Friday, December 14, 2007

Wrapping Around Rosie D: Communities of Care

I got to hear Peter Metz talking about Communities of Care today, which is the Massachusetts version of the Systems of Care approach to care. This is a family-centered approach to managing child-mental health issues. He summarized the philosophy of his program with three statements about the role of families in providing the service:
  • Voice and Choice
  • Nothing About Us Without Us
  • No Shame, No Blame
The key to his program is having Family Partners and Care Managers. He feels that a large part of the problem is engagement, and that the parent parents are the key to the process. The next step is helping the families to convene a team to address the child's needs at many levels, and to address all of the family needs as they are moving through the system. The team makes a plan, monitors the plan and works with the family to make the plan work for them. There are some "flexible funds" to allow the family to fill in the gaps and provide the care. In-home respite care is a really important part of what is going on.

His program also did system level interventions, beyond the 50 kids who got intensive care management as part of his program. School commitments, PPAL, collaborative groups- Worcester Communities of Care has been involved in all of those things. He apologized that the pediatric community was not included on his slide, but I think that his slides reflected the reality that the pediatric community has not done a good job of partnering with the mental health system.

His evaluation has had some problems: the evaluation used a comparison group that was selected in a different manner and there were a lot of gaps in the follow-up data. (50-75% compliance on the various instruments). Still, the CoC kids did well, and the program has been morphed in the MBHP program Coordinated Family-Focused Care currently being piloted in 5 cities. (Soon to be rolled out throughout the State).

They also do a Training, Consultation and Coaching (TLC) program to bring state-agencies around to do more strength-based, family-driven work, working with lots of agencies around the state.

Finally, there is the collaboration with the Court System through the CMCC Youth and Families Center, located in the North and South Counties, that are partnering with the State to to work with children who are court involved and see if we can work with children with mental illness to keep them out of lock-up with intensive services. The effort is new, and is working its way through the system.

Hard to type while so much information is being presented. You really had to be there. Nice work, Peter.
Please note that these notes reflect my understanding of what was said, and likely reflect my biases and my hidden agendas, which are often hidden even from me. Please let me know if I have misunderstood what is going on- the nice thing about blogs is that you can edit and correct them.

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