FSP FY2004 DMH

 Department of Mental Health

DMH Family Support Plan

Human Service Agency Overview of Family Support

Definition used by the Department of Mental Health:

The Department of Mental Health defines family support
through program and practice expectations. Family support includes all
activities that assist families to support the growth, recovery and
rehabilitation of their affected family member. In providing family
support, DMH uses a very inclusive definition of family, which may include
parents and guardians, other relatives, and non-related individuals
whom the client defines as family and who play a significant role in
the client’s life.

Types of family support services available

education that enables families to better
understand the mental health problems and the treatment being offered
to a family member

• direct assistance in caring for a family member with
mental health problems

• training in managing problems that a family member
presents

• linkage with other resources that can reduce the care-giving
burden

• linkage with other families either coping or struggling
with the same concerns

• training and assistance in advocating on behalf of
family members

• support in accessing services and entitlements for
family members

Network for providing family support services Family
support is interwoven into numerous activities of DMH.

Case management

The Department’s goal is to provide each eligible client
with a case manager. Virtually all case management for children, and
some of it for adults, can be defined as family support. For adults
living at home, much of case management support is directed to assisting
the family. Even if the adult is living out-of-home, case manager’s
work with the adult’s family so long as the adult has given consent.
Case Managers for children, adolescents, and adults help families think
through the effects of the client’s mental health problems on their
lives, identify the strengths and resources they have available, and
identify those who can best support the client’s recovery and growth.
Case managers link families with assistance for themselves as well as
for the client as part of the service planning process, and are the
people families turn to for help in case of crises and unexpected events.
Case managers authorize the provision of services which directly support
the family’s care-giving capacity, help families get benefits for the
client, and assist families in advocating with other entities for services
and supports.

Contracted family support services

DMH contracts with providers in each of its sites for
Individual and Family Flexible Support Services for children authorized
by DMH to receive such services. Services to families provided under
these contracts may include consultation on advocacy strategies to assist
the family in securing services from schools and other entities, teaching
behavior management skills, and access to respite care, parent aide
services, homemaker, and chore services. The contracts include money
for purchasing individualized services to address unique challenges
that families face.

DMH funds parent partners as part of the joint DSS-DMH
Collaborative Assessment Program (CAP). Families going through CAP,
an assessment and crisis stabilization process for children at risk
ofout-of-home placement, are offered parent partners. These are parents
who have raised children with mental health problems and can assist
CAP parents in figuring out their needs and how to get them met.

Parent support is also available to all parents of children
and adolescents with behavioral, emotional or mental health problems,
whether or not their child is a DMH client. DMH funds at least one parent
coordinator position in each of its six Areas. Parent coordinators facilitate
parent support groups that offer emotional support, provide education
about mental health problems and state of the art treatment, teach advocacy
strategies, and serve as a self-help venue for parents. For families
of adults, NAMI’s Family-to-Family provides structured support
groups, and in addition, while not funded by DMH, NAMI has 27 affiliates
who hold regular support and information meetings across the state.

DMH funded adult services also provide support to the
families of adult clients, provided the adult client has given consent.
Family support is provided for both clients living at home and those
who are not. Services that involve families and spouses of mentally
ill adults include: the Program of Assertive Community Treatment (PACT)
which makes intensive supports for the adult and his family available
24 hours a day; Community Rehabilitative Support activities; and supported
housing services, particularly in cases where a client resides at his
family home and receives residential and rehabilitative support there.
In these programs staff not only provide direct service to the client,
but provide and coordination, referral, and support services to household
members and help them achieve a realistic understanding of the nature
of mental illness, its treatment and its prognosis.

DMH provides funding to the Massachusetts Chapter of the
National Alliance for the Mentally 111 (NAMI-Mass) and the Parent Professional
Advocacy League (PAL) for educational programs for families. NAMI offers
Family-to-Family, a free, 12 week psycho-educational course designed
for family members of older adolescents and adults This course helps
families learn essential skills and information relevant to caring for
a family member with major mental illness. Trained family member volunteers
teach the courses. NAMI and PAL jointly offer Visions/or Tomorrow,
a similarly structured 8-10 week course to help parents and other primary
caregivers of children and adolescents. These programs are open to all
families in the community who care for people with mental health problems,
and are offered in both Spanish and English.

Process used to get input on the plan from families
of individuals who. receive DMH-funded services

• DMH Area and Site boards regularly participate in needs
assessments and program planning. A draft of the family support plan
was distributed to the citizen advisory boards in the six Areas and
29 Sites. In those Areas and Sites in which there are separate child/adolescent
committees, DMH solicited feedback from families of children and adolescents.

• DMH discussed the plan and distributed the draft to
the Commissioner’s Statewide Advisory Council.

• DMH discussed the plan and distributed a draft to the
Board of Directors of the Parent Professional Advocacy League (PAL),
an organization whose board membership includes parents and guardians
of children under 18 and parents of young adults.

• The draft plan was distributed to DMH-funded parent
coordinators and presented to parents in family support groups.

• The draft plan was reviewed by the Massachusetts Chapter
of National Alliance of the Mentally 111.

• DMH discussed the draft plan with the executive of Adoptive
Families Together, an organization providing support groups for parents
of adoptees with behavioral problems.

• The draft plan was reviewed by the Massachusetts Association
for Mental Health, a citizen advocacy organization.

• The committee addressing supports for parents with mental
illness who are raising children discussed the draft plan.

The initiatives discussed below to address inadequacies
in family supports are a response to the input given by families through
the ongoing DMH processes of constituent involvement in program development.
Parents and family members have been involved in both the design and
implementation phase of these initiatives. Specific levels of involvement
are identified below as part of the discussion of the activity.

The Plan I. Family Empowerment

Current Initiatives

Family members are represented on the Commissioner’s Statewide
Advisory Council. Parents of both adult and child mental health consumers
are also key members of the State Mental Health Planning Council. The
Council must review and approve the annual State Mental Health Plan
and the Implementation Report that Massachusetts must submit in order
to receive federal funds through the community mental health services
block grant. Parents are also represented on the statewide Professional
Advisory Committee on Children’s Mental Health, an informal group that
has been in existence for 25 years and that advocates at the state level
on issues related to the mental health of children and adolescents.

The Area and Site-based structure of DMH also promotes
Family Empowerment. Family members are represented on Site and Area
Boards that advise on local program development, and regulations, statutes
and policies. Family members participate in the service procurement
process through participating on proposal review committees that provide
recommendations to the Department about contract awards.

DMH partially funds the statewide organization of PAL,
which is responsible for making sure that the voices of parents and
family members of children with mental health problems are represented
in all policy and program development forums both within DMH and in
other agency and interagency forums. PAL provides training to the network
of 33 parent coordinators and parent partners to enhance their advocacy
skills. PAL maintains regular communication with each of the local support
groups and, through them, solicits input on proposed changes to state
and federal laws and regulations and program designs that affect children
with mental health problems. PAL provides feedback to DMH staff about
problems that parents are experiencing in regard to service access and
quality based on information from support groups, problems presented
to the Parent Resource Network Hotline, and studies that it conducts.
A DMH staff member serves as an ex-officio member of the PAL board and
attends the monthly meetings of the parent network to hear concerns
directly and solicit parental feedback

DMH also works with Adoptive Families Together (AFT),
a network of parents of adopted children with special needs. AFT offers
support groups across the state and develops written material for parents
to help them advocate for the best services for their children. DMH
provided funding to AFT in FY ’03 for a revised third edition of the
booklet “In Their Own Words.. .Reflections on Parenting Children
with Mental Health Problems:
The Effect on Families” and
to
support their participation in program development and policy forums.
In addition, AFT has just published a pamphlet Restraint and Seclusion:
What Families Need to Know,
which includes a list of 10 specific
steps parents can take to help change restraint and seclusion policies.
DMH will distribute this information to the families that it works with
and to parents involved with the PAL network.

New Initiatives

The gaps identified in DMH’s initial assessment o’fits
family support activities included limited capacity across the state
to provide intensive wraparound services that are family-driven. This
is beginning to be addressed at several levels. The Executive Office
of Health and Human Services (EOHHS) has identified “distressed children”
as one of its key concerns. Several projects are underway to facilitate
service access and enhance service coordination, and joint service procurement
is being discussed. DMH will continue to advocate for having parents
participate in service system design across all human service agencies
to assure creation of a system that is responsive to needs as identified
by families. One of the lenses through which DMH will evaluate proposed
service system changes will be the degree to which such changes make
the system more family-driven and family-centered.

In FY ’03 the first local chapter of PAL was formed in
Worcester with its own director. Whereas representatives from PAL and
other parents have been involved in policy and programming decisions
for many years, the creation this chapter creates a distinct local voice
for parents.

DMH has joined the Department of Public Health in an initiative
that convenes leaders of parent support groups to share strategies for
addressing crosscutting concerns, such as increasing family representation
in planning and policy forums, increasing involvement of minority populations,
etc.

II Family Leadership

Current Initiatives

NAMI’s “Family to Family” curriculum and “Visions for
Tomorrow” taught by PAL and NAMI utilize a train-the-trainer model to
help families learn essential skills and information relevant to caring
for a family member with mental illness and become knowledgeable about
available interventions and resources. Trainers then run groups in their
local areas and thus continue to build an informed family base. DMH
parents continue to participate in trainings offered through Families
Organizing for Change that focus on advocacy strategies. PAL provides
monthly trainings for the parent network that build skills in specific
areas, such as effective advocacy with schools and insurers. Family
support funds are used to pay for expenses associated with attending
conferences and trainings, and parents from across the state attend
and often present at the national conference of the Federation of Families
for Children’s Mental Health and at the national Children’s Mental Health
Research Conference.

The Director of the statewide PAL organization has co-chaired
the Family Advisory Committee of the Massachusetts Behavioral Health
Partnership since its creation, and participates on the statewide Steering
Committee for the Coordinated Family Focused Care (CFFC) initiative.
CFFC is an interagency service delivery model being piloted in six cities
that incorporates family supports and promotes a partnership of families
and professionals in service planning. It was officially launched in
May 2003 and began accepting clients in the summer of 2003.

New Initiatives

Parents are being recruited to serve on each of the six
local CFFC steering committees, now in the process of being established,
which will offer additional venues in which parents can exercise leadership.
DMH has advocated for parent representation on the EOHHS Steering Committee
developing a pilot project directly targeted to improve collaboration
between the schools and the state human service agencies, and expects
that parents will be added to the group this fall.

PAL has been involved in initial trainings for CFFC staff
and is submitting a proposal for training CFFC parent partners. DMH
supports the practice of parents serving as trainers for other parents.

Ill Family Support Resources and Funding

Current Initiatives

DMH currently spends $3,753,325 for case management services
for children and adolescents, not including the costs of supervision.
As noted above, parents are the legal guardians, and the ones responsible
for their child’s care, and thus most case management activities are
designed to support families in their role. Case managers work with
parents to develop a child’s Individual Service Plan, check in with
the family regularly, and are available to families to help resolve
situations as they arise.

DMH currently spends $18,010,877 for case management for
adults. Approximately 25% of adult clients live with their families,
and, for those who receive case management, a significant portion of
case management activity is directed to supporting the family in maintaining
the client at home. Approximately $2,340,000 of the adult case management
budget should be considered as family support.

DMH spends $13,115,322 for individual and family flexible
support, direct services for families of children and adolescents who
have been determined eligible for DMH continuing care services, or who
require immediate intervention. The contract reporting mechanism does
not distinguish how much is spent on direct services for the individual,
as opposed to support to the family, to enable the child or adolescent
to remain at home, but contract managers estimate that at least half
of this money is spent on family support. Most respite care for caregivers
is funded through these flexible support contracts. However, the DMH
also has $1,260,478 in contracts that are exclusively for respite care
for children and adolescents, most of which is aimed at providing relief
to caregivers.

DMH also funds community family support activities that
are not restricted to individuals who have been determined eligible
for DMH services. DMH contracts with NAMI for $231,336 and with PAL
for $135,000. For families of children and adolescents, there are area-based
contracts totaling $1,450,000 that cover family support services provided
by 39 locally based parent coordinators and parent partners working
in the DSS-DMH Collaborative Assessment Program. Parent education, parent
support groups, training and leadership development, and parent mentoring
activities are some of the activities offered with these funds. By enabling
parents to develop their knowledge and get emotional and practical support
from other parents, these activities enable many families to support
their child’s growth without the necessity of formal state agency involvement.

Also, DMH contributes $53,750 to the Clubhouse Family
Legal Support Project (CFLSP), which was established in 2000. The project
attorney, working with the Mental Health Legal Advisors Committee legal
team and the staff of the Employment Options Clubhouse provides legal
representation to low income parents with mental illness who are at
risk of losing custody and/or contact with their children. The project
is proving effective in helping some parents regain or retain custody,
and helping others gain visitation rights.

As noted above, DMH provides flexible funding to families
of children and adolescents through individual and family flexible support
and/or intensive wraparound contracts with mental health providers.
If the DMH Individual Service Plan, drawn up by the case manager in
collaboration with the parent or guardian, and signed off by the guardian,
calls for family support, the family is referred to the flexible support/wraparound
provider. The provider then draws up an initial program specific treatment
plan with the family, indicating the family support services to be provided
by the agency’s staff, by services purchased on behalf of the family,
or through vouchers given to the family. The provider is responsible
for assuring that expenditures support the treatment goals for the child
or adolescent. Supports are changed to address new needs or circumstances
with me agreement of the family and the provider. The flexible support
provider or the case manager authorizes respite care services.

New initiatives

Under the administration’s reorganization plan, human
service agencies under EOHHS have been undertaking planning as a single
entity. EOHHS submitted a grant in August 2003 to the Center for Mental
Health Services to expand the Worcester Communities of Care initiative
to include the other 65 cities and towns in the DMH Central Massachusetts
Area. This grant, targeted to children and adolescents with serious
emotional disturbance, places families at the center of all client activities,
with the families deciding who they want at the table to plan for addressing
their service needs. Family-specific treatment and support plans are
created by the family with the help of the team, and flexible funds
are available for each family. The grant will also focus on expansion
of capacity in those services most frequently requested by families,
particularly respite care.

Planning for re-procurement ofDSS and DMH services is
currently in process under the aegis of EOHHS. EOHHS has committed to
creating a more community-based system of care, and to providing families
with the supports they need to maintain their children at home, whenever
home placement is suitable. Placing families at the center, and creating
a flexible continuum of care, with flexible funding, are core values
embraced by EOHHS in this planning process.

At the local level, DMH staff and families participate
in a varying of training activities related to creating a more family
responsive system. DMH Southeastern Area is holding a conference September
22,2003 on family support and family driven services.

IV Accessing Services and Supports

The mission of the Department of Mental Health is to serve
adults with serious mental illness and children and adolescents with
serious emotional disturbance who have continuing care needs that cannot
be addressed by acute care services. DMH’s budget is predicated on the
assumption that the acute care sector will fulfill its role, that insurers
included under the state’s parity legislation will fund the mental health
services identified in the legislation, and that generic community agencies
and organizations, given some assistance, can and will serve and include
most children and adults, including those with mental health problems.

One approach DMH has taken to assuring access to services
is to create savvy consumers and families who can access high quality
acute care services, and necessary funding. It should be noted that
for adults, unless the parent is the legal guardian, DMH cannot contact
the family without the client’s permission. Thus, outreach work targets
both families and adult consumers themselves. DMH funds entitlement
specialists to work with consumers and families around access to the
full array of entitlements and supports for individuals with mental
health problems, including Medicaid, private health insurance coverage,
SSI and SSDI, housing and legal aid, and provides training on entitlements
for its case managers so that they can assist families with these matters.
Both PAL and NAMI provide information to families regarding access to
DMH services, and other means of securing mental health services. Since
most children and adolescents with serious emotional disturbances also
have special education needs, PAL is a resource for parents around special
education services for children with mental health problems.

DMH does extensive outreach and training with community
agencies and organizations to make them aware of DMH services available
to the community at large, such as education and family support activities
sponsored by NAMI and PAL, as well as to inform them about the services
available to individuals who meet DMH eligibility criteria. The Consumer
toll-free help-line at DMH fields calls from families as well as from
clients. For children and adolescents DMH works collaboratively with
Adoptive Families Together, Parents for Residential Reform, the Federation
for Children with Special Needs, and the Consortium fur Cmldren with
Special Health Care Needs, assuring that they know what services DMH
can offer. DMH provides training to acute care psychiatric units, and
to other state agencies such as DSS to keep them abreast of the service
we can offer as well as our eligibility requirements. NAMI has a statewide
information and referral line that services thousands of callers a year.
Through these calls and other requests, NAMI-MASS mails and distributes
approximately 10,000 informational packets a year, covering issues ranging
from the basics of mental illness to issues surrounding guardianship.

Focus groups of parents and governmental study commissions
over the years have identified the complexity of the children’s mental
health service system and the multiplicity of agencies who need to involved
in child’s care as a barrier to accessing care. There have been numerous
requests to establish an 800 number. In FY ’03, DMH provided start-up
funding to PAL to create a Parent Resource Network Line (PRN Line),
a toll-free number for parents of children and adolescents, staffed
by trained parents, who provide callers with support, information, and
referrals related to youth mental health. Staff address information
requests and may refer callers to local parent coordinators who connect
families to local resources. Ongoing support for this initiative is
coming from the major HMOs in the state. The HMOs have taken responsibility
for publicizing the line to the community at large, including media
relations. DMH assisted the publicity committee in designing strategies for reach school staff,
mental health practitioners in private practice, and professional organizations.

General community information campaigns are conducted
by the Massachusetts Association for Mental Health (MAMH) as part of
its campaign to combat stigma about mental illness. Media are particularly
involved during the month of October to promote the national depression
screening day, and also during May, which has been designated nationally
as Mental Health month. The first week in May is Children’s Mental Health
Week. The DMH areas distribute materials to libraries, schools and pediatricians”
offices that explain mental illness and that direct families to resources.
For the past 5 years, PAL has created a poster for Children’s Mental
Health Week with the names and telephone numbers of the local coordinators.

Many activities are being undertaken at the local level
also. PAL and DSS and DMH through CAP have collaborated to present two
evening programs for parents of children with serious emotional disturbance
about the services and supports available to children transitioning
to adult services. These programs were open to the general public and
will be offered again this year.

New Initiatives

DMH’s earlier assessment of family supports indicated
the dismay of many parents because services are not available until
a child’s functioning is significantly impaired. EOHHS is committed
to prevention and early treatment and DMH is part of an EOHHS initiative
to figure out approaches and funding mechanisms to address this concern,
including the use ofMedicaid dollars. The American Academy of Pediatrics
also has a broad-based work group involving DMH and others that is looking
at screening children for depression. DMH has also highlighted the need
to identify and treat children early to the Office for Child Care Services
and the interagency workgroup on School Readiness. These activities
are in progress.

DMH, Department of Social Services (DSS) and University
of Massachusetts researchers who have studied parents with mental illness
have designed training for DSS staff to enable them to better identify
adult mental illness and provide support for adult caregivers involved
with DSS. The plan is for the agencies to jointly offer these trainings
this fall. This training is a follow-up to a change that DMH made in
its eligibility regulations in January 2002. That change requires DMH
to ask adult applicants if they are involved with DSS, and if so, whether
they want short-term DMH services while their application is being considered.
If the answer is yes, DMH will then provide immediate family supports
to assure that the children in the home are maintained safely.

DMH continues to participate on the Steering Committee
for Parents with Mental Illness and their families created through the
UMASS Medical School. The committee representatives from DMH, PAL, UMass
Medical School, Employment Options, Cole Resource Center, and Mental
Health Legal Advisors Committee. DMH makes a significant contribution
to the research and intervention projects developed by the Parents’
Project Team at the UMass Medical Center School’s Center for Mental
Health

Research. DMH administrators, staff, and clients are key
stakeholders in identifying the team’s agenda, implementing projects,
and disseminating findings to the field, consumers and family members.
“Parenting Well When You Are Depressed” was written collaboratively
by UMass Medical School, researchers/providers, community stakeholders,
consumers and family members. Employment Options, a DMH funded clubhouse,
sponsors a unique family support program which specifically focuses
on the needs of parents with mental illness and their families. There
are parent support groups at Employment Options and Atlantic House clubhouses.

The Cole Resource Center, acting as the agent for the
committee, has submitted a grant proposal for a conference on providing
support to parents with mental illness. Employment Options is also finishing
a consensus-building grant, focused on the Metro-West region, which
is seeking to build community consensus about the types of wraparound
or flexible support services that are needed and strategies for service
delivery.

V Culturally Competent Outreach and Support

All services are made accessible to individuals and families
as needed. If English proficiency is limited, then interpreter services
are made available. Likewise, interpreters are made available for the
deaf and hard of hearing. DMH attempts to insure that all written materials
are available in the client’s preferred language. Translations are done
on an as needed basis for individuals, for client-specific matters.

The DMH Office of Multi-Cultural Affairs reviews DMH-prepared
documents to assure that they are culturally appropriate for all populations.
In this past year, they reviewed “Psychiatric Medication for Children
and Adolescents: Orientation for Parents, Guardians and Others” and
subsequently prepared a Spanish translation of that document.

In FY’03, DMH worked in numerous ways with community groups
to help minority communities respond to the aftermath September 11th,
and to increase community capacity for coping with disaster and trauma.
This outreach was particularly critical as a number of the new immigrant
populations come to the United States to escape political violence in
their own countries, and are particularly vulnerable to re-traumatization.
Funding given to the Haitian Health Institute/Boston Medical Center
paid for minority parents to participate in a “train the trainer” training,
so that they are now able to educate other parents about mental health
issues and trauma. The Institute also developed public service announcements
for radio teaching families about trauma and community resources.

The Massachusetts Initiative for Multicultural Community
Outreach (MIMCO) contracted with several organizations to increase information
and access to services related to responding to trauma and disaster.
Funded groups included: .(1) Boston Health Care (working with the Islamic
Society of Boston); (2) Child and Family Service of Pioneer Valley (serving
Russians, Bosnians and Vietnamese in Western Mass.); (3) International
Institute of Boston (working with Muslim Community Support Services);

(4) Haitian American Public Health Initiative (leading
a collaborative of Mutual Assistance Associations, including Somali
Development Center; Somali Women and Children’s Association; Ethiopian
Community Mutual Assistance Association; Universal Human Rights International;
Russian Community Association of Massachusetts; and Vietnamese American
Civic Association); (5) The Black Ministerial Alliance (Boston).

The Latino Mental Health Project was also initiated in
the DMH Central Mass. Area. The Area has established a partnership with
Latino consumers, their families, representatives of local community
support systems and three community-based agencies: Great Brook Valley
Health Center, Family Health Center and Central Mass. Area Health Education
Center, for the purpose of building capacity to better meet the medical
and psychiatric needs of Latinos in Worcester. This will be accomplished
by outreaching to the community, conducting a meaningful assessment
of mental health needs and collaboratively designing innovative and
culturally competent mental health services and programs.

New Initiatives

Although the initiatives noted above involved one-time
funding, most of the grants involved work with community leaders or
to individuals trained to be trainers who could continue to work within
their community after the grant funding expired. DMH will provide professional
support to maintain the momentum of those grants.

FY’04 represents the third year of DMH Cultural Competence
Action Plan, a three-year project. DMH will continue to work on outcomes
identified for the third year of that plan. DMH will provide diversity
education, training and education to additional boards and committees
to increase the recruitment of racially, ethnically and culturally individuals
in the design, development and oversight of DMH funded programs. A process
to identify the cultural/ethnic affiliations and linguistic capabilities
of all newly hired staff will continue. Foreign language instruction
will continue to be offered for all staff. In addition, several DMH
contracted and operated services will be reviewed to assure maintenance
to cultural competence standards such as training interpreters, training
DMH staff, and implementation of the interpreter services legislation.

The multicultural population resource directory, translated
materials catalog and bibliography will be updated and available to
the general population through the Intranet. The repository of cultural
competence and diversity training materials will be expanded and maintained.

Interagency Collaboration

DMH is engaged in numerous activities with EOHHS itself
and other .EOHHS agencies as EOHHS takes steps to create a seamless
system of care that is easy for families to negotiate. DMH is participating
in thinking through approaches for creating a single point of entry
or virtual gateway to state services. DMH is also actively involved
with

EOHHS, DMA and DPH in the discussions about its relationship
to and oversight responsibilities for the various components of the
Medicaid system, and in particular, behavioral health services, including
mental health and substance abuse services. The reconfiguration of DMA
is intended to enhance service delivery through more effective use of
the Medicaid dollar. Projects aimed at improving access, quality and
coordination of services for adults as well as children and adolescents
include: re-procurement of the Medicaid MCO contracts; providing access
to low cost prescription drugs, and improving service delivery to individuals
with substance abuse and mental health problems. The continues to be
a paucity of programs and staff trained to treat seriously mentally
people with co-occurring substance abuse problems.

EOHHS has identified distressed children as one of its
top priorities and the legislatively mandated Children’s Mental Health
Commission, chaired by EOHHS Secretary Preston, has identified subcommittees
to address problems that have direct bearing on family support. Parents
are represented on the Commission. The discussion of new initiatives
above often references EOHHS activities. The Commission’s subcommittees
include:

Stuck and Homeless children – This subcommittee
is charged with coming up with short term recommendations and a long
term plan to resolve the problem of children remaining in acute care
inpatient psychiatric beds after they are clinically ready for discharge.
The subcommittee will look at the specific services and supports that
should be available to prevent/divert hospitalization in acute situations,
and the specific changes that need to be made, and/or capacities that
need to be increased, to promote timely discharges.

Continuum of Care/Evidence Based Care

EOHHS is proposing a merger of these two committees. This
merged group would then have the mission of developing recommendations, based
on the best research available, for a range of services/interventions that are specific
to the needs of clearly identified populations.

Insurance

This subcommittee will document coverage for mental health
services and utilization of mental health services. Insurance coverage
is a significant support for families, as it eliminates or reduces a
significant financial burden.

Other EOHHS initiative, not directly linked to the Children’s
Mental Health Commission, include:

0-5 Initiative: This initiative is considering
a number of discrete interventions, including screening for mental health
problems in children, working with physicians, and assisting teachers
in early education settings to create supportive classrooms for children
with challenging behaviors. There is also a group working on readiness
for school. See new initiatives under Accessing Services and Supports
above.

Enhancing Collaboration between the Courts, Schools
and Public Agencies’.
DMH is participating in development of a model
for a pilot project that would use educational collaboratives as the
linchpin in coordinating interventions for the child and family.

Coordinated Family-Focused Care: DMH serves on
the steering committee overseeing implementation and evaluation ofCFFC.

Purchasing Strategies: With EOHHS in the lead,
the agencies are examining the situations in which they procure similar
types of services. The goal is to institute more streamlined methods
of procurement that will promote a more integrated service delivery
system. Consideration of how the agencies can decrease reliance on out-of-home
placements and move to a more community-based system of care is part
of the discussion of purchasing strategies.