Best Practices Family Youth Partnership

Best PracticesImplementing Volume OneFamily Youth2008ProfessionalPartnershipVolume 1The County of San Diego Children’s Mental Health Services has a County oflong history in the promotion of a Children’s System of Care that San Diegoimplements Family Youth Professional Partnerships. This CMHSdocument captures lessons learned and concrete best practices Familythat support the advancement of these partnerships. Youth Professional PartnershipCounty of San Diego Children’s Mental Health Family Youth Liaison – last updated: June 25, 2008

Best Practices FYPP Volume 1, June, 2008Table of ContentsAcknowledgement.............................................................................................................. 3Background – San Diego..................................................................................................... 4Key Events – San Diego...................................................................................................... 5Family & Youth Partner Categories ...................................................................................... 7Best Practices – Getting on track ......................................................................................... 9Best Practices – The Basics ................................................................................................10Best Practices – The San Diego Experience .........................................................................11References .......................................................................................................................13Footnotes .........................................................................................................................13Appendixes…………………………………………………………………………………………………………………… 14 2

Best Practices FYPP Volume 1, June, 2008AcknowledgementWe would like to acknowledge the Mental Health and Social Service professionals whohad the courage to forge a new pathway for families and youth by supporting Family-Youth Professional Partnerships and thank the family and youth partners from theCounty of San Diego, the State of California and all over the United States who havespoken up to share their success, struggles, needs and dreams.We thought it important to acknowledge that many family and youth partners and theirprofessional partners believe there are risks to building genuine Family YouthProfessional Partnership (FYPP). The National Federation of Families forChildren’s Mental Health identified this barrier many years ago. They worked withtheir professional partners to document a dialogue in Learning from our Colleagues,Family Professional Partnerships-Moving Forward Together, first published inSeptember 1998. We believe it is beneficial to the reader of this document to reviewchapter two of Moving Forward Together and we have copied this chapter in AppendixOne for convenience. Government agencies must do what many of America's best businesses have done: renew their focus on customers. Al Gore 3

Best Practices FYPP Volume 1, June, 2008Background – San DiegoSan Diego County’s concept of Familyi Youthii Professionaliii Partnership (FYPP) came about as aresult of the County of San Diego public child family systems’ examination of their servicedelivery. The goal of this examination was to work together to improve outcomes for thosereceiving services from the county system. One of the first steps was a summit held in the late1990. where family, youth <clients> and their professional partners from schools, child welfareservices, juvenile justice, private mental health providers and community organizations cametogether to dialogue on improving system outcomes. The San Diego County Board ofSupervisors began to formalize an element of this concept with a board action on September19, 1995 which became policy # E 13 Family Centered Practice Appendix 2. This policy’sintent was to promote a family centered approach to service delivery. Since that time manylocal, state and national initiatives have indicated system improvement should be familycentered to improve outcomes for Families, Youth, Children, and Public Systems. In 1998, SanDiego County Health and Human Services Agency (HHSA) received a grant from SubstanceAbuse Mental Health Service Agency (SAMHSA) under the Children’s System of CareivCommunities grantsv. This grant gave County of San Diego HHSA and the community theopportunity to plan, analyze and take steps to operationalize a collaborative and integratedarray of services that incorporated family- centered practices. Stewardship for this grant cameunder County of San Diego Children’s Mental Health Services (CMHS). In 1999, CMHSleadership established the Children’s System of Care Steering Committeevi At the cornerstone ofthe County of San Diego CMHS Children’s System of Care was the full inclusion of allstakeholders (Public, Private/CBO, Education, Family/Youth and Community). Early in thedevelopment CMHS recognized that to support a practical family-centered service system theywould have to build authentic Family-Youth-Professional Partnerships at all levels of the system(Policy, Program and Practice). A significant challenge in this innovative approach was the fullinclusion Family and Youth <recipients of services>. With this recognition, CMHS Children’sSystem of Care addressed these challenges by hosting an array of key events that gave way toestablishing a foundation for Family Youth Professional Partnerships. 4

Best Practices FYPP Volume 1, June, 2008Key Events – San Diego2002: The First CSOC Annual Conference was facilitated by Todd Sonsa, Ph.D. andConnie Burgess; Family Partnervii which gave CSOC partners the opportunity to share ideason how each sector could operationalize partnership with recipients of their services.Family Professional Partnership annual conference follow-up was facilitated by ToddSonsa, Ph.D. and Pam Hawkins, Family Partner. The results of this forum were thedevelopment of community recommendations for language around the titles of family partners,identification of roles for family partners, and recommendations that would support theadvancement of family partnership within the CSOC.2003: The Second CSOC Annual Conference, “Building Bridges to Youth” was facilitatedby San Diego Youth and Community Services. This conference resulted inrecommendations provided by the CSOCcommunity on development of supports Many feel that changing organizational behaviorsto ensure culturally competent in the public sector is not only possible, butapproaches for youth inclusion.The above events were followed up essential. In today's business environment,with two community forums in 2003 government agencies, like organizations in thefacilitated by Dr. Barbara Miller, private sector, are subject to the forces ofCMHS Chief. These forums shared downsizing, customer satisfaction, customerinformation with CSOC partners on retention, revenue loss, and streamlining of services.current practices related to Family How customers are treated is often the differenceYouth Professional Partnership and between organizations that succeed and those thatinvited community recommendations fail.1on advancement to ensure authenticFamily Youth ProfessionalPartnership. These forums alsoresulted in the formation of two workgroups which were chaired by a representative from CMHS administration and a family partner.The work groups held representation from public systems, education, and community basedorganizations, and families and youth. The tasks of these groups were to develop policies andprocedures on ―Familyviii & Youthix Support Partners. One identified role for Family and Youthxpartners is to provide direct services to family/youth receiving services. These two work groupswere given the task to describe and standardize the selection, training, supervision, distributionand, work of Family/Youth Support Partners. This work resulted in three HHSA and CMHSGeneral Administration policy and procedures approved on June 11, 2003 and renewed April 9,2007 Appendix 3. To further advance the Family Youth Professional Partnership, Dr. BarbaraMiller and a Family Partner drafted a fourth policy and procedure that described a structure andmonitoring process for Family and Youth Support Partners. The policy also illustrated 5

Best Practices FYPP Volume 1, June, 2008implementation of Family Youth Partners in roles other than Support Partners at the policy,practice, and service levels. This document was reviewed by a CMHS Quality Review Counciland accepted as a HHSA and CMHS General Administration policies and procedure #06-01-122approved May 4, 2004, Appendix 4.Another piece to CMHS foundation for Family Youth Professional Partnership was thedevelopment of a Memorandum of Understanding in 2005 between the Mental Health Directorand an independent Family and Youth Lead organizationxi <Family & Youth Roundtable >. Thisagreement, which in many ways was a milestone, granted families and youth receiving servicesa voice that has direct access to the Mental Health Director.The CMHS CSOC Council created a task force, led by Shirley Culver <Professional PartnerEducation>, with a purpose of creating a menu of ways in which providers and/or systemadministrators could operationalize Family Youth Professional Partnership. This work wascompleted in April 2007.These key events and many other efforts have pieced together a San Diego County CMHS CSOCfoundation to support Family Youth Professional Partnership. Family, Youth and ProfessionalPartners have worked together for well over ten years in San Diego County. The Family & YouthRoundtable (Roundtable) has had the privilege of acting as a hub for family youth partnershipinformation and support. This role as a ―hub‖ was enhanced, when in 2005, the Roundtable wasawarded a contract with the County of San Diego as the Children’s Mental Health Family YouthLiaison. This opportunity allowed the Roundtable to accumulate successes and challenges aspartners forged new pathways to an improved service delivery system. The following of bestpractices demonstrates concrete ways in which systems, providers; family and youth maypractice this fundamental key to improve service delivery. 6

Best Practices FYPP Volume 1, June, 2008Family & Youth Partner CategoriesThese categories were adopted by the San Diego CSOC Community at the first FamilyProfessional Partnership Forum in 2003.Policy: Policies shape and guide programs and agency services, and the activities of direct linestaff. Family and Youth Partner activities should include:Family/Youth perspectives in amendments of establishment of policies;Participation in policy level committees, boards and executive meetingsAdministrative: Agency’s Administrators and Mangers oversight of services. Family and YouthPartner actives should include: Personnel selection; advisory committees; budgeting contractmanagement; outcome evaluation; quality improvements; contract management; outcomeevaluation; and quality improvement and program design.Public Education: Educational and supportive activities champion and promote improvedoutcomes for children youth and their families. Family and Youth Partner activities shouldinclude:Newsletters; Support Groups; and Educational Forums.Advocacy: Helps families and youth be assertive about the rights for services andaccommodations. Advocacy may be in support of an individual or in support ofprograms/initiatives. Family and Youth Partner activities should include:Assisting families/youth in understanding and benefiting from entitlement programs; may serveas ―watch dogs‖ holding systems accountable and ensuring rights of children, youth andfamilies.Training: Professional learning opportunities for both the professional partner, family partnerand youth partner may take the form of pre/post employment, in-services and continuingeducation with the goal of influencing the practices of current providers and systems. Familyand Youth Partners activities should include:Develop curriculum and Trainers <Instructors>. 7

Best Practices FYPP Volume 1, June, 2008Support Partnersxii <Direct Service>: Your journey toward Family YouthThe provision of formal services and Professional Partnership begins from wheresupports. Support Partners are typicallyinvolved in case management, counseling you are, not from where you wish you were.and service plan development and may The important thing is to get started.participate in or facilitate wraparoundmeetings. The characteristics of formalservices provided by a Support Partnersare unique from similar services providedby traditional services because of the partners’ personal experiences as a consumer of services.Support Partners are particularly effective in bridging the gap between agency staff andfamilies/youth, resulting in sharing of information and shared decision making. SupportPartners work to make assessments strength-based, eliminate blame and shame and promotefamily/youth decision making in the selection of goals and development of care plans. Familyand Youth Support Partners activities should include:Membership on the interagency service teams; staff meetings; case reviews; supervision teams;and crisis servicesThe following Best Practices are delivered in three This report may be found on oursegments. Children Mental Health FamilySegment One: ―Getting on Track‖ are tangible ways in Youth Liaison webpage at:which an organization may support the practice of Family www.fyroundtable.org/fylYouth Professional Partnership. we encourage you to share this document with others and send usSegment Two: ―The Basics‖ are simple ways individuals your comments or questions via<family, youth or professional partners> may enhancetheir Family Youth Professional Partnerships skills. the webpage.Segment Three: ―The San Diego Experience‖ are bestpractices identified by organizations, Family, Youth andProfessional Partners, practicing Family YouthProfessional Partnership. 8

Best Practices FYPP Volume 1, June, 2008Best Practices – Getting on trackEstablish credibility. Top level administrators to line staff, including janitorial and volunteersmust know the Family Youth Professional Partnership vision, mission, and policies of youragency. If you don’t have one, you may want to first establish some credibility on this topic.Develop a good knowledge base of what Family Youth Professional Partnership is, or could be,in your organization. You can start by reading this report, marking those sections that lookinteresting and taking some notes as you go along.Determine your organization's (and your) attitude. Determine what your organization'scurrent mission, vision, strategic plan, or value statements say about Family Youth ProfessionalPartnership.Take a \"snapshot\". Determine where in your organization might be the best place to take a\"snapshot\" of how Family Youth Professional Partnership is currently being practiced. Choose anoffice or section that already has an interest in knowing more about FYPP capabilities. If it’s notobvious at first where to start, arrange a meeting with an appropriate official or committee towhich you can provide a short briefing on the benefits of looking at organizational behaviorsleading to exceptional FYPP.Publicize, promote, and popularize. Through information, actions and tools help yourorganizations’ journey toward Family Youth Professional Partnership: o Send a copy of this report to the formal and informal leaders in your organization and ask for their thoughts and ideas. Use their suggestions as the basis for your next steps in moving toward an organizational culture that supports Family Youth Professional Partnership. o Help organize an action team that assesses the organization's current level of Family Youth Professional Partnership and establishes recommendations for improvement. o Administer an organizational self-assessment on Family Youth Professional Partnership to a randomly selected group of employees. Then perform an analysis and present the findings to a group of individuals who are empowered to lead the organization toward exceptional Family Youth Professional Partnership. o Identify an interested group or section within your organization, and let its employees act as a hub for the advancement of Family Youth Professional Partnership. Use ideas from this group to stimulate and promote FYPP within your organization and to set standards of practice within your organization. Finally, use this group to develop your organizational training needs. o Summarize and publish your findings/activities on FYPP in your newsletter or any similar publication that reaches the maximum number of employees within your organization. 9

Best Practices FYPP Volume 1, June, 2008Best Practices – The BasicsBe flexible. People’s expectations vary; learn to take your cue from your partner. Quiet,reserved people tend to appreciate a more reserved and dignified approach. Loud, spiritedpeople often like to know that the person they are talking to is \"getting it.\" Always use goodjudgment, but be ready to stretch a little to make your style match your partner's expectations.Take some risks. Consider the mental health worker who, upon realizing the services beingprovided were not working for a child, immediately sat down with the caregiver andacknowledged the services were not getting the outcomes anticipated. Furthermore, the mentalhealth worker, committed to the caregiver that they would work together to find effectiveservices for the child.Practice servant-leadershipxiii. Develop a passion for service and then put that passion towork in whatever position you now hold. If you are already a recognized leader, then serve as amentor for others who wish to become servant-leaders.Smile your best smile. People appreciate a pleasant atmosphere. A smile always helps. Useyour smile frequently when dealing with the public. You will come to enjoy the many benefits itwill bring you.Truly Listen. The greatest compliment to another person is listening to them. Really listening.You have to listen as if you mean it. Sit up, take a few notes, ask clarifying questions, and showsome reaction to what is being said.Develop a partnership focus. Partnership is definitely needed when it comes to improvingthe emotional health of a child/youth. Demonstrate your teamwork in all decisions and actions. Each partnership created will be unique. There are individuals involved each with their own perspective and culture. The key is you, and your partner’s commitment to each other and your common purpose. 10

Best Practices FYPP Volume 1, June, 2008Best Practices – The San Diego ExperienceWhat we have learned so far…Establish individual formal relationships between the family/youth partner and the professionalpartner at the appropriate scope of work assignment (policy/administration,program/management, practice) level.Identify supports for family/youth involvement in Request for Proposal (RFP), grants, subcontracts, etc. These supports should provide some type of Honorarium, Cost Reimbursement,Consultation fees, and/or wages to support Partners in participation without undue financialstress.Encourage and support peer to peer networks outside of your agency’s culture. This givesfamily/youth the opportunity to build self supports and discover ways to better partner withsystem providers.Plan for identifying the diverse roles your agency needs for family/youth partners. One sizedoes not fit all. A family/youth partner that has the skill set of an advocate may not be thesame family partner to develop programs. Different skill sets are needed for certain activities.Utilizing a one size fits all approach creates burn-out, setting up for failure, and leaves no roomfor fidelity.Provide orientation to both family/youth partners and staff about issues, desired outcomes, andgoals of the board, task force or committee, process and the role of each individual. Thisapproach evens the playing field.Implement public awareness/educational forums where experienced family and youth partnersspeak at various venues (Board Meetings, Youth centers, Fund Raisers, Staff Meetings etc.), toeducate on the benefits and supports Family Youth Professional Partnership offers.Support Family/Youth Partners in collaborating with peers in order to bring a collective voice tothe roles they serve. Family/Youth Partners should always clarify whether they are speakingfrom personal or collective experience.Establish convenient ways in which family/youth may participate and have influence in decision-making. Family Youth Professional Partnership may be foreign to families and/or youth socontinued reminders of ways to get involved should be implementedEstablish a clear plan that encompasses roles and expectations in all FYPP activities.Create safe and non-punitive environments where family, youth, and professional partners mayopenly identify barriers and challenge each other to create solutions together.Support Partners must have access to all experts’ perspectives that influence the life domains ofthe families and youth they serve. Experts like: Mental Health Clinicians, Court Systems, ChildWelfare, Juvenile Justice, Housing etc. However, Support Partners should not be supervised byor looked upon as extensions of these expert services. 11

Best Practices FYPP Volume 1, June, 2008Case loads of Support Partners should be better monitored when developing distribution of caseloads.Agencies that hire family/youth partners need to create succession planning and advancementopportunities.Family/Youth Policies for hired family/youth should take into account the distinctiveness ofthese staff positions. Family/Youth Partners may require longer family leave times due to thevery life experiences that give them the expertise to perform their job. Example: If they mayhave children still receiving services, allow them flex time to take care of ―special needs‖surrounding their family situations.Agencies should establish polices that result in staff reduction of stigma around previous orcurrent family/youth partners’ ―life experience.‖Family and Youth Partners must have access to outside supports that assist them in maintainingfidelity to their role. 12

Best Practices FYPP Volume 1, June, 2008ReferencesAmerican Academy of Pediatrics Division of Children with Special Needs. (2000). FamilyProfessional Partnership.Center for the Study of Social Policy with Council of Chief State School OfficersFederation ofFamilies for Children’s Mental HealthNational Technical Assistance Center for Children’s MentalHealth. (1998). Family Professional Partnerships Moving Forward Together.Irene Bergfelds, Joan McChesney, Todd Sosna for Califorina Institiue for Mental Health. (2002).Family Professional Partnerships Making Them Work.Miles, P. (2001). Parent Partner Check List.National Human Services Assembly . (2005). Family Stenthing building momentium aroundfamily centered practices and policy. Washington, DC.Shorr, L. (1998). Common Purpose: Strengthening Families and Neighborhoods to RebuildAmerica (Paperback).Footnotesi Family- indicating a parent/caregiver of a child that has or is receiving services from a public child family servingsystem. <Children’s Mental Health, Child Welfare, etc.>ii Youth-indicating a person under age 25 that has or is receiving services from a public child family serving system.iii Professional-indicating a person employed by a public child family service system and/or contracted providers thatdo not identify themselves as client peers.iv United States Department of Health And Human Services Substance Abuse Mental Health ServicesAdministration definition: Systems of care is not a program — it is a philosophy of how care should be delivered.Systems of Care is an approach to services that recognizes the importance of family, school and community, andseeks to promote the full potential of every child and youth by addressing their physical, emotional, intellectual,cultural and social needs.v United States Department of Health And Human Services Substance Abuse Mental Health ServicesAdministration: The purpose of this program is to support developing integrated home and community-basedservices and supports for children and youth with serious emotional disturbances and their families by encouragingthe development and expansion of effective and enduring systems of care.vi In 2005 the Children’s System of Care Steering Committee changed its governance structure and name to CMHSChildren’s System of Care Council.vii County of San Diego Health and Human Services Agency Children’s Mental Health Policy and Procured #06-01-217Family Partner: An overarching term for: A) care giver of a child/youth who is a consumer in a public agencyserving children. B) An individual with experience as a consumer in a public agency serving children. C) Familypartner roles may include, but are not limited to: Administrative. Advocacy, Community Engagement. Training andSupervision. Support Partners (direct service). Peer to Peer. Outcome and Evaluation.viii County of San Diego Health and Human Services Agency Children’s Mental Health Policy and Procured #06-01-217Family Support Partner (FSP) An individual with experience as a consumer or caregiver of a consumer of a public 13

Best Practices FYPP Volume 1, June, 2008agency serving children/youth who is employed full or part time to provide direct (potentially billable) services to achild, youth, or family with a mental health case.ix County of San Diego Health and Human Services Agency Children’s Mental Health Policy and Procured #06-01-216Youth Support Partner (YSP): An individual with experience as a consumer of a public agency servingchildren/youth who is employed full or part time to provide direct (potentially billable) services to a child, youth, orfamily with a mental health case.x County of San Diego Health and Human Services Agency Children’s Mental Health Policy and Procured #06-01-216Youth Partner: An overarching term for: A) An individual with experience as a consumer in a public agency servingchildren/youth. B) Youth Partner roles may include but are not limited to: Administrative. Advocacy/CommunityEngagement. Training and Supervision. Support Partners (direct service). Peer to Peer. Outcome and Evaluation.xi Independent Family and/or Youth organizations are 51% of Board of Directors membership made up of family oryouth according CMHS policies. Leadership positions should be filled by family or youth or past consumer. At aminimum Director of the organization shall be a family/youth individual meeting the definition of County policy –Definition approved by CMHS CSOC Council November, 2006xii See County of San Diego HHSA CMHS Policies and Procedures for full detail on training and supervision of SupportPartners.xiii Servant leadership is an approach to leadership development, coined and defined by Robert Greenleaf andadvanced by several authors such as Stephen Covey, Peter Block, Peter Senge, Max Du Pree, Margaret Wheatley,Ken Blanchard, and others. Servant-leadership emphasizes the leader's role as steward of the resources (human,financial and otherwise) provided by the organization. It encourages leaders to serve others while staying focused onachieving results in line with the organization's values and integrity. 14