The Jacksonville System of Care Initiative
In 2010, Jacksonville received a $9 million dollar grant from the Federal Substance Abuse and Mental Health Service Administration (SAMHSA) to facilitate the transformation of Northeast Florida’s mental health services into a system of care that integrates home and community-based services and supports for youth with serious emotional disturbances. The Partnership for Child Health implements this cooperative agreement by using existing agencies and joint ventures with other community stakeholders and initiatives, the System of Care focuses on improving access and assuring that services to all children and youth, specifically those in the child welfare, juvenile justice, subsidized childcare, and homeless systems, are family-driven, youth-guided and culturally responsive.
The over-arching objectives for the six-year grant period are to:
- Expand community capacity to serve children and adolescents identified with serious emotional disturbances by utilizing a public health framework to screen and assess all children and youth for behavioral health issues and refer appropriately for treatment;
- Increase the community capacity to provide a broad array of accessible, clinically effective and fiscally accountable services, treatments and supports for children and families;
- Provide for the integration of physical and behavioral health through the development of the pediatric/psychiatric collaborative care model;
- Implement authentic participation of families and youth in the development, evaluation and sustainability of local services and supports and in overall system transformation activities;
- •Serve as a catalyst for broad-based, sustainable systemic change inclusive of policy reform and infrastructure development.
For the past six years, the Jacksonville System of Care Initiative and its community partners have worked with youth and families to achieve these objectives. Our notable accomplishments are featured in the end of grant report titled "Solid Tracks for Development" published in October 2016 including:
Northeast Florida Federation of Families
A family support organization that focuses on education, support and advocacy for families with children living with emotional challenges.
Youth M.O.V.E. (Motivating Others through Voices of Experience) Jacksonville, is a youth organization dedicated to improving the services and systems that serve young people by uniting the voices of youth who have experience within the mental health, foster care, juvenile justice, substance abuse and homeless systems. The youth use their familiarity with these systems to be voices and advocates for systems change.
Jacksonville Youth Council
The Office of the Children’s Ombudsperson
The mission of the Office of the Children’s Ombudsperson is to build the capacity of children, families, institutions and systems to fulfill the rights of children required to promote and attain their optimal health and wellbeing.
Implemention of processes for screening children in early learning centers for social and emotional challenges
A screening process was developed and implemented for children in subsidized childcare in October 2013. Year to date, 1,040 children were screened in 30 subsidized childcare centers. 249 children were referred for needing additional services based on their screening scores.
Implementation of the Medical Home
The purpose of the Medical Home concept is to ensure that all children, specifically children in our targeted populations (foster care, homeless) have their medical, dental and behavioral health needs identified and addressed through a coordinated system of care. Since 2012 more than 1200 children and youth in foster care and 400 children and youth in the homeless system have been screened and connected with a medical home and provided nurse care coordination for their medical, dental and behavioral health needs.
Implementation of the Collaborative Care Model
The System of Care has partnered with Nemours to develop and implement the pediatric/psychiatric collaborative care model. The purpose of the collaborative care concept is to increase the quantity and quality of the mental health service capacity through training pediatricians to identify signs of depression and suicide risk, determine appropriate treatment, and know when/where to refer. This year’s expansion will include training pediatricians on screening for social and emotional wellness in children under 5 years of age.
Since 2013, more than 11,000 adolescents were screened by their pediatrician for suicide and depression and since 2014 more than 1200 children ages 18 months to 5 years old were screened for social and emotional challenges.
Implementation of High Fidelity Wraparound Care Coordination
High-fidelity wraparound is an intensive, holistic method of engaging with individuals with complex needs (most typically children, youth, and their families) so that they can live in their homes and communities and realize their hopes and dreams.
Although “wraparound” has been defined in different ways, high-fidelity wraparound has primarily been described as an intensive, individualized care planning and management process. The wraparound process aims to achieve positive outcomes by providing a structured, creative and individualized team planning process that, compared to traditional treatment planning, results in plans that are more effective and more relevant to the child and family. Additionally, wraparound plans are more holistic than traditional care plans in that they are designed to meet the identified needs of caregivers and siblings and to address a range of life areas. Through the team-based planning and implementation process, wraparound also aims to develop the problem-solving skills, coping skills, and self-efficacy of the young people and family members.
Wraparound’s philosophy of care begins from the principle of “voice and choice,” which stipulates that the perspectives of the family—including the child or youth—must be given primary importance during all phases and activities of wraparound. The values associated with wraparound further require that the planning process itself, as well as the services and supports provided, should be individualized, family driven, culturally competent, and community based.
The Jacksonville System of Care Initiative (JSOCI), a federally funded initiative designed to assist communities in transforming their mental health system of care, currently contracts with Jewish Family and Community Services, Daniel, Mental Health Resource Center, Children’s Home Society and Child Guidance Center to provide high-fidelity wraparound. In Duval County there are currently five trained wraparound coordinators providing services to up to 50 youth at any given time who are living with mental health challenges.
For the next two years, the System of Care will continue to work with our community stakeholders to develop and sustain services and supports for children and youth living with mental health challenges and their families through training, the identification of revenue maximization strategies and continuous quality improvement of systems that are family-driven, youth-guided and culturally and linguistically competent.