities Ø Track 1 (Newly Detained Cases): Availability of Assessment Slots and Assessment Capacity Ø Track 1 (Newly Detained Cases): Difficult Deadlines, Expectations, and Additional Costs Ø Track 2 and 3 (Non-Detained and Existing Cases): Distancing, Roles, and Partnerships

KEY STRENGTH Mental Health Service Provision Ø Confidence that Wraparound services provided mental health services. CSWs and Intensive Social Workers reported that they regularly check in with Wraparound service providers regarding case files.

KEY CHALLENGES Mental Health Service Provision Ø Children Social Workers (CSWs) lack of clarity concerning their roles. Ø CSWs lack of strong mechanisms for cross-agency collaboration. Ø Structural constraints: 1) 2) 3) Inability to bill fully; Costs of training; and, Department managers lack clear buy-in and a set of expectations about the practice principles.

RECOMMENDATIONS Screening Process 1) Further formalize the roles of staff that are responsible for ensuring that in existing cases, children are screened for mental health needs. 2) Improve the process of filling out the mental health screening tool in specific context, namely for children 0 -5 years of age, for crisis situations and in the Medical Hubs.

RECOMMENDATIONS Referrals to Assessments 1) Improve the ways in which release of information and consent for mental health treatment are obtained. 2) Minimize the problems of Medi-Cal enrollment and disenrollment, particularly for children with private insurance, HMO Medi-Cal, or placements outside Los Angeles County.

RECOMMENDATIONS Assessment and Service Linkage 1) Align the various deadlines for completing assessments. 2) Reduce delays of reports from the Medical Hubs.

RECOMMENDATIONS Assessment and Service Linkage 3) For Newly Detained Cases: a) Consider establishing a system to redistribute MAT slots across SPAs. b) Increase MAT provider capacity for conducting assessments in specific SPAs. c) Strengthen the protocols (roles, expectations, processes) for completing the Summary of Findings Report. d) Address the billing issues reported by MAT providers regarding covering the full costs of assessments and service linkage.

RECOMMENDATIONS Assessment and Service Linkage 4) For Non-Detained and Existing Cases: a) Clarify the role of DMH Co-located staff and mental health providers. b) Address partnership issues between DCFS and DMH staff.

RECOMMENDATIONS Assessment and Service Linkage 1) Increase the understanding of CSWs regarding their role in Child/Family Teams. 2) Strengthen the relationship between CSWs and mental health providers. 3) Address the structural constraints reported by mental health providers.