System of Care
Missouri System of Care Web Site
Status of Children Annual Report (2006)
What is SOC?
In a System of Care (SOC), mental health services (psychiatric, mental retardation/developmental disabilities, alcohol and drug abuse) as well as other services and supports are organized in such a way as to enable children with the most complex needs to remain in their homes, schools and communities. System of Care brings the right people together-at multiple levels-to develop resources and remove barriers for children with complex needs that might otherwise fall through the cracks.
Origin of SOC
Since the early 80's there has been a call for reform in children's mental health across the country. In 1984 the federal government initiated the Child and Adolescent Service System Program (CASSP) to help states begin to address the systemic problems facing children's mental health. CASSP articulated core values which specify that services should be community-based, child centered and family focused, and culturally competent. The proposed reform called for comprehensive, community-based systems of services and supports, which became known as "systems of care". Missouri received a CASSP grant in 1989 which identified necessary components of a system of care and began to build interagency partnerships at both the state and local level. In 1992-1993 DMH piloted the 503 Project, an interagency system of care demonstration for children and youth with Severe Emotional Disturbance (SED) in St. Louis County. SOC incorporates and builds on this rich history.
How does SOC operate?
Children with the most challenging mental health issues, particularly those who are involved with multiple agencies will have a local coordinated team of individuals that will work to meet with the family's needs for as long as is necessary. This team is referred to as the Family Support Team. Many such teams (though perhaps under different names) already exist for children with complex needs. In addition to the Family Support Team, a System of Care brings a Local System of Care Policy Group into plan. The Local SOC Policy Group's functions include reviewing and identifying policy (local and state) that may be creating a barrier to children getting their needs met. It is also responsible for contributing appropriate resources from its member agencies (for example, dollars or in-kind services), to assist in meeting the needs of a child being served in System of Care.
Who participates in System of Care?
- State Level Coordination
- Family Members
- Family-run Organizations
- Child Advocacy Organizations
- Department of Social Services (DDS)
- Division of Youth Services (DYS)
- Children's Division (CD)
- Division of Medical Services (DMS)
- Courts and Office of State Courts Administrator (OSCA)
- Department of Health and Senior Services
- Division of Community and Public Health
- Department of Mental Health (DMH)
- Division of Comprehensive Psychiatric Services (CPS)
- Division of Alcohol and Drug Abuse (ADA)
- Division of Developmental Disabilities (DDD)
- Local Representation
- Juvenile Court
- Children's Division
- Local Level Coordination
System of Care at the local level includes representatives from the aforementioned state agencies as well as a variety of individuals representing many different organizations and interests.
Quality Service Review
The State child serving departments within Missouri and family advocates realize that in order to evaluate the effectiveness of the system of care and its components, the process had to move beyond just reporting data about families served to a mechanism that tracks progress, measures quality and makes adjustments as needed.
The Comprehensive System Management Team (formerly known as the State System of Care Team) chose the Quality Service Review (QSR) developed by Dr. Ivor Groves as the mechanism to measure system of care quality improvement. QSR is a management tool that measures the quality of interactions between frontline practitioners and children and their families and the effectiveness of the services and supports provided. It is a case based review of practice, results, and working conditions used to both evaluate and stimulate practice development. It is based on th e logic that each child and family reviewed through the QSR becomes a unique and valid descriptor of the service system capability to meet that child and family's presenting needs. The QSR process reveals what is working now for the child and family and illuminates areas in which service programs and case-based practice can be defined.
The QSR process looks at current records for the child and family selected for review, but more importantly utilizes interviews with the various persons and providers who are currently working with and providing services to that child and family. The interviewing of various formal and informal service providers is the most important piece of the QSR as it is through these interviews that the most telling information about the child and family can be discovered.
Proper use of the QSR requires reviewer training and supervision. The working papers, collectively referred to as the System of Care Quality Service Review Protocol are used to support a professional appraisal of child status and system of care performance for individual children and their caregivers in a specific service area and at a given point in time.
Data collected from QSR site visits is aggregated at the stat level and the results shared with the legislature, Comprehensive System Management Team as well as the local system of care sites.
Show Me Kids
Mission Statement
Show-Me Kids is an expanding partnership of agencies, organizations, and families dedicated to serving children who have or are at risk of developing serious emotional problems. Together we strive to integrate culturally appropriate services and natural supports that children and families need, want, and can use to live happy, healthy, and successful lives.
Three Objectives Support our Mission:
- Improve access to integrated services for children and youth who have Severe Emotional Disturbances** - especially for those with co-occurring diagnoses*.
- Improve access for children and families to mental health services that are sensitive and responsive to their unique family cultures.
- Identify potential problems and intervene earlier with young children who are at-risk for Serious Emotional Disturbances**.
Target Population Defined
Children who have or are at-risk for *co-occurring diagnoses have a diagnosable Serious Emotional Disturbance and also have or are suspected to have: substance abuse or dependence; or a conduct disorder or oppositional defiant disorder; or mental retardation or a developmental disability.
**Serious Emotional Disturbance (SED) is defined for our objectives as an emotional, behavioral, or mental disorder that requires multiple services; severely disrupts daily functioning in the home, school, or community; and has either been present for one year, or is expected to last a year or more.
Show-Me Kids serves children and families in Greene, Christian, Stone, Taney, Barry, and Lawrence counties.
Funding & Partners:
Show-Me Kids is primarily funded through a six-year federal cooperative agreement awarded through the Missouri Department of Mental Health. Our sixth fiscal year begins October 2007. Local project development is managed through partnerships with Burrell Behavioral Health and Clark Community Mental Health.
For more information on Show-Me Kids, please contact Nora.Cox@coxhealth.com or visit the Show-Me Kids web site at www.showmekids.org
