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MINUTES - 09271994 - 2.1
A- TO: BOARD OF SUPERVISORS ; `� Contra s �Costa FROM: Sara Hoffman °` _ - oaf Wu Senior Deputy County Administrator County �oSTA-covii'� DATE: September 20, 1994 SUBJECT: Application for AB 1741 'Youth Pilot Program" SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECOMMENDATION(S).- APPROVE ECOMMENDATION(S):APPROVE submittal of an application under AB 1741, Youth Pilot Program, to support the County's service integration effort. AUTHORIZE the Chair, Board of Supervisors, to sign the County's Certification form and State Evaluation Participation form as required for the AB 1741 application, Youth Pilot Program. FINANCIAL IMPACT The Youth Pilot Program does not provide any new monies to support service integration. It does permit reconfiguration of existing resources. As part of the application, the County has requested waivers of state and federal regulation to permit redirection of staff time to prevention and intervention activities that support family self-sufficiency. In addition, the application provides for exploration of the feasibility of establishing a consolidated budget for service integration. CONTINUED ON ATTACHMENT: A YES SIGNATURE: C RECOMMENDATION OF COUNTY ADMINISTRATOR_RECOMMENDATION OF BOARID COITTEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON h.llq4 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A UNANIMOUS(ABSENT ) TRUE AND CORRECT COPY OF AN AYES:0_, 3r- NOES: ACTION TAKEN AND ENTERED ABSENT: I ABSTAIN: ON MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact:Sara Hoffman,646-1390 ATTESTED PHIL BATCHELOR,CLERK O THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR cc: Bill Weidinger via CAO Service Integration Management Team via CAO BY DEPUTY r, BACKGROUND/REASON(S) FOR RECOMMENDATION(S): AB 1741 (Chapter 951, Statutes of 1993) established a pilot program to allow five counties to test the feasibility of : • making local decisions regarding the best use of state and local human services funds; • blending funding streams to facilitate integrated services and programs for children and families; • increasing the efficiency of administering human services. Applications for the pilot program, called the "Youth Pilot Program," are due to the State by September 30, 1994. The application requires the Board of Supervisors to approve submission of the application, participation in the pilot program and agreement to participate in a state evaluation of the pilot program. Designation as one of the five pilot programs would be very supportive of the County's service integration effort. Service integration is designed to increase the efficiency and effectiveness of services to children and their families by reducing duplication, allowing workers to serve families through a common case management approach and refocusing worker activities to prevention and other efforts that support family self sufficiency. 2 J I I CONTRA COSTA in 41,11 "All Al -AM &- -,aypt Sm N 't 31 tF7 FAM IF RUN", x -nJgus�4 Af RK, -NmRgt, Y,V, W., o of w 1�d 77 PIL .. ...... FJ a PRO m �� --2 FO �2 jji Contra Costa County , ASSEMBLY BILL 1741 APPLICATION FACE SHEET County Name: Contra Costa County Implementation date for the pilot project: January 1, 1995 Person to be contacted concerning the application: Name: Sara Hoffman Title: Senior Deputy County Administrator Address: 651 Pine St., 10th Floor Martinez, CA 94553 Telephone: (510) 646-1390 Fax: (510) 646-1353 Contra Costa County County Certification Form The signatories below hereby approve this application for pilot status under Chapter 951, Statutes of 1993 (Assembly Bill 1741, Bates). Tom Powers, Chair Ronald L. Stewart, Ed.D Board of Supervisors Superintendent of Schools Contra Costa County Contra Costa County v Robert W. Baum, Ed.D Herbert Cole, Jr. bd.D Superintendent Superintendent Mt. Diablo School District West Contra Costa Unified School District Contra Costa County NEEDS ASSESSMENT Families in crisis or at risk of crisis are those who are most heavily dependent upon County services and most often served by multiple County programs. Contra Costa's service integration model is based on the premise that the County should focus on communities with high concentrations of low-income, high-risk, multiple-problem families. Identifying target areas, scope of services and optimum service configuration entailed a three-stage process comprised of a county-wide data match, community-based needs assessments and a program and fiscal systems assessment. The county-wide data match identified and prioritized the nine communities with the greatest need for services, based on current service utilization. The community-based needs assessments, conducted in two pilot communities, assured service congruence with community needs. The program and fiscal systems assessment identified how to restructure the current fragmented system of service delivery to make services efficient and effective. County-wide Data Match In April 1992 and June 1993, geographical mapping software was used to identify the location of households, by census tract, of families receiving income maintenance (AFDC, MediCal, Food Stamps), child welfare services, probation oversight, mental health treatment, hospital/clinic services and substance abuse treatment (partial program data only). Public health program participants were identified manually. The data match identified census tracts with the highest number of households receiving four or more services, as well as those served by three departments (Health Services, Probation and Social Service). Census tracts were then identified by neighborhood and ranked in order of highest usage. Nine communities were identified as sites for service integration, i.e., Family Service Centers (See Appendix C). Bay Point and North Richmond were selected for the first Centers based on the data match assessment and community "readiness." Both areas had strong community leadership dedicated to improving local services. Bay Point had an established local governance body, the Bay Point Municipal Advisory Committee (MAC), and North Richmond was in the process of establishing a MAC. Both local school districts made strong commitments to working with the County in obtaining Healthy Start planning and operational grants, key to community needs assessment, community capacity building and resource development. Finally, there was a history of interagency cooperation in both communities, for example, the Interagency Family Preservation Program. Community-Based Needs Assessments The County and Healthy Start collaboratives in Bay Point and North Richmond conducted in-depth needs assessments, including: census and school data analyses; household surveys; focus groups; sample client evaluations; and service adequacy assessments. Contra Costa County Similar needs assessment processes will be conducted for the remaining seven sites. Say Point: The Mt. Diablo Unified School District and the Service Integration Management Team (STMT) formed a 35-member community-based planning coalition to guide the community needs assessment for both Healthy Start and Service Integration. A. Census and school data. Of the 17,453 residents of Bay Point, 11% are African- American, 10% are Asian (6% Filipino, 2% Vietnamese, 2% other), 22% are Latino (predominantly Mexican, Salvadoran, Puerto Rican, Nicaraguan) and 55% are white. Approximately 29% of residents over the age of 18 have not completed high school. Approximately 2,400 residents live in poverty. Half of Bay Point's poor are under the age of 18; two-thirds of the poor children in Bay Point live in single-parent households. About 1 in 5 residents receive public assistance. Data from the one middle and three elementary schools serving Bay Point indicate that the area contains a high-risk student population. While Bay Point's students account for under 8% of the school district's student population, they account for 28% of the district's AFDC enrollment; 28% of the district's English as a Second Language (ESL) enrollment, 35% of the district's children in foster care, and 34% of all students referred to the School Attendance Review Board as habitually truant (more than 12 unexcused absences by mid-year). In addition, 56% of students receive free and/or reduced cost breakfast and lunch. Kindergarten immunization records indicated that 69% of all students had not completed recommended age 2 immunizations. Relative to the other 162 census tracts in the County, Bay Point ranks 2 in the number of single-parent households; 2 in the number of adults without high school diplomas; 3 in the unemployed population; 4 in the minority population; 5 in the number of persons in poverty; and 3 in the number of households served by three departments. B. Household Surveys. Surveys were mailed to all residents in September 1992 with a response rate of 8% (Response rates typically average about 1% in Bay Point). Surveys in Vietnamese and Filipino (Tagalog) were targeted based on school data. All other households received Spanish/English versions. Over 100 door-to-door surveys were conducted in high-risk, low-response areas. Identified service needs were, in order of ranking: 1) job training; 2) drug, alcohol and gang prevention; 3) recreation; 4) after- school tutoring; 5) health services; 6) parent education; 7) employment services; 8) child care; 9) counseling, and 10) drug-alcohol intervention. C. Focus Groups. In nine focus groups including Filipino, Latino and African- American representatives, 156 adults and students refined the survey results. Adults discussed specific activities, services, program needs, barriers to use, services appropriate to a family resource center and ways to govern a community family resource 2 Contra Costa County center. Students discussed their perceptions of drug, alcohol and health issues, and specific needs (child/parent classes, after-school programs and recreational activities). D_ Sample Client Evaluation. To better capture the client perspective, the planning coalition hired a half-time family service advocate for six months to assist families in "negotiating the system." Most of the families were overwhelmed by the multitude of their problems and immobilized by stress. However, with support and encouragement, many families were able to prioritize their needs and begin working toward manageable goals. E. Service Adequacy Assessment. The surveys and focus group results helped analyze the strengths/weaknesses and gaps/overlaps of existing services. While health and social services support services were available, staff was not located in the community. School programs included substance abuse prevention, after/before school tutoring, parent involvement programs and ESL. Other community resources included the Family Stress Center (family support programs); Ambrose Park District (recreation/social programs); and church and civic groups (including a soup kitchen). Transportation and program knowledge were major barriers to service availability. Also, limited program resources, coupled with high demand, made it impossible to meet all service needs. North Richmond: The County worked with an advisory council representing 25 community-based organizations in the spring of 1992 to conduct a household survey to learn about residents' service needs. After its formation in September 1992, the Healthy Start initiative's Verde School Community Action Committee (VCAC) and the County completed a more in-depth needs assessment. A. Census and School Data. Of North Richmond's 2,310 residents, 72% are African- American, 18% are Asian (16% Laotian, 2% Asian Indian), 9% are Latino (7% Mexican, 2% Guatemalan) and 1% are white. Children and youth comprise approximately 39% of the population; over half of this age group live in single-parent households. 57% of all adults have not completed high school. The median household income is $8,763; the unemployment rate is 29%. Approximately 53% of residents live in poverty. Despite its small size, North Richmond ranks fifth among all census tracts in the number of households relying on services from the three major departments, Health, Probation and Social Services. Over 50% of North Richmond residents rely on public assistance. Data from North Richmond's Verde Elementary School demonstrates that the community's children are faring particularly badly. 79% of the students qualified for AFDC (compared to 23% for the West Contra Costa County School District as a whole). Only 75% of all kindergarten students enrolled at Verde are fully immunized, versus 93% for the entire school district. Depressed California Achievement Test scores indicate that the combined effects of poverty and family stress are taking their toll on academic achievement. Both math and reading scores for Verde School students in grades 1-5 are dramatically lower 3 Contra Costa County than the district average. B. Household Surveys. Surveys were mailed to, all 6,000 households with 519 responses (8.6%). Identified service needs were: 1) employment training and placement; 2) safety; 3) after-school recreational activities, 4) child care; 5) health services; 6) food services; and 7) integration and coordination of County services to improve access. C. Focus Groups. To increase focus group participation, interviewers were recruited from North Richmond residents including the three main ethnic groups, African-American, Laotian/Mien and Latino. Thirty-seven focus groups discussed the strengths and weaknesses of existing services and identified missing services. All ethnic groups were concerned about employment, the absence of services to support youth and accessibility/coordination of community services for families. Mien, Laotian and Latino families also expressed a need for translation services and ESL classes. Latino focus groups cited a need for more after-school programs and greater safety and protection for their children (often citing incidents of perceived racial discord). To address their concerns, focus groups called for increased after-school tutoring, recreation, child care programs, a full service health clinic, family counseling services, alcohol and drug programs, vocational training/counseling and improved transportation access. D. Sample Client Evaluations. Community interviewers also conducted 12 individual questioning sessions with representative North Richmond residents. The client evaluations probed for individual concerns that could be missed in a group setting. E. Service Adequacy Assessment. Those organizations with service ties to North Richmond were inventoried, surveyed (service description, eligibility requirements, North Richmond service utilization and known barriers to access) and then analyzed for gaps and overlaps. While North Richmond residents are eligible for a number of programs offered by public, private and community-based organizations, very few services are actually located within the community. Transportation is a major barrier to services located outside of the community, due to the fact that AC Transit has only one bus route stopping in North Richmond and infrequent service. Services located in the community include three Head Start programs, Shield Reed Recreation Center, Neighborhood House (sports programs) and limited after-school programs; all, however, lack the capacity to meet current demand. Agencies and families concurred on the barriers to existing services: lack of service availability and knowledge about services, uncertainty about eligibility requirements, reluctance to go outside of the community, lack of transportation, child care needs, inability to speak English and safety concerns. On the positive side was a growing sense of community, through the VCAC Coalition, as 4 Contra Costa County well as the new Richmond Municipal Advisory Council. Over the past two years, the community has rallied together to sponsor two community wellness festivals, a forum on gang involvement, a PTA calapter, a SIMBA chapter, a Laotian tutoring program, a job training program for parents and expansion of the after-school performing arts program. Community Priorities The community priorities identified by Bay Point and North Richmond were very similar with two exceptions: Bay Point identified the need for a community communication network about service availability; and North Richmond identified the need for language services; i.e., ESL, translation, classes and activities in Lao/Mien, Vietnamese and Spanish. The common community priorities included: 1)More vocational and employment programs for both adults and teenagers; 2) Greater availability of youth-focused proarams, particularly after-school recreation and tutoring; 3)Complete community-based health services offering immunization, dental care and other basic health care services; 4) Improved safety conditions on community streets, at schools and at any community- based service center; 5) improved chli' care ser- ices to allow parents to participate in job training, vocational services and other educational programs; 6} este; aya!!;a �wy elf '-j.,-In and abuse Cr::veinti'or: anu nteryer-Ai°on programs and services; 7) Frequent and reliable community transportation allowing community members to access services provided outside of the community; 8) Increased social and cultural activities, with a particular emphasis on joint parent/child activities and libraries, 9) Better coordination, accessibility and integration of services, including eligibility services, health care, child welfare and services for youth. Program and Fiscal Systems Assessment The Systems Assessment examined how to restructure service delivery and design a supporting fiscal strategy to best meet community needs. The systems analysis included: A) Assessment of Existinq Service Delivery System: Through interviews with service providers, supervisors and service recipients, the current service delivery system was mapped, from intake through termination, in order to identify gaps, overlaps and inefficiencies within the Health Services, Probation and Social Service Departments. B) Re-engineering the Delivery System: This analysis focused on the specific rules, regulations and processes that could be altered to improve the efficiency and effectiveness of the service delivery system. C) Proposals for an Improved System: This final step developed specific proposals to improve service delivery, including redirecting staff time in order to maximize use of available resources. (See Implementation for waiver proposals). 5 Contra Costa County VISION AND GOALS Healthy Children. Clusters of children of diverse ethnicity, walking unafraid to school. Eager students, who do their homework. Safe after-school play, both spontaneous and organized. Well fed, healthy children, dressed warmly in the winter. Cherished children with a well organized structure to their lives. • Healthy Families. Healthy family members who support and respect each other. Appreciation of the family's cultural andlor ethnic heritage. Stability and self sufficiency, a job or purposeful effort towards employment. A clean, well cared for home. An understanding of the family's strengths. For families experiencing difficulties, a well-planned strategy(in partnership with support organizations) that leverages family strengths to overcome barriers. • Healthy Communities. Opportunities for families to participate in mutual support and self-help activities. Strong community, school and government organizations that respond to community needs and work with families as partners. Community leaders who can mobilize community resources. Clean, safe streets and neighborhoods. After-school activities for children. Employment opportunities. Contra Costa County's vision was first articulated in July 1992 when the Board of Supervisors adopted "Healthy Families 2000: A Plan to Improve the Health of Children, Youth and Families in Contra Costa County." The plan was the outgrowth of intense dialogue with communities, community members and service providers. It delineates Contra Costa County's commitment to developing an effective interagency system that fosters healthy development and opportunity for children in Contra Costa by promoting, enhancing and strengthening family life and community capacity. The plan envisions a collaborative, community-based system of services ("Service Integration") to serve families in a holistic manner by establishing a new working relationship between agencies with a common case management approach and engaging families as partners in the process. Service Integration also focuses on family strengths as resources that expand a family's ability to achieve and maintain stability and self-sufficiency. Since Contra Costa's Service Integration is community-based, needs assessments were conducted in each pilot community. While there were differences, common priorities emerged, including: increased accessibility to services; youth-focused programs; vocational and employment training; and social and cultural activities. Families recognized that the need for broader support systems in order to ensure continuing functioning of self-sufficient families and the reversal in the number of families at risk or in crisis. Both needs assessments clearly indicated that the current fragmented, uncoordinated, narrowly targeted system of service delivery for children and families was failing to meet the priority needs. Focus on short term crisis management over 6 Contra Costa County prevention was not promoting the enduring well being of families. Our fragmented delivery system was serving only to further fragment people's lives. Service Integration is child-centered, family-focused and community-based, designed to address the broad base of issues facing children and families in the social and economic environment in which they live and interact. This focus is reflected in the goals of Service Integration- 0 Improve the health and safety status of children and families. © Increase the number of children who succeed in school. © Support, promote, encourage the integrity of families. © Increase the economic stability and self-sufficiency of families. © Increase physical safety and improve the aesthetic environment. Q Expand the capacity of the community to support children and families. Individual agencies and departments do not have the resources or the power to achieve the goals of service integration alone. Children's opportunities for success are rooted in the well-being of families and the stability of communities. Families are the first and, in most cases, the best providers for their children's needs. When families do not flourish, children often suffer. Just as families are the best providers for their children, communities provide essential support systems for families. A functioning, effective community, comprised of extended families and friends, neighborhoods, schools, churches and other formal and informal local institutions, provides families with opportunities, resources and, above all, hope. Communities need job opportunities for economic support (and income security strategies when employment opportunities are inadequate), educational and recreational settings in which children can learn and thrive, and preventive and interventive health care resources for all family members. A child's sense that a caring community is invested in his or her well-being is a pre-requisite for healthy child development. Contra Costa's approach is the outgrowth of several years of discussions, debates and enlarged understanding on the part of county service providers, schools, community organizations and community members. It brings families, communities and agencies together to leverage individual resources and achieve shared goals. 7 Contra Costa County OUTCOMES Outcome accountability is an integral part of Contra Costa's service integration model: • The focus on outcomes for children, families and communities encourages inter- departmental and intra-community partnerships by creating common, achievable goals for service providers, schools and communities -- promoting a culture of responsibility and collaboration. • Outcomes provide communities with tangible yardsticks to chart their successes. • Outcome accountability diminishes the need for bureaucratic micro-management and strict regulations, allowing services to become more efficient and effective. • Outcomes shift focus from the system to people and the environment in which they live. The vision of healthy children, healthy families and healthy communities and its six supporting goals reflect the needs identified through the community needs assessment process. The SIMT then embarked on a collaborative process, working with a wide range of personnel from County Departments, schools and family-serving organizations, to develop key outcomes that serve as quantifiable indices of the success of each Family Service Center in achieving these goals and, thus, the overall vision. Each outcome represents a measure of well-being of the whole child, family and/or community. Each outcome is supported by several concrete, measurable indicators, each representing varying dimensions of the outcome. The following outcomes and indicators have undergone numerous revisions and refinements based on feedback from members of the Healthy Start Coalitions, the Coordinating Council, Policy Academy, Family Service Center staff and department personnel. Further refinements are expected, based on service integration line experience and community and client feedback. The indicators rely on data already maintained by County Departments and/or on information available through the Family Assessment Records on clients served by the Family Service Centers. The Family Assessment Records will be maintained through a data system currently in design, which will allow for regular tracking of key indicators. Each indicator is associated with at least one existing data source. The data sources are listed in the Evaluation Plan contained in the "Implementation" Section. By January 1995, the two existing Family Service Centers will have established a set of baseline indicators from the data sources as part of the evaluation process. 8 Contra Costa County HEALTHY CHILDREN -* GOAL 1: Improve the health and safety status of children and families. Outcomes: Indicators: • Higher rate of healthy births Percentage of pregnant women who receive prenatal care in their first trimester; Number of low and very low birth weight infants; Number of births to women younger than 18. • Higher rate of children ready Percentage of MediCal-eligible children and children for school under 200% of poverty line entering school programs who receive Child Health Disability Prevention Program screening, referral and necessary follow up; Percentage of 2 year olds meeting basic immunization requirements. • Higher rate of Number of participants completing substance abuse substance abuse programs; Number of youth, aged 9-12, enrolled in avoidance and recovery school-based substance abuse prevention programs. • Decreased incidence of child Number of child abuse and neglect incidents abuse and neglect reported and substantiated. • Decreased domestic violence Number of reports of domestic violence. GOAL 2: Increase the number of children who succeed in school. Outcomes: Indicators: • Improved school attendance Rates of school attendance for children. • Higher rates of academic Average standardized test (e.g., CLAS) scores of success children; Number of eligible children screened by Student Study teams; Percentage of eligible children enrolled in Head Start or equivalent. • Lower school drop out rates Percentage of individuals completing high school. • Higher rates of involvement Number of positive community activities for youth in school-based activities and children; Number of after-school activities. HEALTHY FAMILIES * GOAL 3: Increase the economic stability and self-sufficiency of families. Outcomes: Indicators: • Greater employability and Percentage of adults and youth who have higher rates of employment employment; Number of participants in employment/job training; Number of Cal Learn graduates; Number of GAIN clients placed in jobs. • Higher family incomes Median family income in target area; Number of grant reductions due to job income; • Increased responsiveness, Accuracy rate and timeliness of provision of efficiency and accuracy income maintenance benefits to eligible recipients, 9 Contra Costa County of benefits provision Number of discontinuances due to non-compliance. GOAL 4: Support, promote and encourage the integr�'.y of families. - Outcomes: Indicators: • Increased share of Number of children successfully completing children safely maintained in Family Maintenance programs; Percentage of their own homes in-home family maintenance cases maintained by voluntary supervision. • Increased share of children Number of children successfully maintained in in least restrictive place- relative placements, Number of probation-supervised ments, preferably relative placements; Percentage of foster care children placement returning. home, Average stay for children in out-of- home placement; Level of placements. • Increased share of children Number of youth who exit the Foster Care system leaving foster care prepared against the advice of the Social Service Department; for independent living Number of minors emancipating from foster care having completed high school, vocational training programs and/or the Independent Living Skills program. �K HEALTHY COMMUNITIES GOAL 5: Increase physical safety and improve the aesthetic environment. Outcomes: Indicators: • Increased safety of the Rate of violent injury; Number of unintentional physical environment deaths; Number of intentional injuries to children and youth; Rate of juvenile crime. • Improvements in aesthetic Rate of housing code compliance; Number of land- environment of community use violations; Extent of graffiti and visual blight. GOAL 6: Expand community capacity to support children and families. Outcomes: Indicators: • Increased opportunities for Number of mutual support opportunities; Number mutual support of participants in self-help groups. • Greater involvement in Number of participants successfully completing activities supporting ethnic, ESL classes and other culturally based racial and cultural diversity programs offered in the community. • Greater involvement in Number of residents participating in PTA, Municipal community advisory groups Advisory Council, Neighborhood Council, Residents' and activities Council, Home Owners' Association, Church groups, Head Start and other community groups. • Increased community- Number of recreational and educational events and initiated and -run activities activities. 10 Contra Costa County COORDINATING COUNCIL Contra Costa's service integration `is built on a foundation of over 15 years of collaboration. Past successes have created a high level of trust among agencies and established good working relationships. The Service Integration Management Team (STMT), designated the Coordinating Council, has reflected this agency diversity since its inception in 1992. Service integration itself is based on the premise that no one agency alone has the resources or ability needed to support Contra Costa's children and families. A Continuum of Collaboration Contra Costa's collaborative efforts in children and family services began in 1979 when the Board of Supervisors formed the Youth Services Board (YSB). Comprised of the County Administrator, the County Superintendent of Schools, the Juvenile Court Judge and Directors of the Departments of Community Services, Health Services, Probation and Social Service, YSB establishes interagency priorities, addresses multi-agency issues and stimulates collaborative efforts. An early effort of the YSB was the Youth Interagency Assessment and Consultation Team (YIACT). Created in 1980, as a multi-agency, multi- disciplinary team (Office of Education, Mental Health, Social Service, Probation), it works with the most troubled youth. In 1982 the Center for the Study of Social Policy identified YIACT as a model program for the nation. YIACT now serves over 500 children/year. In 1985, the YSB enlarged its collaborative effort with creation of the Expanded Youth Services Board (XYSB). The XYSB brings the YSB together with community-based organizations, advisory boards,community representatives, schools and private agencies. The XYSB developed the family-centered framework and philosophy that is the foundation of service integration. It was also the genesis for Interagency Family Preservation, a nationally recognized program begun with foundation support. Serving 80 families in East Contra Costa in 1988, it is now county-wide, serving over 200 families per year. The Policy Academy is the County's most recent broad-based collaborative effort, bringing together education, county agencies, community-based organizations and community leaders. This body is charged with examining the major child and family strategies, including service integration, to better understand their relationships and roles in the continuum of childtfamily support. Many STMT members are also Policy Academy members. Other collaboratives fall into three broad categories: A. County collaboratives with schools. These collaboratives include the Bay Point School Linked Services Planning Coalition, Verde Community Action Committee, Cambridge Healthy Start Planning Coalition and Parkside Healthy Start Planning 11 Contra Costa County Coalition, all of which have received Healthy Start planning grants and two of which have received operational grants. Collaborative efforts with these groups include jointly conducted ;:ommunity-based needs assessments. The County is also collaborating with the Contra Costa Office of Education on the Healthy Start YOUTH FIRST initiative, which provides comprehensive support services to incarcerated youth. B. Community-based collaboratives focused on targeted geographical areas. These collaboratives include: Opportunity West, a coalition of the City of Richmond, community groups, County and schools (San Francisco Foundation funded)to examine how services for children and families can be made more accessible; Delta 2000, a coalition of private and public agencies which supports projects ranging from the East County Hunger Walk to Women Re-entering the Workforce and the Midnight Basketball League; PACT Coalition in West County aimed at preventing violence; PATHS, in Bay Point, which fosters interagency, interdisciplinary approaches to service delivery for homeless/at risk families, including a computer network of community resources. C. County-wide collaborative networks. These include the Juvenile Hall Replacement Committee, which is examining the continuum of intervention for the juvenile justice system; Partnership for a Drug Free Contra Costa, a public/private collaboration ($2.5 million five-year grant) that leverages and coordinates prevention efforts; PAC which focuses on developing resources for homeless prevention ($2.9 million shelter plus grant). Contra Costa's successful collaborative history reinforced the belief that a multi-agency, multi-discipline service integration approach would be most effective in supporting children and families. Coordinating Council The existing SIMT has been designated as the Coordinating Council for service integration. The SIMT also authored the Policy Academy application and formed the nucleus of its team. SIMT has been responsible for all aspects of service integration, including: 1) community needs assessment (in cooperation with Healthy Start); 2) service integration strategy, 3) staffing configuration (including job descriptions and recruitment); 4) site selection and renovation oversight; 5) staff training; 6) meet and confer process participation; 7) development of goals, outcomes and indicators; 8) development of family assessment records, 9) identification of information management system needs; 10) program and fiscal strategy assessment, including waiver identification. The SIMT has operated on a consensus basis and will continue to do so. Its decisions on staffing, program scope and sites have cut across multiple agencies. This decision- making authority has been accepted and supported by the participating agencies because these agencies are clearly aware that service integration enhances their ability to serve 12 Contra Costa County their client population. The basis of this authority lies in the acknowledged benefits of the synergy of working together. The Board of Supervisors is very supportive of the SIMT and -the County Administrator's Office representative reports regularly to the Board's Internal Operations Committee. Similar reports are made regularly to the Superintendents of Schools. The Board of Supervisors, Mt. Diablo Unified School District and West Contra Costa Unified School District have committed significant resources to the Family Service Centers. School district commitments have been made possible through Healthy Start grants and foundation grants (facility space has also been made available). The Board of Supervisors has committed staffing, facility and information management resources. These resources meet the needs identified by the SIMT to implement service integration, however, it should be noted that the Board's continued staffing commitment is contingent upon receipt of waivers to redirect staff time to early intervention and prevention activities (see Implementation). In addition, the Board's commitment assumes no changes in the County's share of cost or state allocations for service integration programs. Selection of Members The SIMT has evolved over time. Initially, it was a small planning group with representatives from the County Administrator's Office, Probation, Social Services, Community Services, Health and Mt. Diablo Unified School District. This group developed the Healthy Families 2000 report. When implementation planning began, participation was broadened to each of the programmatic areas and school districts. Labor organization representatives were added following conclusion of the meet and confer process. Similarly, after Family Service Center staff selection, the two team leaders were added to SIMT. Service provider representatives will be added following conclusion of the client recruitment process. Additional school district representatives, team leaders and city representatives will be included with Family Service Center expansion. SIMT members were selected based on their ability to contribute to the service integration project, with agencies selecting their own representative. Client representatives will be selected by the SIMT, with MAC input. SIMT members come from a variety of backgrounds, including front line workers, supervisors, mid-management, and upper management. Membership is predominantly female and has both African-American and Asian representation. Latino representation will be added with the addition of client members. SIMT members reside in each of the County's geographical areas and, consequently, represent the varying perspectives of their home communities. 13 Contra Costa County IMPLEMENTATION "...a place where people are truly cared for, a center that focuses on the person in the context of their family, community and our larger society. The center is a growing force that is inclusive and that offers persons the opportunity to be self sufficient. Staff at the center realize the value of caring and respecting, and live the belief that valuing another person is the highest form of empowerment. The center becomes a problem solving place, a healing place, a hopeful place. Departments recognize their differences and also cherish the creativity that comes from working together with our families to further the growth of the whole family. I want to aid the clients and the community to realize their goals and capabilities and to assist in helping others to use their strengths to achieve their own successes, whatever they may be. We all have wants and sometimes, with just the right encouragement and opportunity, they can be accomplished." - Statement of Service Integration Team member on the new Family Service Centers In August 1994, Contra Costa opened its first two Family Service Centers. The Centers herald a new era for families in Contra Costa County, where the needs of people will take precedence over paperwork. Service Integration Strategy The community needs assessment clearly indicated that the needs of children and families are not being met under the current service delivery system. Service is now focused on families in crisis, through narrowly focused, categorical services for individuals that ignore the importance of the family as a whole. Early intervention and prevention activities, such as gang alternatives and parent education programs, are minimal. Families concur on the need for more youth activities, social and cultural activities, health care and assistance in obtaining employment. Many families are unable to use existing services due to lack of knowledge about services or inaccessibility. Service integration shifts the service paradigm to be child-centered, family-focused, community-based, collaborative and outcome-driven. Integrated services: • view the whole family and not just individuals as the appropriate level for service intervention. • have the flexibility to respond to cultural and ethnic diversity, as well as 14 Contra Costa County individual family differences. • recognize family strengths, capabilities and resources and engage the family as a partner in achieving/maintaining stability and self sufficiency. • reduce the number of self-sufficient families moving to "at-risk" status or at- risk families moving to crisis through early intervention and prevention services. • recognize the pivotal role of schools in the family services network. • recognize that government, schools, churches, community groups, neighborhood groups, service clubs, community-based agencies and extended family systems all need to work together to support families and improve the quality of life for children. • link families to existing resources and stimulate development of new resources to meet family needs. • foster the creativity and initiative of service providers, families and the community. • are accessible and delivered on a human scale by competent people who know, care about and have established mutual, personal trust with the people they serve. • are simple in structure and management with a minimum of red tape, costly interagency transactions, eligibility requirements and other complicated bureaucratic procedures. Under Service Integration,families can access income maintenance, mental health, public health, substance abuse, GAIN, probation and child welfare services at their local Family Service Center. In Bay Point, these services have been augmented with family resource workers and foster care social workers through the Mt. Diablo School District, as well. Center staff are responsible for stimulating and facilitating the availability of services to meet family needs through leveraging and linking existing resources: 1) among the disciplines represented on the team; 2) with the network of community-based organizations, such as churches, municipal advisory councils, non-profit agencies, Head Start and schools (The Bay Point Service Center is piloting a new automated network of community-based resources to better link clients with services; 3) with the broader resource pool of services that are available county-wide or regionally. 15 Contra Costa County Service integration engages families as partners in the process. Participation is voluntary. The family begins to work with its primary caseworker by first cataloguing its strengths and mutually agreeing upon goals for achievement (using the Family Assessriient Record). Center staff works together to assist families based on a common case management approach, with one worker taking lead as the contact person. Common case management is supported by a data base system which contains tiered family case information with appropriate controls to preserve confidentiality. Service integration redirects staff time to focus on meeting the family's individual needs by linking families to available resources and concentrating on preventive and early intervention services (for example, after-school activities, self-help strategies, referral to services for food and clothing). At this time, staff in the two Family Service Centers can redirect their time because of caseload reductions, in accordance with a six month union agreement. Continuation of these activities is contingent upon receiving state waivers to eliminate currently mandated, unproductive processes and allow staff to continue spending time on preventive and early intervention activities and resources linkages, while maintaining average caseloads. Implementation During the process of establishing the first two Family Service Centers, Contra Costa had to resolve numerous issues around client participation, staffing, organizational structure, collaboration and community linkages (See also Barriers and Milestones, Appendix C). Client Participation. Under Service Integration, families are expected to assume a new role in achieving/maintaining stability and self sufficiency. Clients are expected to be partners in the process, to draw upon their own strengths and work in concert with a team of service providers in achieving their family's goals. Confidential information is made available to all service center staff. In recognition of these new demands on families, and the need for willing support, participation is voluntary. Client .Recruitment was broad-based and insured accessibility to minorities and non- English speaking clients consisting of: 1) Introductory Meeting Invitations. In July 1994, flyers were sent to all potentially eligible households: about 1,100 in North Richmond and 1,700 in Bay Point who receive 2 or more County services. Targeted households identified through census printouts received Vietnamese or Lao/Mien versions. All others received English/Spanish flyers; 2) Follow-up Phone Calls. Center staff called households to answer questions and encourage introductory meeting attendance; 3) Introductory Meetings. In English language meetings, as well as meetings with Spanish-, Vietnamese- and Lao/Mien-speaking staff and translators, Center staff described service integration, the new role for clients, confidentiality issues and invited participation; 4) Follow-up Outreach. Further efforts included team members going door-to-door; placing 16 Contra Costa County flyers at key community hubs; and encouraging clients to spread the word. As of mid-September 1994, the Bay Point Center had achisved its first client participation milestone, with a client base of 395 families. North Richmond's client base was 126, just under half of its target of 300. Confidentiality release records can be very detailed, very complex and very intimidating. Clients are being asked to allow information previously limited to themselves and their specific service provider to be available to multiple service providers. While the aim is to better serve the client, nonetheless this could be perceived as threatening. This was handled by making participation voluntary and combining the release and participation form, called "Consent to Participate and Authorization to Share Information" (See sample in Appendix E). Forms are available in four languages. Forging the partnership between client and staff is another client participation issue. While the ultimate success will depend upon the development of personal relationships and progress towards meeting family goals, the Family Assessment Record was developed as a tool to support the new relationship. The family sits down with its lead caseworker to catalogue the family's strengths and to identify mutually agreed upon goals to increase family stability and self sufficiency. This process also helps identify additional family service needs. Staffing for the two Family Service Centers was based on the needs assessment of each community. The numbers and type of staff vary. For example, Bay Point is staffed with a Public Health Nurse, a Substance Abuse Counselor, a Deputy Probation Officer, a Mental Health Counselor, AFDC, Medi-Cal, and Food Stamp Eligibility Workers, a Child Welfare Social Case Work Specialist, GAIN Social Workers (County staff) and Family Resource Workers and a Foster Care Social Worker (Mt. Diablo School District). Staff Recruitment. Job announcements, job descriptions and flyers were first circulated within the participating department divisions. Group sessions were held to introduce service integration and to answer questions. 67 applications were received to fill the 31 positions. The interview process varied by department. For example, in Social Service, interviews were conducted by the Division Managers, Service Integration Coordinator and a community representative. Interviewers sought a diverse staff with existing relationships to the communities. Thus, for example, a number of the Bay Point team members grew up in Bay Point, went there to high school and/or currently reside in the neighborhood. This high level of personal investment adds another level of commitment to service integration. A number of team members are also bilingual. 17 Contra Costa County STAFF GENDER, ETHNIC & CULTURAL REPRESENTATION Female Male African Cauca- American Latino sian Other North Richmond 69% 31% 62% 15% 23% 0% Bay Point 85% 15% 40% 20% 35% 5% Training. To facilitate the physical and philosophical transition, team members participated in weekly training sessions, beginning in June 1994 with attendance at the California Family-Based Services Conference. Other training topics included: history and philosophy of service integration in Contra Costa; community-based approaches to service delivery; family-centered services; de-escalation of violence; conflict management among clients and within the community; self-managed teams; and diversity sensitivity training. Representatives from the MACs, local community-based organizations, schools and churches in the two communities attended the training, introducing themselves to the teams and familiarizing the team members with specific community needs and characteristics. Errmfoyee Organizations:Center staff are represented by Local 1, AFSCME Local 2700, AFSCME Local 512 and SEIU 535 (worker and supervisor chapters). The new Service Centers changed working conditions and consequently, were subject to meet and confer. Issues focused on working conditions and transitions, such as caseloads of Center staff (agreement was reached with 535 to reduce team caseloads by 20% - 50% and to backfill department staff). A six-month agreement allowed for the opening of the Centers. Final agreement depends on waivers. Employee Organizations have been a positive partner with the County's Service Integration efforts. Employee Organizations are members of the Coordinating Council. One of the employee organizations provided space for team training. Another is donating art work for the Centers. Organizational Support Structures New working relationships and locations required new organizational support systems, including confidentiality, management information systems, the Family Assessment Record and new site facilities. Confidentiality. Every program included in service integration is bound by a complex web of confidentiality rules that restrict and control the exchange of information among workers of different programs involved with the same family. The laws on release of information are also very detailed. The SIMT researched confidentiality, conducted focus groups with 18 Contra Costa County program confidentiality experts and consulted with County Counsel and Youth Law Center. For Probation, the Juvenile Court Judge granted authority to share information. For'all other programs, the confidentiality release form goes as far as possible to allow sharing of information; however, in certain areas, such as drug usage, confidentiality cannot be generally waived. In order to meet this confidentiality requirement and still maintain a common case record, the information management system was designed with a tiered system (with certain levels of data available only to authorized program personnel). Management Information Systems. The need to transfer information from home departments to the Family Service Centers, to institute common case management to track data on client progress, required an approach more sophisticated than hard copy files. Currently in implementation, the MIS is interactive with the SSR, CDS, Juvenile Justice, Health and school MIS systems. It has a main frame index and online linkage to maintain mandated state information on the larger systems. It also has the capacity to switch to client-server technology. The MIS creates an index of shared clients that includes the family assessment information, demographic data, service statistics, follow- up, termination and outcome measurements. MIS is tiered to ensure that confidential data is available only to authorized staff. MIS allows teams to share common information, provides an easily accessible reference on family status, family goals and tracking of what really helps the family. In addition, the Bay Point Center will be linked to the PATHS network, a referral system to community-based organizations and services. Family Assessment Record. Part of the process of engaging families as partners in the process includes developing their belief in themselves and their ability to achieve stability and self sufficiency. The Family Assessment Record is designed as a tool to both catalog family strengths as well as to help the family identify areas that they believe need improvement. Setting these goals down in black and white makes them more real. Facilities. Identification, design and renovation of facilities was primarily a logistical, financial hurdle. The dearth of acceptable buildings in the communities made location identification fairly easy. Facility design was more complex, requiring meet and confer. In addition, each team participated in the design process to insure that the physical configuration met their needs and was "client friendly," e.g. a small play area for children in North Richmond. The County allocated $46,000 for renovation. Collaboration and Linkaqes Since its inception, Service Integration has emphasized developing and maintaining strong linkages with schools,community-based organizations, churches, local governing bodies and other services. The service implementation strategy is predicated on collaboration between the Service Integration Teams and Healthy Start. In both North Richmond and Bay Point, the County, the school districts and the community were partners in the Healthy Start Initiative proposals. This emphasis on 19 Contra Costa County Healthy Start is a critical strategy in engaging the community and developing community capacity. Mt. Diablo School District contributed 3 staff to the Bay Point team as well as classroom space. West Contra Costa School District is contributing after-school programs ($65,000 grant funded) and classroom space. The SIMT also worked closely with the MACs at all stages of planning and implementation. Opportunities for collaboration continue to emerge. In Bay Point, for example, the Contra Costa Community Conservation Corps (community support programs) and the County's Drug and Alcohol Rehabilitation program (individual/group counseling and relapse prevention) is working out of the Bay Point Family Service Center. The PATHS homeless family network is being linked to the Center database to help match family needs with community resources. For North Richmond, the County is currently considering co- locating a new planned Health Clinic and the Family Service Center. Linkages occur on three levels: 1) among the different departments and agencies represented in the service integration teams; 2) among the teams and the network of community-based organizations, such as churches, MACs, schools, Head Start and non- profits; and 3) among the teams and the broader resource pool of services that are regional or county-wide. Expansion to New Sites and Timelines The County is committed to expanding the role of Service Integration in Contra Costa. As outlined in the Needs Assessment section and Appendix C, seven additional Family Service Centers have been proposed for high-need areas. The anticipated process for each community will be similar to Bay Point and North Richmond, i.e., 1) Applying for a Healthy Start planning grant; 2) Conducting a community needs assessment; 3) Applying for a Healthy Start operational grant; 4) Identifying, procuring and renovating a Family Service Center facility, 5) Selecting Service Integration Team members; 6) Conducting team training; 7) Opening the Family Service Center; and 8) Recruiting the initial client base. Based on experience with the first two Family Centers, two more could be opened each year (See Timeline, Appendix C ). For the next two planned centers, the Coordinating Council and the school district worked with the Parkside (Pittsburg) community to procure planning and operational grants and with Cambridge (Concord) on its planning grant. Service Integration entails two levels of activities: 1) establishment of the Family Service Centers and 2) establishment of the organizational and other support systems necessary to facilitate the delivery of integrated services (i.e., waivers, fiscal strategies, management information system). The programmatic waiver process needs to be substantially implemented in 1995 to allow for opening new Centers. The fiscal strategy 20 Contra Costa County would follow for the next fiscal year. Other organizational milestones are listed in the Timeline and Barriers/Milestones charts, Appendix C. Program and Fiscal Restructuring Strategy AB 1741 and AB 1763 support funding and programmatic flexibility to better serve the needs of children and families. Contra Costa believes that programmatic flexibility is an integral part of the fiscal flexibility and, consequently, proposes a two-phase restructuring strategy: 1) negotiations and agreements with the state on waivers that redefine allowable and required staff activities; 2) creation of Family Service Center budgets, based on negotiated county, school, state and federal funding allocations. The phased restructuring strategy reflects the community needs assessment and the belief that neither the State nor the County has significant new resources to devote to the project. Yet, staff time needs to be spent on early intervention and other activities which currently have no source of funding support. Consequently, addition of staff activities must be balanced by elimination of other staff activities. Contra Costa County will request state waivers on the requirements to perform the following functions: monthly CA-7 and yearly reinvestigations on AFDC, food stamps and Medi-Cal cases (absolutely essential, since these requirements consume approximately 50% of eligibility worker time); deprivation eligibility criteria; foster care reimbursement, difficulty care review for Child Protective Services; use of multiple forms that collect duplicative data; and duplicative job search requirements. Other waiver needs will likely emerge as the Service Integration Teams gain experience. The County will also be examining its own processes to leverage staff resources, such as increased voluntary Family Maintenance participation to reduce staff time spent on court. Common case management should significantly increase efficiency. Staff time would be redirected to focus on prevention and early intervention services for all children and their families, promoting safety, health, enrichment programs, recreation and cultural experiences. Staff time would also be spent providing necessary services that lead to family self sufficiency,jobs, employment opportunities and community service alternatives. In this area, waivers would also be requested to combine efforts (such as child protective/public health/probation cases); to expand allowable services(for example, CPS services in the community to promote healthy parenting practices and refocused public health assessments to include schools) and to allow time for project evaluation (See Evaluation Plan). New activities could be easily and quickly "permitted" by redefining eligible time study categories within Social Service. Since many health programs (mental health, public health, substance abuse) are funded on a unit of service/ service plan basis, the waiver mechanism for these programs will require a higher level of creativity. Probation services are largely county funds and, consequently, program 21 Contra Costa County "waivers" should not pose a difficulty. In eliminating required activities, the County acknowledges that it is very important to work with the State to ensure program integrity. For example, the CA-7 and yearly reinvestigations could be replaced by a random sampling of clients for eligibility. (In addition, it would not obviate the client's responsibility for notification of change of circumstances, which could be filed on the CA-7 form). Redirection of staff effort may not be sufficient to provide all levels of support necessary for Center clients. For example, there may be need for specialized services or capital expenditure (for tutoring materials or a money management advisor, for example). For this reason, Family Service Center budgets are proposed under a phase two fiscal strategy. Once the staff of each Family Service Center is stabilized and waivers negotiated with the State, it will be possible to determine a "staffing standard" under the new service model. At this time, we would recommend an agreement to "freeze" county/school/state/federal funding at that level (with COLA/pay equity adjustment provisions). The feasibility of this approach may depend upon flexibility on the federal level, since counties are increasingly dependent upon reimbursement from federal funding sources such as SB 910, Title IV-E and Title IV-A-EA. The timing on phase one and phase two of the fiscal strategy will depend upon negotiation with the state and federal governments on waivers and allocation agreements. We propose that agreement on CA-7s and yearly redetermination of eligibility be made as soon as possible, with negotiation completion by the end of the first year. This would allow for a full four years of program implementation under a "mature" service model. Evaluation Plan The evaluation plan consists of the following elements: • Service Integration effectiveness • Evaluating client satisfaction with services • Evaluates the organizational structure. • Examining the fiscal and programmatic strategy success, including waivers • Examining the cost-benefit of Service Integration. • Replicating the Service Integration model to the seven proposed sites. A. Service Integration Effectiveness. Success will be measured by achievement of outcomes, which will measure the effectiveness of the new Family Service Centers. The indicators rely on data already maintained by County Departments and/or information that will be available through the Family Assessment Records on clients served by the Family Service Centers. The data system will allow for regular tracking of key indicators. Each 22 Contra Costa County indicator is associated with at least one existing data source. Data sources include: birth certificate data; Child Health and Disability Prevention (CHDP) program data; Immunization Assistance program data; inventories of the number and partic,pation rate of support, self-help and assistance groups; school data; crime data; incarceration recidivism rate; death certificates; child abuse reports; juvenile probation recidivism data; juvenile crime data; employment statistics; GAIN and Private Industry Council data; Quality Control Unit data; SIT Client Satisfaction forms; Social Service Department data; Probation Department data, Living Free & Born Free Program data; Independent Living Skills program data; Child Protective Services data. The baseline indicators for the first two Family Service Centers will be collected by January 1, 1995. Baseline information for subsequent Centers will follow participant recruitment. The Family Assessment Records will be maintained through the MIS system now being programmed to produce status reports on record indicators and outcomes. The goal will be to conduct these evaluations and issue status reports every six months, although some of the indicator data (e.g., median household incomes) may only be available on an annual basis. B. Evaluating Client Satisfaction with Services. Client satisfaction is an important component of service integration. With Service Integration Teams and service recipient input, the Coordinating Council will design a client satisfaction forms to be distributed to Center clients. The forms will address issues such as the way clients are treated at the Center, how helpful clients find the staff and accessibility and comprehensiveness of the services, compared to the "standard" services. These forms will be reviewed at team meetings and assessed biannually by the Service Integration Coordinator and Coordinating Council. Periodic interviews with a random sample of clients will also provide a means of assessing client satisfaction. In addition, the Service Integration Coordinator will examine client participation and drop- out rates as a measure of each Center's success. An increase in volunteer rates would signal success. Client termination rates would be assessed based on cause of termination, i.e., Are families dropping out because they are no longer eligible due to self sufficiency or because the program is not relevant to their lives? C. Organizational Structure. Service integration training emphasized self-managed teams and empowered workers. Staff at each Center meet monthly to assess the status of their efforts and suggest improvements to forms, processes and systems. These suggestions are then brought before the Coordinating Council by the team facilitators for consideration and implementation, as appropriate. This process will continue to provide an invaluable communication and evaluation tool. 23 Contra Costa County All team facilitators will meet together every six months, joined by the Service integration Coordinator, to trouble shoot and share successes. A joint evaluation report will be issued after each of these meetings. Team mewbers with common specialties will also be encouraged to meet with their colleagues at the other Centers to work through common barriers and/or share innovative approaches. Schools, church groups and other community-based organizations will also be asked to regularly evaluate the strengths and weaknesses of the Family Service Center located in their community through surveys, one-on-one interviews and focus groups. These community evaluations will be conducted every six months for the first two years of each project and annually thereafter. D. Programmatical Strategy. The primary goal of service integration is to improve the efficiency and effectiveness of services using existing resources. The ability of staff to redirect their time relies heavily upon the receipt of waivers. Waivers received, waivers not granted and alternate waivers will be carefully documented. Time studies will assess their impact on use of staff time (compared to non-service integration staff). Center staff will be surveyed to determine if sufficient time is available to support families. From a fiscal perspective, evaluation will encompass the logistical, practical and regulating barriers to creating the consolidated budget (e.g., continued ability to claim under SB 910). Following one year of experience, the budget's impact will be assessed (e.g., were activities funded that were previously not possible?), E. Cost-Benefit Analysis. As part of the long-term evaluation, funding support will be sought to perform a cost-benefit analysis, including family recidivism rates, avoided income maintenance costs, justice system costs, avoided health crisis intervention. The cost-benefit analysis will profile a "cost of failure" compared to the cost of service integration. F. Replicating the Service Integration Model to the seven proposed sites. Each service integration site poses different challenges. Thus, one of the tests of the service integration model is expansion to the seven remaining proposed Family Service Center sites. 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County Superintendent of Schools, or superintendent of each school district included in pilot project. Ronald L. Stewart, Ed.D Superintendent of Schools Contra Costa County (Gary Rutkin, Alternate) Robert W. Baum, Ed.D Superintendent Mt. Diablo School District (Rich Clarke, Alternate) Herbert Cole, Jr., Ed.D Superintendent West Contra Costa Unified School District (Jennifer Jennings, Alternate) 2. Juvenile Justice System representative. Paul Zaro, Manager Juvenile Field Services Contra Costa County Probation Department 3. County, city and school officials responsible for the funds or services included in the pilot project Yvonne Bullock Assistant County Welfare Director Social Service Department Contra Costa County Rich Clarke, Director School-Linked Services Mt. Diablo Unified School District Mary Foran, Director Office of Service Integration 1 Contra Costa County Health Services Department Contra Costa County Sara Hoffman Senior Deputy Administrator for Health & Welfare Contra Costa County Jennifer Jennings Health Education Coordinator West Contra Costa Unified School District Shirley Kalinowski, Division Manager Income Maintenance Bureau Social Service Department Contra Costa County Bili Massey, Program Supervisor Contra Costa County Substance Abuse Services Ruth Ormsby, Chief Child & Adolescent Services Health Services Department Contra Costa County Bill Reid, Division Manager Income Maintenance Bureau Social Service Department Contra Costa County Gary Rutkin, Education Specialist Youth Interagency Assessment Consultant Team William Weidinger Service Integration Program Coordinator Contra Costa County 4. Service providers affected by the pilot project. Kathi Kelly 2 Contra Costa County North Richmond Service Integration Team Facilitator Contra Costa County Social Service Department Deborah Polk Bay Point Service Integration Team Facilitator Contra Costa County Social Service Department 5. Local organization representatives representing employees who will be affected by the pilot project Jere Copeland Probation Department Local 1 Representative Contra Costa County Employees Association Billie Jo Wilson Health Services Department, Public Health Local 1 Representative Contra Costa County Employees Association Barbara Murphin Social Service Department Local 535 Representative Contra Costa County Employees Association Jan Watson Social Service Department Local 535 Representative Contra Costa County Employees Association 6. Service recipient representative Client representatives will be selected from Family Service Center participants. ADDITIONAL TEAM MEMBERS: Judy Campbell Personnel Officer Social Service Department Contra Costa County 3 Contra Costa County Nina Goldman Associate Analyst Contra Costa County Julie Kelley Office of Service Integration Health Services Department Contra Costa County Grace Schmidt Family Self-Sufficiency Coordinator Housing Authority of Contra Costa County Joan Sparks, Director Community Services Director Contra Costa County NOTE: Additional representatives will be added as more Family Service Centers are opened, to include clients from each Service Center, Center Facilitatiors and participating, as appropriate. 4 Contra Costa County PROJECT RESPONSIBILITIES OF COORDINATING COUNCIL MEMBERS The county superintendent of schools; superintendent of each sc'•`. ool district; the county juvenile justice system representative; and other county, city and school officials responsible for project funds or services also share oversight responsibility for the success of Service Integration. Their role additionally includes providing linkage to their particular agency/department so there is adequate communication between the Family Service Center staff and their agency/department. It is important that this communication be two way and prompt. This group of representatives is also responsible for the removal of barriers encountered by the Service Integration teams. The Council members function as extended team members who use their knowledge and expertise in their own organizational system to help remedy team problems and assist with the team goals. The influence and power of these high level representatives also extends their role to the making or changing of policy. These representatives have developed, through their long history of working collaboratively, a culture of innovation and change that asks not only what the problems/barriers are, but how we can work together to creatively solve and remove those barriers. A vortex of change and innovation swirl around this group and extend to their service purview. The service providers are the team facilitators who are unique conduits between both the teams and the Coordinating Council. The team facilitators are responsible for bringing systems issues from the pilots to the Council. They are also responsible for informing the Council on the effectiveness of policy changes. The team facilitators also manage the day-to-day operations of the teams and serve as the hub for problem solving and development of creative ideas and solutions. The labor organizations' representatives also have a variety of functions. They represent both the team members and the members of the functional departments of the specific team members. One of the labor representatives is also a team member of one of the pilot sites, which presents a unique opportunity for her to see several sides to each issue. Labor representation on the Council provides an early alert of possible meet and confer issues so that the Council can address and resolve them prior to escalation to meet and confer, if possible. The active participation of the labor representatives on the Council has stimulated a growing belief that by working together to identify and then resolve problems, the Council is an extremely positive force that reflects the collaborative paradigm. The representatives from the service recipients will also play a vital role in keeping the Council focused on how services are being delivered. The Council will hear first hand how it feels to be on the receiving end of the services. This insight into how the teams are performing from the viewpoint of participating families will be invaluable information about how well Service Integration is working and how it can continue to improve. 5 Contra Costa County The Program Coordinator has many different roles in this exciting project. Primarily, the Coordinator will be gathering information from many different sources and presenting it to both the teams and the Council for discussion and decision making. Following up on these many and varied issues is of primary importance. Supporting the team facilitators and the teams will also be very important. Liaison work with the many involved entities plays a key role in keeping the communication channels open and vibrant. The Coordinator is responsible for MIS implementation; preparing reports; tracking the success of the stages of the project; and replicating Service Integration in the additional seven sites. 6 Contra Costa County Appendix B State Evaluation Participation Form The signatories below hereby agree to participate in a state evaluation of the pilot project under Chapter 951, Statutes of 1993 (Assembly bill 1741, Bates), should non-state resources for such an evaluation be secured, as required by the Califomia Health and Welfare Agency. 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Fr.•-• .y O "� -"�"' Ti Y��{fy 7� nap ?N R•.`" 7 '�. ..s%+`��i� t+'i �� .._r -mss } n• O b ro *< tP o ro ro m -:� �?; .tri, •+ rr�f" '", t S I VII N d 0 o c o ? r r L a:A to R { 0 ^'o 5 =r n y ro o •� m � +,'. :, � Nv d n n `0 ^N 3� •t.+��Y •st' � •3',..yy�'�-r 'y,•• t�*d R ry �• ro � o V y �� 0 O r N n 1 V Appendix E Contra Costa County NORTH RICHMOND FAMILY SERVICE CENTER CONSENT TO PARTICIPATE AND AUTHORIZATION TO SHARE INFORMATION The Family Service Center is designed to improve services for the families of North Richmond.- 10. ichmond: ► to make services easier to get to, putting workers from various county offices in a single, local neighborhood center. ► to reduce the number of forms to complete and the number of workers to talk to. ► to permit sharing of information about you so that all workers can do a better job in serving you. ► to help you get the health, education, social and community services you need. In order for the Family Service Center to serve you and your family, Center staff must be able to talk with each other on your behalf and to review the records of each agency in the program. Family Service Center staff consists of representatives of the Contra Costa County Social Service Department, Health Services Department, Probation Department, Community Services Administration and the West Contra Costa County Unified School District. According to state and federal law, we need your permission to share information and records about you and your family. Information and records will NOT be given to anyone except staff of the Family Service Center and their supervisors. Supervisors will review information in your records to make sure that the programs are in compliance with county, state and federal rules. If information or records show that drug or alcohol treatment services are/have been provided to you, they cannot and will not be used to criminally investigate or prosecute you. Service Center staff is required to keep all information and records CONFIDENTIAL. Family Service Center staff is legally required to report any suspicion of child abuse to Protective Services. If you and your family would like to be part of the Family Service Center, please initial each of the statements below to show that you have read, understand and agree with each statement: I wish to receive services for myself and my minor child(ren) at the Family Service Center. I allow staff of the Family Service Center to share information and records about me and my family with other staff of the Center and their supervisors to plan, to check and to see that I am receiving services and treatment that best meet my family's needs. The staff may share with each other the following types of records provided by me that will enable them to better provide services to me, including but not limited to: o information in my Medi-Cal records, Aid to Families with Dependent Children (AFDC) records, General Assistance records, Greater Avenues to Independence (GAIN) records, Food Stamps records, Child Care records, Children's Protective Services records, Child Welfare Services records, Juvenile Court records, Public Health records, Family Assessment Record (which contains information about my family's goals, strengths, needs, plan of action and services to be received), school and job training records, financial information and social history. In addition, the staff may share information about my work with the following other agencies: and We will not share information about your medical records, psychiatric/psychological evaluations and drug/alcohol abuse records without first asking you for your written permission. Your agreement to participate in the Family Service Center and permit sharing of information begins , 19_and ends , 19_ (1 year). You may cancel your consent at any time during the year. No information will.-be shared with anyone after the date you quit the Center. Your consent applies to you and your minor child(ren), including the child(ren) for whom you are the legal guardian. Please print the names and birth dates of your minor child(ren). Child's name: Birth date Child's name: Birth date Child's name: Birth date Child's name: Birth date Child's name: Birth date If you have any questions please ask. Your participation is important. We want to do a good job working with you to achieve your goals. Signature Date / / Name (please print) Birth date Social Sec.# Address City Zip Code Witness. Signature Date Name (please print) Title This form is designed to comply with Health & Safety Code 1795; Welfare and Institutions Code 10850 and 5328; Education Code 49073; Civil Code 56 and 1796 and 42 CFR Part 2. All records governed by 42 CFR Part 2 shall include the statement: "This information has been disclosed to you from records whose confidentiality is protected by federal law. Federal regulations, 42 CFR, Part 2, prohibit you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is NOT sufficient for this purpose."