**One Coordinated TA Plan --**

**Pilot, Circle of HOPE MO**

**Date: 09-07 Report prepared by: Frank Rider, RTAC**

# Introductory Information

-   Community Name: Circle of H.O.P.E.

-   Location: St. Joseph, MO

-   Year Funded: 2006

-   Project Officer: Elizabeth Sweet, SAMHSA - CMHS

-   Regional Technical Assistance Coordinator: Frank Rider -- Region III

**TA Team Members**:

-   Family Resource Specialist: Gwen Palmer

-   Youth Resource Specialist: Reyhan Reid

-   TA Partnership Director/Resource Specialist: Regenia Hicks

-   SOC Alumnus: Greg Bullard, Greenville SC (former project director):

-   Communications Campaign Liaison: Erin Turner

-   ORC Macro Evaluation Liaison: Connie Maples

-   Other TA Support: Sandy Keenan, TA Partnership Mary Tierney MD, TA
    Partnership

One Coordinated TA report

Area 1

# 

# [Area of Focus 1 : Effective Collaboration - Partnerships with Education]{.underline}

-   Description of Area of Focus: The Circle of HOPE is building a
    system of care for children and families that integrates primary
    health care, (public) education, behavioral health care and other
    child serving systems in partnership with young people and their
    families. Planning focused on partnerships involving education
    yielded the following:

-   Strengths:

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-   Educators are substantially involved in the Circle of HOPE. St.
    Joseph school district (12,000 students across 40 sites) and
    Humboldt Elementary School (an initial pilot site) are well
    represented in the initiative.

-   Humboldt Elementary School has a long history of innovative best
    practice and partnership with mental health, has a community support
    worker, and aspires to a schoolwide behavior management approach.

-   The former superintendent of the school district had signed the
    collaborative MOU, and the current administrative leadership is
    ready to participate substantially in the Circle of HOPE initiatives

-   Improved school performance, attendance; decreases in expulsions and
    suspensions are reported widely in system of care communities. These
    documented results can be effective motivators for education
    partnerships in the Circle of HOPE.

-   All Title I Schools have family involvement coordinators.
    ***Action:** The school district will share the names of these FICs
    with Joe Turner, KFC. **Action:** The Circle of HOPE will consider
    inviting FIC's to participate in upcoming wraparound trainings.*

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-   [**Action 1.1** RTAC to arrange a specific conference call with
    Sandy Keenan, Humboldt Elementary School representatives (e.g. Sara,
    Principal) and Circle of HOPE personnel, before 12/15/07, to help
    plan implementation of pilot activities.]{.mark}

    -   TA Resources for Action 1.1

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-   \"Toward A Shared Agenda\" document, discusses Missouri and
    national-level partnerships among education systems, mental health
    systems and families; at:\
    <http://schoolmentalhealth.missouri.edu/focusgroup/agenda03.rtf>

-   National report, describing Missouri\'s role among six states that
    have received seed grants to support partnering among schools and
    mental health systems, at:\
    <http://www.ideapartnership.org/report.cfm?reportid=47>

-   Positive Behavior Intervention and Supports resources:

    -   Lucille Eber, Positive Behavior Interventions and Support -
        [www.pbisillinois.org](http://www.pbisillinois.org/) (Ph: 708
        482-4860)

    -   National Center on PBIS, based in Portland OR --
        [www.pbis.org](http://www.pbis.org/)

    -   National Conference on Positive Behavior Supports -- Chicago IL
        March 27-9, 2008 (see <http://conference.apbs.org/>)

    -   New Hampshire's graduated SOC initiative spread PBIS statewide,
        was successful, has published very positive outcomes.

-   Sandy Keenan, TA Partnership -- <skeenan@air.org> -- will provide
    follow-up direct TA to educators in this community.

-   In addition, Sandra will provide direct TA and facilitation in
    state-level activities to build partnership with the education
    system during Spring 2008; it is hoped that a current \$7.5-million
    Legislative appropriation to support school-based mental health
    services will pass, and be a focal point of Sandra's work
    (coordinate with Connie Cahalan, Missouri DMH).

> Sandy Keenan's initial technical assistance call 9/12/07:

-   Collaboration at multiple levels:

a.  Individual child/student level -- school representatives are
    involved at the child/family team level.

b.  Needs of a group of children (6, 12, 15) e.g. individual or group
    therapy services on site at school, after school programs, programs
    after hours or co-located at school

c.  Schoolwide collaboration and support (e.g. schoolwide PBIS, MH
    provider assigned to school; school offers BH support center)

d.  District level support -- comprehensive programming.

e.  Countywide or statewide level of implementation.

-   Six specific promising practices emerged from early SOC work related
    to education:

a.  Use clinicians and other support providers in schools must work not
    only with children and families, but also with the staff of the
    school (consultation, professiona development, education for staff).

b.  School-based and school-focused wraparound processes tp support
    improved educational outcomes.

c.  School-based case management

d.  Schoolwide prevention and early intervention programs, and

e.  Creation of "centers" within a school (that is, physical places)
    around emotional and behavioral needs of children; and

f.  Use of family liaison and family advocate roles.

-   Positive Behavior Interventions and Supports (PBIS):

a.  Universal (school wide) interventions and approaches

b.  Targetted interventions (10-15% of children may need special
    support, reminders, practice; and

c.  Chronic, longterm, intensively needy students need specific
    approaches.

d.  PBIS is a pretty comprehensive staff training and development
    initiative, might take 2-3 years, and can be used well beyond the
    schools, to after school programs, day care, in family homes, group
    homes, scouts, etc.

e.  Fits well with system of care: pre-referral/intervention team at
    school.

-   Social/emotional learning and anti-bullying programs are also
    compatible with system of care values and approaches.

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-   [**Action 1.2 -** Clarify legal and regulatory issues around the IEP
    process in particular, and around confidentiality/information
    sharing concerns of families and schools in general.]{.mark}

    -   TA Resources for Action 1.2

> Sandra Keenan will provide information, resources and forms to special
> education and non-special education personnel within the school
> district, to ensure that school-based wraparound processes, and school
> representatives' participation in family support (a.k.a. wraparound)
> teams.

-   [**Action 1.3** - Provide wraparound training to pilot site
    personnel (Humboldt Elementary School); implement and refine
    protocol with input from families and school personnel. *(See Area
    of Focus #5: Building Clinical Services and Supports.)*]{.mark}

    -   St. Louis Youth in Transitions' CAS site is hosting wraparound
        training effort that Circle of HOPE constituents will access for
        initial training.

-   [**Action 1.4** - Determine how best to involve the family
    involvement coordinators that the Title I schools already have in
    place, in the Circle of HOPE initiatives.]{.mark}

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-   Beth Berndt, McHenry Co. Family CARE (<bberndt@mc708.org>) --
    regarding family resource developer positions deployed in schools.

> One Coordinate TA report
>
> Area 2

**[Area of Focus 2]{.underline} - Governance**

-   Strengths:

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-   Policy team participants have signed MOU

-   Group Rules and Decision-Making Process have been developed

-   Policy team has worked hard to coalesce, and to behave in accordance
    with the principles of "family-driven"

-   Policy team bylaws require that families have 51% of the voting
    power.

-   Policy team has engaged in intensive strategic planning (February
    and May 2007 sessions with outside facilitation), revisited initial
    goals and has revised, based on family and collective input, and has
    taken ownership of the Circle of HOPE initiative

-   Team members have a long history of working together prior to this
    cooperative agreement.

-   Commitment of participants is evident. People are willing to make a
    substantial contribution.

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-   Challenges:

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-   Need to establish a process for conflict resolution that can be
    replicated at the agency/provider and the child/family team levels

-   Need to increase ethnic/racial diversity on the Governing Board
    (e.g. to ensure effective proactive outreach to the emerging Latino
    population)

-   Have not yet been able to organize youth to participate effectively
    in Governance

-   Need to define Governance for this community. Power/authority must
    be appropriately shared among Policy Team/Governance members, staff,
    private agencies, state agencies, etc. See Theme #4 in GFA Crosswalk
    for its list of 20 key questions.

-   Finding "win/win" solutions that take into account, and satisfy, the
    self-interest of members and their constituents (The "what's in it
    for me?" question.

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-   [**Action 2.1**- Develop a clear, limited set of local indicators of
    progress, success. Publicize these, use them to galvanize the
    governance participants. Consider developing a local version of the
    Missouri "Stats Blast."]{.mark}

> []{.mark}

-   TA Resources for Action 2.1

a.  Local and/or national evaluation team members.

b.  Arizona example of four functional outcomes, and its statewide,
    published outcomes reporting

c.  SAMHSA NOMS (National Outcome Measures)

-   [**Action 2.2** - Continue to figure out where we need to go with
    further development of our governance structure. Use the 20
    questions from the GFA crosswalk as a tool to guide this process.
    Identify goals, objectives mand strategies to address areas]{.mark}

> []{.mark}

-   TA Resources for Action 2.2

a.  GFA and System of Care Implementation Crosswalk (TA Partnership,
    2006), list of 20 key questions on Pages 17-19, at:
    [http://www.tapartnership.org/download/GFA%20Crosswalk%20Year%20One%203%2014%2006%202.pdf](http://www.tapartnership.org/download/GFA Crosswalk Year One 3 14 06 2.pdf)

b.  Bruce Strahl, TA Partnership and Sheryl Schrepf, project director,
    Sarasota FL have been identified by project director and RPT
    (10/07), with approval of principal investigator, as preferred
    external consultative resources to assist Circle of HOPE to
    strengthen governance practices in coming months.

c.  Arrange a visit to, or by, one of the three team learning centers:
    Dawn Project, Wraparound Milwaukee, Westchester Co. NY:

The Dawn Project, Indiana, Knute Rotto, CEO -
[krotto@choicesteam.org](mailto:krotto@choiceteam.org)

(also see [www.kidwrap.org](http://www.kidwrap.org/))

Westchester Community Network, NY - Michael Orth, Director -

[www.westchestercommunitynetwork-]()

Wraparound Milwaukee, Wisconsin - Bruce Kamradt, Director -

<bkamrad@wrapmilw.org> or
[bkamradt@milwcnty.com](mailto:bkramradt@milwcnty.com)

d.  Other communities that can provide useful teaching examples:

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1.  Cuyahoga County Tapestry Project -- Beth Dague, Cleveland OH

2.  McHenry Co. Family CARE, Crystal Lake IL -- Todd Schroll, Project
    Director

-   [**Action 2.3** - Develop a barriers identification and resolution
    process.]{.mark}

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-   Teach, motivate, incentivize FSA's, care coordinators and agency
    partners to use this process.

-   Empower youth and families to use this process.

-   Motivate people to resolve conflicts at the lowest level possible.

-   Analyze the barriers, develop systemic solutions when possible, and
    develop protocols that account for the majority.

-   Incorporate this process into our MOU.

-   Use this as an excellent starting place to apply meaningful youth
    voice.

-   "Don't Just Say No!" Consider using mediation.

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-   TA Resources for Action 2.3

> Arizona's barriers identification and resolution procedures, provided
> by Frank Rider (<frider@ffcmh.org>), RTAC 10/07.

One Coordinated TA report

Area 3

## Area of Focus 3 -- Strategic Planning 

-   Description of Area of Focus:

> Policy Team has focused primarily on near-term tasks, and has not yet
> developed a longer-term strategic plan. Ideally, would like to develop
> timely annual planning process to establish goals/objectives and make
> budgetary decisions in time to support annual reapplication for
> cooperative agreement funds.

-   Strengths:

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-   Policy Team is actively applying the results of its concept mapping
    process in setting goals and objectives.

-   Policy Team has developed and approved a nearterm workplan, which
    can be expanded upon and updated

-   Policy Team has developed a logic model which can serve as primary
    basis for strategic planning.

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-   Challenges:

> Policy Team has focused primarily on near-term tasks, and has not yet
> developed a longer-term strategic plan.

-   [**Action 3.1 -** Describe a clear vision of a transformed system of
    care for St. Joseph; and ensure this is reflected in the Logic
    Model:]{.mark}

> [Schedule and facilitate strategic planning sessions for the Policy
> Team to establish a clear, shared vision, and a longer-term strategic
> plan.]{.mark}

-   TA Resources for Action 3.1

> Community has identified Bruce Strahl, TA Partnership and Sheryl
> Schrepf, Sarasota FL project director as preferred external
> consultative resources to help facilitate this process (10/07).

One Coordinated TA report

Area 4

## Area of Focus 4 - Sustainability

-   Description of Area of Focus: 1. Securing, documenting matching
    resources 2. Determine which essential elements of the Circle of
    HOPE system of care will be sustained; and begin to determine
    strategies for sustainability (e.g. financial, structural,
    personnel, advocacy)

-   Strengths:

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-   Two local legislators are champions for MH services.

-   Child welfare is dedicating two children's service worker staff
    positions to the philosophy of Circle of HOPE. They work with intact
    families, in prevention. Has an existing staff member dedicated
    already.

-   Active, engaged family members can be key to advocating as needed in
    support of sustaining resources.

-   Many Circle of HOPE goals are congruent with current local United
    Way goals.

-   Several potential matching resources identified in brainstorming
    session: What are the enhancements to services and supports that
    become added to the local system of care? Examples: Karate class at
    community college? College students volunteering time as youth
    mentors? Student internships? Red Alert, Blue Alert? Time Banking?
    "Eminem?"

-   The community's United Way has an Unmet Needs committee which could
    serve the Circle of HOPE's flexible funds. This was the arrangement
    in Greg's SC community.

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-   Challenges: Matching funds requirements, given limited financial
    resources.

-   [**Action 4.1** -- Develop, implement a process to secure matching
    resources to meet the Maintenance of Effort and matching funds
    requirements of the cooperative agreement.]{.mark}

    -   TA Resources for Action 4.1

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    -   Greg Bullard, SC's suggested strategy to frontload longterm
        agreements with providers so that they contribute more in the
        later years, allowing the cooperative agreement to pay a greater
        portion in early years, ands a lesser portion in latter years of
        the cooperative agreement (e.g. the co-located MH person in the
        pediatrics clinic example). To wit:

> ***" I would suggest 5 year contract with the grant providing
> staff/services free for the first 2/3 years(by all means, however,
> share your data with those contractors, and use your MIS systems to
> show the dollar amount of services provided, cost savings, etc,
> etc..). The contract should, after the third year, start increasing
> the amount contributed by the contractor (e.g. \$5,000 for the 4^th^
> year, \$10,000 for the 5^th^ year, \$15,000-\$20,000 in the 6^th^ and
> 7^th^ years). My experience taught me that if I didn't enter into
> long-term contracts, then some system partners will fail to remember
> verbal commitments. Especially if I failed to provide them with
> meaningful data, or if there were key leadership changes for the
> contractor."***

-   Bazelon Center matching funds guide (already provided to community)

-   Matching funds scenarios prepared by Frank Rider, RTAC for NW
    Minnesota (provided 11/07)

-   Frank Rider to pull arrange conference call with project directors,
    CFOs from other communities (e.g. Beth Dague, Sue Bowler)

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-   [**Action 4.2** - Strategic Planning process to develop the budget
    needed to support the third year reapplication. Make this an annual
    process that occurs in time to]{.mark}

[prepare the next year's reapplication process. (See Focus Area #3 for
TA Resources).]{.mark}

-   [**Action 4.3** -- Strategic Sustainability Planning]{.mark}

[]{.mark}

-   TA Resources for Action 4.3

Frank to furnish research and Ppt presentation by Beth Stroul on this
topic to help guide

local planning (provided 11/07).

One Coordinated TA report

Area 5

## Area of Focus 5 -- Building Clinical Services and Supports

-   Strengths:

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-   A great service delivery team has been working hard and productively
    since May to develop a service delivery process for the first
    children and families.

-   The community has identified three initial pilot sites, intending to
    identify and work through challenges on a small scale before
    expanding service delivery.

-   Existing Misouri pilots around MST and FFT

-   The service delivery team has developed an initial protocol,
    covering the following steps: engagement of the family, clinical
    assessment, immediate crisis stabilization, strengths needs and
    culture discovery, Family Support Team formation, team support plan
    development and implementation, ongoing crisis and safety planning,
    tracking and adapting, transition, and evaluation.

-   Have developed job description for family support assistant role,
    and state

-   Medicaid is expected to cover FSA activities in Missouri before end
    of 2007. RTAC is assisting principal investigator with resources to
    facilitate this initiative (11/07)

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-   Challenges:

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-   Still need to figure out best service delivery "client flow" process
    (e.g. where does the CAFAS fit?).

-   Need effective clinical approaches to address externalized (e.g.
    oppositional defiant disorder) behavior problems.

-   Clinical services and supports for emerging Latino population

-   Provide culturally sand linguistically appropriate assessment forms,
    and the provision of interpretor and/or translation services

-   Different service delivery strategies may be needed to expand COH
    service delivery in rural communities, in contrast to strategies
    with St. Joseph's urban hub

-   Strategies to engage youth early in the service delivery process
    (consider the

-   option that the youth coordinator, when hired, can do this.)

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-   [**Action 5.1** -- Implement the dry run of the proposed
    intake/enrollment process for two volunteer families, and one youth,
    to test it for "family friendliness," for cultural and linguistic
    sensitivity, and against the requirements of funding
    sources/agencies.]{.mark}

[]{.mark}

-   TA Resources for Action 5.1

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-   Regenia Hicks assisted Vickie on-site to help inform assessment
    process/tools (e.g. clinical interview) in regard to cultural
    sensitivity.

-   Frank to furnish Family Guides to Wraparound Process from National
    Wraparound Initiative website (10/07); and from Cuyahoga County
    Tapestry, OH).

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-   [**Action 5.2** - Determine what kind of documentation Circle of
    HOPE personnel will meet. For 10/1/07 start-up, use the Medicaid
    standard of documentation as the minimum. Over time, account for the
    documentation of needs of all other major system partners, and
    incorporate into a revise, longer-term documentation
    procedure.]{.mark}

    -   ***Completed -- no TA Resourcesneeded***

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-   [**Action 5.3** - Determine minimum staff training
    requirements.]{.mark} The basic training curriculum should
    include: 1. Understanding and applying key Circle of HOPE values,
    including: family-driven, youth guided; interagency collaboration
    and coordination of care; accessibility of services; culturally and
    linguistically competent; and equity/non-discrimination 2.
    wraparound process 3. strength/need based planning 4. explaining the
    new local processes, including the new role of family support
    assistants, and 5. initial information to meet requirements of the
    national evaluation protocol.

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-   TA Resources for Action 5.3

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-   St. Charles has a good System of Care training curriculum model that
    can be adapted by Circle of HOPE to for this, per Gary Hammond.

-   Frank Rider will furnish Elizabeth a sheet of practical suggestions
    to promote active youth participation in their own service planning,
    and in positive youth activities (FAX to Jayme Neal 11/07).

-   Reyhan will review proposed training curriculum to help ensure it
    substantially addresses expectations for/how to support meaningful
    youth participation.

-   National Wraparound Initiative website -- tools, consultants;
    Arizona protocols and technical assistance documents on Child and
    Family Team Process have been provided by Frank Rider (Oct-Nov 2007)

-   Communication Campaign has developed presentation templates about
    benefits of systems of care that could be adapted to help support
    training curriculum.

-   Frank Rider, RTAC can provide several training presentations that
    could be adapted to help support training curriculum.

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-   [**Action 5.4** - Determine how to incorporate consents and releases
    in the service delivery process. Adequately meet the requirements
    (EDIF, NOMS) for national evaluation. Test this during dry
    run.]{.mark}

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-   TA Resources for Action 5.4

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-   Local evaluation team, Connie Maples, service delivery team

-   Show Me Kids, St. Louis Transitions, state of Missouri have consent
    forms/releases that

-   can be adapted by Circle of HOPE.

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-   [**Action 5.5** - Develop clinical (best practice) capacity to
    address identified needs of children with externalized behavior
    problems, and their families.]{.mark}

[]{.mark}

-   TA Resources for Action 5.5

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-   <http://www.parenting.org/>

-   PCIT

-   Incredible Years

-   Strengthening Families curriculum

-   the "Common Sense Parenting" curriculum developed by Boys & Girls
    Town (see
    <http://www.girlsandboystown.org/pros/training/child_welfare/CSP_trainers.asp>).

-   Love & Logic training series, by Jim Fay and Foster Cline.

-   See PBIS resources in Action 1.1

-   The major evidence-based approaches that are demonstrated to work
    well with youth with externalized behavior problems who need
    intensive support include:

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-   Multi-systemic treatment

-   Functional family therapy (see existing Missouri initiative in two
    counties)

-   Multi-dimensional treatment foster care

-   Treatment foster home model -- Mary Grealish, existing Missouri DMH
    initiative

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-   Many other EBPs may be added to this list.

    -   See SAMHSA's National Registry of Evidence-Based Practices and
        Programs (NREPP) at http://www.nrepp.samhsa.gov/

    -   The federal Office of Juvenile Justice and Delinquency
        Prevention (OJJDP) selected ten approaches that can be
        replicated (see "Blueprints for Violence Prevention" at
        http://www.colorado.edu/cspv/blueprints/).

-   Research Bian Post

-   [Action 5.6 -- Create a workforce development plan to ensure that
    there is sufficient capacity to facilitate the Family Support Team
    process as the demand grows beyond the initial pilot site.]{.mark}
    Dimensions that need to be accounted for:

    -   Buy-in to process by system partners, that the process works for
        each of the systems, connected to the identified outcomes (see
        Action 2.1)

    -   Higher Education Partnership with Missouri Western State
        University (e.g. student intern program -- with stipend support
        from KC?)

    -   Invest in importing purveyors of high quality wraparound
        practice, and effective clinical services.

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    -   TA Resources for Action 5.6

        -   San Diego wraparound institute model -- Gwen Palmer to
            furnish.

        -   Arizona Roll-Out strategies via Frank Rider

        -   Connection to Missouri's commitment to high fidelity
            wraparound (e.g. through Vroon VanDenBerg LLP and/or
            National Wraparound Initiative) -- Frank Rider, RTAC is
            advising principal investigator on this effort (11/07) .

One Coordinated TA report

Area 6

## Area of Focus 6 -- Management Information System (MIS)

-   Description of Area of Focus:

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-   How can you put information management systems in place to track,
    measure, assess, and communicate your activities?

-   How can you develop an MIS system to provide you with real time data
    to support more informed decision- making at the clinical, program,
    administrative and systems levels and to measure progress toward
    different level outcomes?

-   What is the best approach to developing an MIS for systems of care:
    build your own, purchase off the shelf, or a combination of
    approaches?

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-   Strengths:

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-   Has an active MIS committee with sophisticated membership across
    multiple dimensions.

-   The MIS committee has studied its end users requirements, and
    developed a "wish list" as well: Family friendly, access from
    multiple portals, case management across systems, and incorporate
    best practices into system

-   The MIS Committee has been exploring some alternatives (e.g.
    Missouri's SERNA system) , and wants to learn from other
    communities' experiences with MIS

-   Missouri has been recently awarded a \$5-million grant to plan
    around electronic health information exchange.

-   The St. Joseph School District has recently extended access to its
    school records to the students' families.

-   Matthew Heil from MIMH developed a web-based application for
    families involved with multiple systems.

-   Missouri has already developed an informed consent/release of
    information template.

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-   Challenges:

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-   Meeting as many of the items on the User Requirement wish list as
    possible.

-   Supporting the national evaluation protocol requirements (GPRA
    requirements, NOMS -- examples: days lost from work, hospital
    admissions, days lost form school, and more recent ).

-   We want an MIS that is easily accessible to all partners within the
    Circle of HOPE, that the families can access,

-   Are schools able to generate the data that the national evaluation
    protocol requirements demand?

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-   [**Action 6.1**- Understand federal reporting requirements: NOMS,
    GPRA and TRAC System -- and develop evaluation processes that are
    family-friendly and efficient while meeting these requirements as
    well as local evaluation priorities.]{.mark}

    -   TA Resources for Action 6.1

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-   Connie Maples, Frank Rider to provide weblinks and other source
    documents for NOMS, GPRA and TRAC system (11/07).

-   Connie Maples, ORC Macro to explain/interpret national evaluation
    protocol requirements, and offer ideas from other communities.

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-   [**Action 6.2** - Understand strategies/options that can best
    support the stated values of the Circle of HOPE/families while
    meeting the requirements of HIPAA, FRPA.]{.mark}

    -   Include release of medical information;

    -   school-based health care clinic option; and

    -   "informed assent" strategies to support youth participation in
        their own care (American Academy of Pediatrics)

    -   Clarify status of involved community entities under state of
        Missouri's statewide HIPAA approach.

    -   Understand FRPA privacy requirements from education.

-   TA Resources for Action 6.2

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-   Clarify status of involved community entities under state of
    Missouri HIPAA approach

-   Secure "informed assent" forms/documents from Dr. Tierney.

-   Share examples of consent/release forms that support cross-system
    sharing

-   Missouri has developed cross-system consent forms, approved by
    attorneys general, and will share it with Andrea in support of the
    Family Support Team process. *(completed by Judy Finnegan, Missouri
    DMH before 09/24/07).*

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-   [**Action 6.3** - Service delivery committee to determine how to
    apply the EDIP data (about 16 questions)]{.mark}

[]{.mark}

-   [**Action 6.4** - Establish ICN access to identified staff (Lisa,
    evaluation team will facilitate this)]{.mark}

[]{.mark}

> Additional TA Resource on MIS Needs/Preferences of Circle of HOPE:
>
> MIS should consider contacting Gabriel Cate, Bowman Systems (Ph: 318
> 213-8780 x116; toll-free 888 580-3831 x116; e-mail:
> <gcate@bowmansystems.com>) concerning Service Point, the MIS used by
> the United Way (that we discussed during our visit), to explore
> customizing Service Point to address the well-described needs/
> preferences of this community.

Additional Areas of Focus

**7. Youth-Guided:**

**Description of Area:** [Preparing the system to effectively apply the
authentic voices of youth - provide training for policy team about
listening to youth; shaping the experience of policy team members
through working with former youth" first.]{.mark}

[]{.mark}

**Strengths:**

-   the youth at the group home are willing to offer input and feedback,
    and demonstrate skill in doing so.

-   The social worker at the group home is very talented and committed.

-   Youth coordinator Jayme Neal has been hired by Circle of HOPE, has
    been oriented by TA Partnership resource specialist and is actively
    involved in youth coordinator affinity processes among Region III
    communities (11/07)

**Input from young people on 9/13/07 PM included:**

1.  **More respect for youth voice**

2.  **Understand us as specific, unique voices -- we are not all the
    same**

3.  **Start with our children when they are young -- do not wait**

4.  **Punish, protect us from child-molesting parents**

5.  **He need to know how to comfort and help young people having
    suicidal thoughts**

6.  **Children who act out as bullies may well be being bullied a home,
    or be reacting to other problems they are having**

7.  **Why should we have to pay for books and fees in order to be
    successful in school**

8.  **We need safe and supportive spaces for children. What this might
    look like: can hang out together, talk to people about what happens
    in their lives, there are games to play; blend very different kinds
    of kids together, don't put kids into compartments based on their
    differences. Schools should be a safe place, too.**

9.  **Sexual education needs to be provided for children at a young
    enough age so that they can benefit from it before it is too late
    (e.g. sexually active)**

10. **We would like to get involved in developing brochures, we want to
    be asked to contribute our ideas. Incentives that would attract us
    to help include: money, the pleasure of both receiving, and giving,
    respect, gift cards, volunteer service hours, pay for our lunches at
    school sometimes.**

11. **Deliver messages to youth in cool formats, like comic strips.**

[**Action 7.1 -** Examine policies and procedures related to hearing
youth voices.]{.mark}

[]{.mark}

[**Action 7.2 -** Youth coordinator can identify existing, natural safe
spaces in the community.]{.mark}

**TA Resources:**

-   Reyhan will share more complete notes back to the community from the
    youth (completed 9/16/07).

-   Frank to furnish contact information for PhotoVoice project in
    Wyoming's SAGE Initiative (see http://wyosage.org/photovoice.html).

**8. Workforce/Workforce Development issues**

[]{.mark}

**Description of Area:**

Bud Salansky described a very limited pool from which to draw for
skilled staff in professional workforce.

**TA Resource:**

-   Reference Annapolis Coalition report/recommendations at
    http://www.annapoliscoalition.org/national_strategic_planning.php.

**9. Cultural and Linguistic Competency**

**Description of Area:** Outreach to emerging new Latino population
(e.g. being attracted to Triumph Foods, a new major local employer).

**Strength:** Circle of HOPE has hired new coordinator for Cultural &
Linguistic Competence, Nicki Samson (11/07). TA Partnership has begun
providing orientation, and foundational information resources, to Nicki
(11/07).

-   [**Action 9.1:** Identify a cultural broker to participate on the
    Policy Team to help ensure that decision making can account for
    cultural and linguistic needs of the population. Work with Title I
    school personnel to learn what they understand to date about
    children and families in this population.]{.mark}

[]{.mark}

Resources: Spanish Language documents/translation: screening form,
CAFAS, Arizona signage. Consider outreach into Missouri Western State
University for interpretor, translation resources.

-   **Action 9.2: Craft and implement outreach and service strategies to
    engage impoverished families.**

**TA Resources:**

-   Specific resources are sought about understanding the impacts of
    poverty:

    a.  Ruby Payne, national expert will be coming to provided training
        this fall. Recommend strong participation by Circle of HOPE
        staff and constituents in Ruby's training, and seek some
        consultation.

    b.  William C. Madsen (Guilford Press, 1999), *Collaborative Therapy
        for Multi-Stressed Families* book will be helpful.

    c.  Develop, provide training on identification of strengths and
        resiliency among poor people.

-   Prepare available operational supports.

-   *Toward a Culturally Competent System of Care, 3 Volumes
    [http://.gucchd.georgetown.edu]()*

-   *Cultural Competence Standards in Managed Care -
    [www.samhsa.gov](http://www.samhsa.gov/)*

-   Broward County CLC Plan (Frank provided a copy 11/07)

**Some Practical Next Steps:**

1.  Community to prioritize some next action steps within its workplan.

2.  Frank shared the single TA Plan document with Andrea by 10/1/07, and
    shared copies with other Circle of HOPE team members, program
    partners and federal project officer at same time.

3.  Frank shared a draft update of the plan document with Andrea and TA
    coordinator Nicki Samson on 11/19/07.