HomeMy WebLinkAboutMINUTES - 09131994 - IO.1 TO: BOARD OF SUPERVISORS Contra
FROM: INTERNAL OPERATIONS COMMITTEE
j : Costa
Aug ust 22 1994
*:�¢ County
DATE: � r?tr�-cdJi+`�'t �V
SUBJECT: REPORT ON THE POLICY ACADEMY AND FAMILY MAINTENANCE ORGANIZATION
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS :
1 . CONCUR in the general direction for the Policy Academy implied
by the Mission Statement and statement of Major
Responsibilities in the attached memo from the Policy Academy.
2 . REQUEST the Policy Academy to prepare a Work Plan outlining
their proposed activities and present it to the Internal
Operations Committee as soon as it is completed.
3 . CONCUR in general with the proposed composition of the Policy
Academy, but request that the Policy Academy consider making
the following additional changes in its composition:
A. That one of the consumer seats be designated for a youth.
B. That one seat be added for a youth, to be appointed by
the County Youth Commission.
C. That the youth on the Policy Academy be entitled to
appoint. an alternate to represent them when they are
unable to be present at meetings .
D. That an employee organization seat be added to the Policy
Academy.
E . That the Policy Academy consider adding a law enforcement
seat representing city police agencies, appointed by the
Police Chiefs ' Association.
.ONTINUED ON ATTACHMENT: YES SIGNATURE:
_RECOMMENDATION OF COUNTY ADMINIVTR ENDATION OF BOARRDCCOMMMITTEE
—APPROVE OTHERJEFF SMITH ) RK DeSAULNIER
;IGNATURE S :
1CTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
'OTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED SEP 13 1994
;OntaCt: PHIL BATCHELOR.CLERK OF THE BOARD OF
C*. See Page 2 (^\ SUPERVISORS AND COUNTY ADMINISTRATOR
DEPUTY
4 . REQUEST the Policy Academy to report further to our Committee
on October 10, 1994 following their consideration of these and
additional changes to the composition of the Policy Academy.
5 . ACCEPT the attached status report from the Family Maintenance
Organization on its Work Plan, Planning Process, Family
Strengths and Needs Assessment, Advisory Group Descriptions
and Comparison Document of the Family Maintenance Organization
and Service Integration Teams and request the Health Services
Director to make further reports to our Committee on the
status of the Family Maintenance Organization as events
warrant further reports.
BACKGROUND:
On July 19, 1994, the Board of Supervisors approved a report from
our Committee which included the following recommendation:
2 . REQUEST the County Administrator to invite the
members of the Policy Academy and Family
Maintenance Organization to meet with the Internal
Operations Committee on August 22, 1994 to update
the Internal Operations Committee on the goals,
accomplishments and future plans of both the Policy
Academy and Family Maintenance Organization.
Attached are two reports, one from Sara Hoffman on the Policy
Academy and the other from Mary Foran on the Family Maintenance
Organization. On August 22, 1994, our Committee met with several
members of the Policy Academy. Sara Hoffman reviewed the attached
status report. The Policy Academy needs to be broadened and made
more inclusive, as is outlined in their report. In addition, our
Committee has suggested the addition of several others groups we
feel should be represented.
We do not believe that the size, composition and structure of the
Policy Academy should be rigidly structured by the Board of
Supervisors or that all appointments need to be made by the Board
of Supervisors . We are, therefore, couching these additional
changes in the form of suggestions for consideration by the Policy
Academy, rather than as action items for approval by the Board of
Supervisors .
We also received the attached report from Mary Foran, on behalf of
the Family Maintenance Organization, which is struggling with
questions about what families need to support them in improving and
maintaining their health status and then applying for funding to
create those support mechanisms. We see this as a very positive
and exciting direction which is being taken by the Health Services
Department and would like to be able to follow the activities on
the Family Maintenance Organization as it continue to develop.
cc: County Administrator
Social Services Director
County Probation Officer
Health Services Director
Community Services Director
Public Health Director, HSD
Mental Health Director, HSD
Substance Abuse Program Administrator, HSD
Sara Hoffman, Senior Deputy County Administrator
Mary Foran, Office for Service Integration, HSD
2
CONTRA COSTA COUNTY
OFFICE OF THE COUNTY ADMINISTRATOR
651 Pine Street, 10th Floor
Martinez, California 94553
Telephone: 646-1390
DATE: August 22, 1994
TO: Supervisor Jeff Smith
Supervisor Mark DeSaulnier
Internal Operations Committee
FROM: Policy Academy
BY: Sara Hoffman;Senior Deputy Administrator
SUBJECT: Parameters for the Policy Academy
The Internal Operations Committee requested that Policy Academy members meet with
them to. discuss goals, roles and membership. Please see the attached mission
statement, major responsibilities and membership for your review and approval.
Presently, the Policy Academy is staffed through the largess of the Policy Academy
foundation consortium and is basically for meeting facilitation. Distribution of materials
is handled through the County Administrator's Office. The Policy Academy does not have
dedicated staff that would be available to prepare reports, do analysis or provide other
support. Consequently, the Policy Academy sees itself as a "self-staffed" committee.
Based on direction from the 10 Committee and the Board of Supervisors on the Policy
Academy's future, the Academy believes the next step would be to prepare a work plan
for the 10 Committee's review and approval.
Attachments
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ATTACHMENT C
CONTRA COSTA COUNTY FAMILY MAINTENANCE ORGANIZATION
FAMILY STRENGTHS AND NEEDS ASSESSMENT:
SUMMARY OF FINDINGS TO DATE
July, 1994
Introduction
Since late April, the staff of the Family Maintenance Organization has been immersed
in research, reading and interviews in attempt to answer the following two questions:
1) What works well within Contra Costa County's families and communities?
(What are the strengths?); and
2) What do families need to support them in improving and maintaining their
health status?
The information which follows is a summary of what the FMO Staff has learned to
date. It serves as a basic introduction to the rationale for the Family Maintenance
Organization, and raises suggested directions for developing the benefit package
options for the FMO.
Methodology
We have used a number of approaches to obtain information, following what is
sometimes referred to as a "community impressions" approach. The primary methods
used thus far are:
1) Review of pertinent County data, including surveys, focus groups, needs
assessments and studies.
2) Literature review;
3). Informational interviews with key community leaders, Health Services
division directors and staff and County Department directors; and
4) Inquiries to recognized community non-profit agencies, academic
institutions and government agency directors.
Although we have learned a great deal in a short time, this information is by no means
exhaustive or comprehensive. Further strengths and needs assessment efforts will
include additional literature review, interviews, peer and focus groups, and further
research on local agency program initiatives.
Page 2
Family Strengths
In recent years, there has been increasing attention to the area of family strengths or
assets. As a response to the predominance of the needs or "deficit" model (which has
been criticized for focusing on what is lacking rather than what exists), policy makers
and service professionals have begun to recommend new strategies which recognize
and measure family strengths.
Much of the literature on family strengths is concentrated on reframing the provider-
family interaction in order to encourage the family to recognize its own strengths and
assets. This shift in thinking at the provider level to a family strengths perspective is
important and necessary, and will involve re-training providers across many disciplines.
It is critical, however, to incorporate this family strengths perspective at other levels as
well. Unlike a needs assessment, which is common practice when planning any
program, a strengths or assets assessment is not usually included. What would a
strengths assessment look like and how would family strengths be measured? Is it
comparable to a list of needs? How would this change the planning process and can
it be incorporated into it? The family strengths perspective has not been applied as
often to this level of program development. One way to think about family strengths is
to think about what a healthy family looks like, and what kind of environment should
be provided for children. How can we build upon the strengths that families already
have?
An additional area of focus for the strengths perspective has been the community.
John McKnight has developed a theory of "community mapping" which records the
assets of individuals and communities. Others have written about the elements of a
"normative system" - a system that provides the resources for all families to survive
and thrive. By determining these elements and ensuring their existence, we move
away from focusing on families that have "failed" or simply counting needs. The Public
Health Division is currently conducting a community mapping project based on the
McKnight model. The results will be incorporated into our planning. Even now, our
interviews and reading tell us that at the least Contra Costa families possess the
following kinds of strengths:
• Social support, including informal networks, provided by kin, friends and
neighbors, community-based organizations, churches and associations.
• Individual skills, such as singing, sewing or athletics and shared family
skills including communication, resourcefulness, dependability and faith.
Family strengths and resources involve complex networks of formal and informal social
support. Often, families may not be immediately aware of these strengths. Providers
Page 3
can help families identify them through careful questioning and listening. These
networks, including relationships with community agencies, are crucial to family
functioning and should be nurtured and supported.
Family Needs
The needs of families have been documented quite extensively in the professional
literature. Studies have been commissioned on all kinds of families, including families
with children with special needs, families in transition and families who live in stressful
environments, in order to understand what these families need in order to function
successfully. Much of the discussion has focused around a theoretical explanation of
how families work.
All families experience stress at one time or another. How families respond to this
stress is critical and affects the development of the family members and the family as a
whole. Some of the literature has focused on the role of social support. It is thought
that social support can buffer the.effects of stress for families. By providing
connections to social support or enabling the family to gain access to a social support
network, the effects of stress may be lessened. However, social support can be ill-
timed or inappropriate. In general, social support is a need of families who are
experiencing stress.
Families also have other, more practical needs. The need for information and
connections to resources is clearly stated in the literature. In addition, families may
need assistance in problem-solving, to address a particular issue. Finally, emotional
support for a family has been noted as a way to help the family cope with stress.
One of the..most important functions of a family is the raising of children. It has been
documented that it is important for children to have a stable, predictable home
environment with a primary caregiver "who is crazy about the kid." This environment is
crucial to the social and emotional development of the child. By helping parents to
provide this environment, through parent education as well as addressing some of the
family's basic needs, children and families will be healthier.
In order to understand the type and range of needs of Contra Costa's families, the
FMO staff reviewed a number of County-produced or County-specific needs
assessments, studies and reports; academic and professional literature and
monographs; and interviewed key County staff and directors of local, state and
nationally-known programs, agencies and institutions.
Page 4
The County surveys and studies included:
• Service Integration Teams' Focus Groups and Surveys (1992);
• Resident Interviews from West County (1992);
• Contra Costa County Head Start Community Needs Assessment (1992);
• Healthy Tomorrow's Project Black Infant Health, Client Satisfaction
Survey (1993);
• Community Forums held in West County (1993);
• PEHAB Report: Community Response-Partnership for a Healthy County;
• Contra Costa County United Way Needs Assessment Report, 1994; and,
• Picker-Commonwealth sponsored study conducted by Merrithew
Memorial Hospital.
Members of the FMO staff also consulted with division directors of the Health Services
Department, Office for Service Integration staff, and the directors of County Probation
and Social Service. Besides County staff, we have also held lengthy interviews with:
• Directors of local programs (i.e., Family Mosaic, Prescott Project) which
either have similar goals, innovative programs, creative funding
mechanisms or something else of interest;
• Nationally-known experts (Center for Social Policy, Foundation
Consortium, etc.);
• Federal government agency directors and staff (Grantland Johnson and
others); and
• Directors of institutions (i.e., Center for Integrated Services for Families
and Neighborhoods) which provide health and human services benefits
and programs to children and families.
Though the information gathered comes from a variety of sources, each with different
goals, objectives and opinions, there was nevertheless quite a bit of agreement around
the issues facing families and what those families need in order to function and be
healthy. Some of the most commonly mentioned issues and needs included:
Issues
• The needs of families are multi-faceted and complex.
• Poverty and economics are often at the root of problems.
Page 5
• Families face many barriers when trying to gain access to support
services, such as fragmentation, language issues, lack of cultural
competence, providers with case loads which are too large and lack of
transportation to and from agencies.
• Families are labeled "at risk" or "in crisis" and are addressed by their
deficits and not their strengths.
• According to the literature, medical providers in general either do not
have the training or sufficient resources to comfortably address issues
such as mental illness, substance abuse, homelessness, or domestic
Violence.
• Consistent throughout the information gathered was the families'
perception that the health system tends to view them in terms of the
presenting symptom rather than addressing "the whole picture."
Needs
• Comprehensive health care, including dental services.
• Nutritious, affordable food.
• Safe and affordable housing and neighborhoods.
• Transportation to and from services.
• Parenting classes and education programs.
• Conflict resolution/violence prevention programs, beginning in grade
school, focusing on domestic and community violence prevention.
• Economic assistance programs, including job training and job search
assistance.
• Childcare, dependent care and respite care.
• Programs and services which are culturally sensitive and relevant,
especially for immigrant families.
• "Situational" or transitional counseling, including peer counseling, stress
management and coping skills for such family stressors as divorce, job
changes, illness and residence changes.
Page 6
• Support for grandparent, foster and "kin" care givers.
• Teen pregnancy prevention program, support programs for teen mothers
and fathers.
• Mentoring programs.
• Information and referral services, with a designated contact person for
follow-up, questions and assistance in creating linkages to other
programs.
• Better continuity of care, including discharge planning.
• Support services such as literacy programs and translation services.
Conclusion and Next Steps
It is clear from reviewing the above-listed information that there is general agreement
about some widely-recognized needs of families. It is also clear that unless the FMO
concentrates on building upon a family's strengths as well designing programs to meet
their needs, the FMO will not be successful in improving health outcomes for families.
The FMO Staff is interested at this point in hearing from Health Services Department
Implementation Team members, Policy and Program Advisors, and Contra Costa
families about the following:
• What key documents, studies, assessments have we not read that we
should read?
• Who else (individual or agency) should we talk to?
• How does this information presented match and/or differ with your
experience of family strengths and needs?
• What other suggestions do you have?
Your input, comments, questions and, of course, time are greatly appreciated.
is ameedsout.2
ATTACHMENT D
CONTRA COSTA COUNTY FAMILY MAINTENANCE ORGANIZATION
ADVISORY GROUP MEMBERSHIP, ROLES AND RESPONSIBILITIES
As part of the planning process for the FMO, it is critical to ensure sufficient input from County
staff, community groups and organizations, national academic and policy experts, and the
County's families. In order to obtain the needed review, critique, guidance and input, the FMO
staff seeks to establish four advisory groups: the Policy Advisory Group, Program Advisory
Group, Parent Advisory Group, and the Implementation Team. The membership, roles and
responsibilities of each group are described below.
ley Advisory Group: After conducting a literature search of academic literature and many
interviews with key community and national leaders, several names surfaced as leaders in the
field of innovative health and human services. The FMO staff will invite a number of these
national or locally-recognized professional experts to advise FMO staff on issues pertaining to
policy, finance and program design. Members of this advisory group will be asked to review
draft documents and consider specific questions in addition to advising in gathering additional
information. Meetings will be convened of the Policy Advisors as needed, although much of
the interaction is expected to be by phone and in writing.
Program Advisory Group: This group of advisors will represent community groups, local
community-based organizations, the range of County Departments and other interested
participants who have particular areas of expertise in developing and managing programs for
children and families. FMO staff have heard already from many interested individuals. Staff
will advise local agencies about the project and invite them to participate by joining the Program
Advisory Group.
Parent Advisory Group: In addition to gaining information on family needs and strengths through
family focus groups, FMO staff will convene a Parent Advisory Group. Comprised of 10-20
members, the group will be racially, ethnically, geographically and socio-economically
representative of the County's demographic mix. It will meet every other month to review
updates, discuss issues and provide input and direction from the system consumers' perspective.
Implementation Team: The role of the Implementation Team is to assist staff in consolidating
input from all the Advisory Groups so that an "implementable" pilot project is designed.
Because the- focus of the FMO is health-related services, the current Implementation Team
includes staff from diverse sectors of the Health Services Department including: Prevention,
Substance Abuse, Public Health, Mental Health, Environmental Health, Family
Medicine/Ambulatory Care, Social Work and Health Plan. Members will be added as the
planning process clarifies key other participants in the delivery of the FMO program. The
Implementation Team has been formed and has had two meetings. The group will meet
monthly.
Page 2
Current members of the Implementation Team are:
TEAM MEMBER DIVISION
Bobbie Baron Contra Costa Health Plan (CCHP)
Bobbie Bonnet Emergency Medical Services
Bill Burr, MD CCHP
Karen Butler Administration
Mattie Davis Hospital & Clinics, Medical Social Services
Kim Duir, MD Hospital & Clinics, Ambulatory Family Medicine
Melanie Fernandez Office for Service Integration (OSI)
Allan Katz Consultant to The Robert Wood Johnson Foundation
Susan Leahy Prevention Program
Bill Massey Substance Abuse
Ruth Ormsby Mental Health
Lewis Pascalli Environmental Health
Ken Saffier, MD Hospital & Clinics
Alan Stein Mental Health
Tenki Tenduf-La, MD CCHP/Hospital & Clinics
Jeff Wanger Finance/Information Systems
Francie Wise Public Health
NM0#2:adviwry.dcf
ATTACHMENT E
CONTRA COSTA COUNTY'S
INITIATIVES FOR FAMILIES AND CHILDREN:
THE FMO AND THE SITs - WHAT'S THE DIFFERENCE?
The child and family-serving departments of Contra Costa County are collaborating to develop
two new programs aimed at improving, streamlining and integrating services provided to families
living in Contra Costa County, especially low income families. These two projects, the Service
Integration Teams (SITs) and the Family Maintenance Organization (FMO), are part of several
efforts to provide more coordinated services to families at a lower cost to the County.
Service Integration Teams (SIT) project is creating neighborhood-based integrated service
centers for families who are seeking social, educational and health-related services. The project
is being piloted in the Bay Point and North Richmond communities, with implementation
beginning August, 1994. These Centers will be staffed by field workers in both income
maintenance and general assistance, child welfare service workers, GAIN social workers, public
health nurses, substance abuse counselors, probation officers and mental health staff. In
addition, the Bay Point center will also be staffed with school personnel. The project will serve
families within these communities who are using three or more county services (including public
housing, economic assistance, probation, family preservation and support, mental health,
substance abuse and public health). Families will work with staff to create individualized family
plans for addressing family concerns. Enrollment is voluntary.
Family Maintenance Organization (FMO) is in the early planning stages to create a new
structure for providing a broad range of health-related services through the County Health
Services Department. The FMO will add benefits to the package of care already provided by
the Contra Costa Health Plan, such as additional mental health and substance abuse counseling
services, peer support, health education and other related services which will help families
improve and maintain positive health. Enrollment will be voluntary and available to all who
choose to receive health services through the Health Services Department. The FMO pilot is
scheduled for implementation in April, 1995.
Program Differences
The Service Integration Teams will serve families with multiple needs in specific communities,
while the FMO will provide comprehensive health prevention, early intervention and treatment
services for all families in the county who choose to enroll. The projects are separate, but are
being developed in coordination with each other as part of the County's larger strategy for
coordinating and improving services to families. Both projects are benefitting from extensive
collaboration with county departments, schools, community leaders and organizations, and
families. The Table which follows summarizes some key differences between these programs.
KEY DIFFERENCES BETWEEN THE FMO AND SITS
FAMILY MAINTENANCE SERVICE INTEGRATION
ORGANIZATION TEAMS
GEOGRAPHIC AREA County-wide Bay Point, North Richmond
SERVICES/PROGRAMS Health-related prevention Social services, public
and early intervention linked health, probation, substance
to treatment. abuse, mental health and
education
ELIGIBILITY All County Families Families using 3 or more
County services
ENROLLMENT Voluntary Voluntary
PROGRAM START DATE Pilot to begin in April, 1995 Pilot to begin August, 1994
(Services and criteria for
selection of families for
pilot not yet determined)
COST TO FAMILIES To be determined NONE
For more information, contact:
Service Integration Teams - Bill Weidinger, Project Coordinator (427-8094)
Family Maint nance Organization - Mary Foran, Director, Office for Service Integration (313-
6254); Janeen Smith, Project Manager, Family Maintenance Organization, (313-6762) at 597
Center Avenue, Suite 365, Martinez, CA 94553.
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