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<ul><li><p>Youth and Family Training Institute: </p><p>Training, Coaching, Credentialing, </p><p>and Monitoring Wraparound </p><p>Youth and Family </p><p>Training Institute </p></li><li><p>Welcome and </p><p>Introductions </p><p>Youth and Family Training Institute: </p><p>Shannon Fagan Director </p><p>Monica Walker Payne Lead Evaluator </p><p>2 </p></li><li><p>Learning </p><p>Objectives </p><p> The importance of stakeholder involvement </p><p> Elements of effective team training </p><p> Utilizing the Coaching Circuit Professional Development Plans and </p><p>Rubrics to assure skill development </p><p> The development of Advance Training and Credentialing Renewal </p><p>(ATCR) </p><p> The implementation of standardized documentation </p><p> Collection and reporting descriptive, outcomes, satisfaction, and fidelity </p><p>data to key stakeholders </p><p> Using the continuous quality improvement process to enhance learning 3 </p></li><li><p>Youth and Family </p><p>Training Institute </p><p>Vision </p><p>Children and youth with behavioral health challenges and </p><p>multi-system needs, and their families will be able to access </p><p>High Fidelity Wraparound anywhere in Pennsylvania. </p><p>Mission </p><p>To achieve quality family and youth driven outcomes by </p><p>advancing the philosophy, practice and principles of High </p><p>Fidelity Wraparound through training, coaching, credentialing </p><p>and ensuring fidelity to the process. </p><p>Website: www.yftipa.org </p><p>4 </p></li><li><p>Who are our </p><p>Stakeholders? </p><p> Youth, Family, and System Partners </p><p> Office of Mental Health and Substance Abuse Services (OMHSAS </p><p>Childrens Bureau) </p><p> Youth and Family Training Institute Advisory Board </p><p> High Fidelity Wraparound Providers </p><p> County Administrators </p><p> University of Pittsburgh / Western Psychiatric Institute &amp; Clinic </p><p> Community Care Behavioral Health / Other Managed Care Organizations </p><p> Child Adolescent Service System Program Coordinators </p><p> Community Organizations </p><p> PA System of Care Partnership </p><p>5 </p></li><li><p> YFTI trains, coaches and credentials High Fidelity </p><p>Wraparound workforce members, which consist of: Coaches, </p><p>Facilitators, Family Support Partners and Youth Support </p><p>Partners. </p><p> YFTI ensures the HFW workforce has the knowledge and </p><p>skills to provide HFW consistently, with accountability, and </p><p>fidelity to the process. </p><p> YFTI provides technical assistance and helps prepare </p><p>counties and system partners interested in implementing </p><p>HFW. </p><p> YFTI has been in existence for 7 years </p><p>Youth and Family </p><p>Training Institute </p><p>(YFTI) </p><p>6 </p></li><li><p>HFW Training </p><p>The focus is on learning the High Fidelity Wraparound </p><p>Model, more specifically, the Ten Principles, the Four </p><p>Phases (activities and skill-sets), Theory of Change </p><p>and workforce roles to effectively practice the model. </p><p>Our trainings were adapted from the </p><p>Vroon VanDenBerg.LLP Model </p><p>7 </p></li><li><p>Training </p><p>Responsibilities </p><p>All HFW workforce members must attend: </p><p>Five Day HFW Team Training </p><p> 2 Day Coach Training </p><p>Online Transition Training </p><p>Chart Form Training </p><p>Evaluation Training </p><p>Advanced Training and Credentialing Renewal </p><p> -Web Based Skill Training and Topics </p><p> -Approved Agency required learning </p><p>Train the Trainer Program </p><p>8 </p></li><li><p>HFW Coaching </p><p>Coaching is the process of teaching someone to do </p><p>HFW by showing them the skills, doing the process </p><p>with them, and providing ongoing consultation and </p><p>feedback. </p><p>Coaching teaches the HFW Facilitators, the Youth </p><p>Support Partners and the Family Support Partners </p><p>how to do the HFW process with fidelity. </p><p>9 </p></li><li><p>HFW Coaching </p><p>Continued </p><p>A High Fidelity Wraparound (HFW) Coach uses the </p><p>Coach Circuit to support the Facilitator, the Family </p><p>Support Partner and the Youth Support Partner in role </p><p>skills to do their work in the team process. </p><p>The Coaching Circuit is a research informed teaching </p><p>progression (learn, watch, practice, do, teach) that </p><p>builds knowledge and skills creating fidelity to the </p><p>process and positive outcomes for youth and families. </p><p> 10 </p></li><li><p>Coaching Circuit </p><p>(NRI based model) </p><p>Targeted Professional Development Plan </p><p>w/Goals </p><p>Coaching on Topic/Family Presentation </p><p>Modeling </p><p>Behavioral Rehearsal </p><p>Live Coaching </p><p>Peer-to-Peer Coaching </p><p>11 </p></li><li><p>Credentialing </p><p>The credentialing process for High Fidelity Wraparound </p><p>refers to the skill attainment each HFW workforce member </p><p>must reach in order to become credentialed in their HFW role. </p><p>All skills are scored on a tool with scoring rubric. Local </p><p>coaches and YFTI coaches achieve inter-rater reliability as a </p><p>part of the Coach Credentialing process. </p><p>The credentialing process ensures that all HFW workforce </p><p>members are receiving the same knowledge and </p><p>education. This leads to consistency in the HFW process and </p><p>fidelity to the process. </p><p> 12 </p></li><li><p>Theory of Change </p><p>for Workforce </p><p> Needs-based coaching utilizing objective data </p><p> Self-efficacy is the goal with credentialing and skill </p><p>acquisition </p><p> Natural supports through peer-to-peer (P2P) </p><p> Integrated Professional Development Planning </p><p>(PDP) utilizing the Coaching Circuit </p><p>13 </p></li><li><p>Team </p><p>Training Coach Prepares </p><p>Staff for Training </p><p>Data, </p><p>Coaching </p><p>Agreement, </p><p>PDP </p><p>Coaching </p><p>Circuit Credentialing </p><p>CQI </p><p>Training </p><p>Coaching </p><p>Sustainability </p><p>and Quality Control </p><p>Youth and Family Training Institute support is ongoing </p><p>Professional </p><p>Development </p><p>Continuum </p><p>14 </p><p>ATCR </p></li><li><p>Evaluation </p><p>Responsibilities </p><p> Evaluation and monitoring functions to continually assess </p><p>quality, fidelity, and outcomes. </p><p> Data and continuous quality improvement information </p><p>highlighting strengths, challenges, fidelity, outcomes, </p><p>services, and costs are reviewed by our Evaluation </p><p>Subcommittee that is comprised of youth, family, and </p><p>system partner stakeholders across the Commonwealth. </p><p> CQI reports are then shared on a quarterly basis with the </p><p>counties, managed care organizations, families, youth, and </p><p>the Office of Mental Health and Substance Abuse Services </p><p>(OMHSAS) to effect change. </p><p>15 </p></li><li><p>Data Collection </p><p>Data in todays presentation has been </p><p>collected from July 2011 February 2015 </p><p>from the: </p><p> Wraparound Fidelity Index Short Form (WFI-EZ) </p><p> Youth and Family Training Institute Chart Form </p><p>Data Pilot </p><p> CMHS National Evaluation - Longitudinal </p><p>Outcomes and Satisfaction Study </p><p>16 </p></li><li><p> 146 families enrolled in the Wraparound Fidelity Index Short Form (WFI-EZ) </p><p> 13 Counties </p><p> Allegheny </p><p> Bucks </p><p> Chester </p><p> Crawford </p><p> Delaware </p><p> Erie </p><p> Fayette </p><p> Lehigh </p><p> Montgomery </p><p> Northumberland </p><p> Philadelphia </p><p> Venango </p><p> York </p><p>Fidelity </p></li><li><p>18 </p><p>Youth Caregiver Facilitator Team </p><p>Member </p><p>Total </p><p>Forms </p><p>PA 90-Day </p><p>(106 families) </p><p>71 110 103 264 548 </p><p>PA Transition </p><p>(47 families) </p><p>34 47 45 113 239 </p><p>HFW Team </p><p>Perspectives </p></li><li><p>19 </p><p>Team Member Type PA 90-Day PA Transition </p><p>Family Support Partner 92 36 </p><p>Youth Support Partner 56 27 </p><p>Therapist/Clinician 31 8 </p><p>Caseworker 20 9 </p><p>Teacher / School Staff 2 4 </p><p>Probation Officer 3 0 </p><p>Residential Home Staff 1 1 </p><p>Sibling 11 8 </p><p>Grandparent 5 2 </p><p>Live-in partner of parent 1 1 </p><p>Foster Parent 1 1 </p><p>Birth/Adoptive Parent 1 0 </p><p>Adult Friend 8 2 </p><p>Aunt or Uncle 4 3 </p><p>Other 28 11 </p><p>System Partners and </p><p>Natural Supports </p></li><li><p>Mean Total Score</p><p>PA 90-Day 72.4%</p><p>PA Transition 77.7%</p><p>National Mean 74.2%</p><p>0.0%</p><p>20.0%</p><p>40.0%</p><p>60.0%</p><p>80.0%</p><p>100.0%</p><p>PA Transition </p><p>= 47 Families </p><p>PA 90-Day </p><p>= 106 </p><p>Families </p><p>20 </p><p>Mean Total </p><p>Scores </p></li><li><p>21 </p><p>Key Element </p><p>Scores </p><p>EffectiveTeamwork</p><p>Natural/Community</p><p>Supports</p><p>Needs-based</p><p>Strategies</p><p>Outcomes-Based Plan</p><p>Strength-and-family-</p><p>driven</p><p>PA 90-Day 68.9% 66.4% 75.0% 70.1% 82.8%</p><p>PA Transition 71.1% 72.9% 77.0% 80.7% 84.6%</p><p>National Mean 72.7% 67.0% 68.8% 76.6% 80.6%</p><p>0.0%</p><p>20.0%</p><p>40.0%</p><p>60.0%</p><p>80.0%</p><p>100.0%</p><p>90-Day = </p><p>106 </p><p>Families </p><p>Transition = </p><p>47 Families </p></li><li><p>Standardized HFW </p><p>Chart Documentation </p><p>Forms were designed to standardize how all </p><p>counties/providers document information about the </p><p>HFW process. </p><p>The process itself will be unique for each family, but the </p><p>information that is categorized, recorded, and tracked </p><p>during the process will be the same. </p><p>The forms will not increase the burden on youth and </p><p>families because they are completed by staff. </p><p>The forms do not have the expense of interviewers and </p><p>participant payments so the data collection is sustainable. 22 </p></li><li><p>Benefits of </p><p>Standardized HFW </p><p>Chart Documentation </p><p> The forms allow us to show how a family progresses through the four </p><p>phases of HFW in greater detail. </p><p> The tracking highlights the specific skills used by the HFW workforce </p><p>(each workforce role can be tracked separately) in assisting and teaching </p><p>families to plan for their own needs. </p><p> At the same time, we document changes in all of the child-serving </p><p>systems (Mental Health, Child Welfare, Juvenile Justice, Drug and </p><p>Alcohol, Physical Health, and Education) </p><p> Data is sent/uploaded to the Evaluation Team so that Continuous Quality </p><p>Improvement (CQI) Reports can be generated and utilized. </p><p> CQI Reports are tailored to youth, families, HFW workforce members, </p><p>and county and state stakeholders. 23 </p></li><li><p>The Chart Form </p><p>Model </p><p>24 </p></li><li><p>The HFW </p><p>Chart Forms </p><p>25 </p><p> Engagement Form Referral info </p><p> Demographics (including expanded cultural, linguistic, and disability information following new </p><p>CLAS standards) </p><p> Living Situations </p><p> Trauma </p><p> Core Family Information </p><p> Supports </p><p> Community Involvement </p><p> Systems (Education, Juvenile Justice, Child Welfare, Physical Health, Drug and Alcohol, Behavioral </p><p>Health) </p><p> Contact Note </p><p> Needs /Goals Form </p><p> Team Meeting Cover Sheet /Updates </p><p> Transition Cover Sheet /Updates </p><p> Post Comparison Form </p></li><li><p>Hewlett Packard </p><p>Teleform Software </p><p> We purchased a software package that allows us to scan paper forms or PDF files </p><p>directly into our database to cut down on the burden of data entry. </p><p> All of our data is de-identified - It is important that providers fill out the ID number </p><p>clearly on the teleforms and mark each answer within the circle or square so they </p><p>are processed accurately. </p><p>26 </p></li><li><p> 47 families enrolled in the Chart Form Pilot </p><p> 5 Counties </p><p> Bucks </p><p> Crawford </p><p> Montgomery </p><p> Northumberland </p><p> Venango </p><p>Chart Form Pilot </p></li><li><p>28 </p><p>49.7% </p><p>32.3% </p><p>10.1% </p><p>3.7% 4.2% </p><p>0.0%</p><p>20.0%</p><p>40.0%</p><p>60.0%</p><p>Engagement Planning Implementation Transition Missing</p><p>Pe</p><p>rce</p><p>nta</p><p>ge o</p><p>f C</p><p>on</p><p>tact</p><p> No</p><p>tes </p><p>Phase </p><p>At what phases are the workforce most actively involved with a family? </p><p>(n=2054 contact notes) </p><p>Chart Form </p><p>Pilot Data </p></li><li><p>29 </p><p>(n = 2054 contact notes) </p><p>Chart Form </p><p>Pilot Data </p></li><li><p>30 </p><p>21.0% 22.0% </p><p>3.7% 6.0% </p><p>33.9% </p><p>12.2% 11.1% 8.4% </p><p>5.0% </p><p>32.9% </p><p>0.0%</p><p>15.0%</p><p>30.0%</p><p>45.0%</p><p>60.0%</p><p>Per</p><p>cen</p><p>tage</p><p> of </p><p>No</p><p>n-s</p><p>ched</p><p>ulin</p><p>g C</p><p>on</p><p>tact</p><p>s </p><p>Domains </p><p>What content are the focus of contacts? (n=1473 contact notes) </p><p>Chart Form </p><p>Pilot Data </p></li><li><p>31 </p><p>What skills are most often used by each role? </p><p>Facilitators % of Contacts </p><p> Provided Support for Family 24.4 </p><p> Progress update 21.5 </p><p> Identified new areas of need 20.3 </p><p> SNCD development/review 17.4 </p><p> Met with team 16.1 </p><p>Family Support Partners % of Contacts </p><p> Progress update 28.2 </p><p> Provided Support for Family 27.9 </p><p> Identified new areas of need 25.8 </p><p> Met with team 23.8 </p><p> SNCD development/review 20.8 </p><p>Youth Support Partners % of Contacts </p><p> Provided Support for Youth 54.8 </p><p> Identified new areas of need 37.3 </p><p> Provided Support for family 31.3 </p><p> Identified new strengths 27.8 </p><p> Brainstormed new ideas for progress 22.2 </p><p>n = 1473 contact notes </p><p>Chart Form </p><p>Pilot Data </p></li><li><p>32 </p><p>Teaching Self-efficacy through the HFW process </p><p>0.0%</p><p>10.0%</p><p>20.0%</p><p>30.0%</p><p>40.0%</p><p>50.0%</p><p>60.0%</p><p>70.0%</p><p>80.0%</p><p>Engagement Planning Implementation Transition</p><p>Per</p><p>cen</p><p>tage</p><p> of </p><p>Co</p><p>nta</p><p>ct N</p><p>ote</p><p>s b</p><p>y P</p><p>has</p><p>e </p><p>Phase </p><p>Doing For</p><p>Doing With</p><p>Cheering On</p><p> n = 1473 contact notes </p><p>Chart Form </p><p>Pilot Data </p></li><li><p>Family Report </p><p>33 </p></li><li><p>Statewide Data </p><p>Collection </p><p>County providers have options for how they can get data to us </p><p> Copies of completed paper forms can be mailed to the Evaluation Team </p><p>in large self-addressed postage paid envelopes. </p><p> PDF forms that were either completed on paper and scanned or typed </p><p>into via Adobe Professional can be uploaded to us securely through the </p><p>YFTI Registration Website. </p><p> Some counties have built the forms into their electronic medical record </p><p>systems and do monthly data dumps. </p><p> We are currently building a web interface that allows users to log into their </p><p>providers portal and complete all of the forms securely online. Forms can </p><p>then be saved in PDF format or printed for local agency use. </p><p>34 </p></li><li><p>Quarterly CQI </p><p>Reports </p><p> Descriptive (Ex. Referral source, system involvement, presenting </p><p>issues, mental health diagnoses, custody, people involved in the </p><p>planning/treatment process, etc.) </p><p> Demographic (Ex. Race, ethnicity, gender identity, sexual orientation, </p><p>income, education, language, disability status, etc.) </p><p> Coaching (Ex. Days in each phase, Time spent, Types of Supports, </p><p>Primary Purpose of Contact, Content Domains, Skill Utilization, Goal </p><p>Progress, etc.) </p><p> Outcomes (Ex. Changes in system involvement, services, functioning, </p><p>living situations, natural supports, community involvement, family, etc.) </p><p>35 </p></li><li><p>CQI Successes </p><p>36 </p><p>Examples of using the data in coaching: </p><p> Developed coaching strategies based on data received regarding transition. </p><p> Number of families/youth that leave before transition phase. </p><p> Refined coaching support regarding recognizing when families are ready </p><p>for transition, confident in their skills to meet their own needs and facilitate </p><p>their own meetings. </p><p> Number of families/youth that left process w/o a plan. </p><p> Refined coaching support to support families/youth in leaving process </p><p>regardless of phase with some type of plan on who they can call, strengths </p><p>they can use, etc. to meet ongoing needs. </p><p> Workforce Development areas indicated in the Contact Notes: </p><p> Documentation Skill development- providing more detail related to the </p><p>skills workforce members are using </p><p> Continued support around engaging natural supports, professional </p><p>supports/system partners </p></li><li><p> 83 youth/caregivers enrolled in the CMHS National Evaluation </p><p> Longitudinal Outcomes and Satisfaction Study </p><p> 11 Counties </p><p> Chester </p><p> Crawford </p><p> Delaware </p><p> Erie </p><p> Fayette </p><p> Lehigh </p><p> Montgomery </p><p> Northumberland </p><p> Philadelphia </p><p> Venango </p><p> York </p><p>Preliminary </p><p>Outcomes </p></li><li><p>37.5% </p><p>50.0% </p><p>81.3% </p><p>62.5% </p><p>50.0% </p><p>18.8% </p><p>0%</p><p>10%</p><p>20%</p><p>30%</p><p>40%</p><p>50%</p><p>60%</p><p>70%</p><p>80%</p><p>90%</p><p>100%</p><p>Intake 6 Months 12 Months</p><p>One Living Arrangement Multiple Living Arrangements</p><p>38 </p><p>n = 16 </p><p>Data reported were collected using the Living Situations Questionnaire (LSQ). This instrument collects data on the status of the child/family in the 6 months prior to the interview. </p><p>A Stable Place </p><p>to Live </p></li><li><p>Data reported were collected using the Education QuestionnaireRevision 2 (EQR2). This instrument collects data on the status of the child/family in the 6 months prior to the interview. </p><p>39 </p><p>Actions Intake 6 Months </p><p>Suspended 40.0% 14.3% </p><p>Expelled 2.9% 0.0% </p><p>Neither Suspended Nor Expelled </p><p>57.1% 82.9% </p><p>n = 35 </p><p>Less School </p><p>Discipline </p></li><li><p> In the past 6 months have you been . . . </p><p>Data reported were collected using the Delinquency SurveyRevised (DSR). This instrument collects data on the status of the youth age 11 years and older in the 6 months prior to the interview. Because participants may have had multiple criminal justice contacts, percentages may sum to more than 100%. 40 </p><p>Questioned by thePolice</p><p>ArrestedTold to Appear in</p><p>Court?Convicted of a</p><p>Crime?On Probation?</p><p>Intake 20.0% 20.0% 33.3% 33.3% 20.0%</p><p>6 Months 6....</p></li></ul>