Values and Principles of a System of Care
Family Advocates work within a system of care. The values and principles of a system of care are:
- A system of care is child/youth-centered and family-focused, with the needs of the child, youth and family dictating the types and mix of services provided.
- A system of care is community-based, with the locus of services as well as management and decision-making responsibility resting at the community level.
- A system of care is culturally competent, with agencies, programs, and services that are responsive to the cultural differences, including racial, ethnic, gender, age, sexual orientation, socio-economic, spiritual (religious), and geographic differences of the population.
- Persistent Commitment to Families, Youth & Children – Colorado and its communities make a commitment to the fundamental rights of every child, youth and family to achieve and maintain permanence and stability of support in a safe environment.
- Safety (Child, Youth, Family, and Community) – Services and supports are developed and implemented to best ensure the safety of the child, youth, family, and community.
- Child Centered – Services and supports are provided in the best interest of the child to ensure that the child’s and family’s needs are being addressed.
- Family-Focused – The child is viewed as a part of the whole family. System, services and supports are based on the strengths and needs of the entire family. Children, youth and their families shall participate in discussions related to their plans, have opportunities to voice their preferences and ultimately feel that they own and drive the plan.
- Individualized – Plans and supports for children, youth and their families are tailored to the unique culture, beliefs and values, strengths, and needs of each child and family. Funding sources must be flexible to support individualization.
- Culturally Competent – The system of care is culturally competent, with systems, agencies, programs, and services that are responsive to the cultural, racial, spiritual (religious), gender and ethnic differences at the system and individual child and family level.
- Strengths-Based – Services and supports are based on identified strengths of the child, youth, family, and community.
- Early Access – Services and supports should have a prevention and early intervention focus to facilitate wellness for the family.
- Community-Based – Services and supports are provided in the most appropriate and least restrictive environment and in the home community of the child, youth and family. The system of care is community oriented with the location of services, management and decision-making responsibility resting at the community level.
- Natural Supports – Children and families are supported by family and community social networks and community resources (e.g., service organizations, faith based organizations and businesses). Services build on and strengthen these natural supports.
- Collaborative – Collaboration between agencies, schools, community resources, youth and families is the basis for building and financing a local comprehensive and integrated system of care that supports easy access to needed services and supports for children and families.
- Family, Youth, and Professional Partnership – Family and youth are partners with professionals at all levels of assessment, planning, implementation and governance of the system of care.
- Outcome Based and Cost Responsible – Services and supports are outcome based with clear accountability and cost responsibility. The system values and funds outcome and quality management. This accountability includes prudent and effective use of public and private funds. As communities find ways to reduce the use of restrictive care the funding is retained in the community and reinvested in the prevention and early intervention that has made these improvements possible.
- Transition – Children should be ensured smooth transitions through all major changes in their lives.
The Principles of Family Support
Family Support is a constellation of formal and informal services and tangible goods that are defined and determined by families. It is “whatever it takes” for a family to care for and live with a child or adolescent who has an emotional and/or behavioral disability. It also includes supports needed to assist families to maintain close involvement with their children who are in out-of-home placement and to help families when their children are ready to return home. A family member or caregiver who is raising or has raised a child with emotional, social, behavioral, and or learning differences always provides family support.
- Decisions must be based on a family’s preferences, choices and values and not on administrative expediencies;
- Families must be recognized as the primary resource and decision-makers for their child;
- Families must have access to a flexible, affordable, individualized array of supports, services and material items that provide “whatever it takes” to maintain them as a family;
- The family’s strengths, including the social networks and informal supports already available to and within the family, should be the foundation upon which new supports are designed and/or provided. Furthermore, if (but only if) the family wishes it, family support services should help to expand and strengthen the informal resources available to the family;
- Support services must be culturally and geographically sensitive and able to meet the diverse needs of the family;
- Family supports must be affordable, well-coordinated, accessible and available to all families who need them, when and how they need them.
What is Family-Driven Care?
SAMHSA, The Department of Health and Human Services, Substance Abuse and Mental Health Services Bureau has defined family-driven care.
Definition of Family-Driven Care
Family-driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes:
- Choosing supports, services, and providers;
- Setting goals;
- Designing and implementing programs;
- Monitoring outcomes;
- Partnering in funding decisions; and
- Determining the effectiveness of all efforts to promote the mental health and well being of children and youth.
Guiding Principles of Family-Driven Care
- Families and youth are given accurate, understandable, and complete information necessary to set goals and to make choices for improved planning for individual children and their families.
- Families and youth, providers and administrators embrace the concept of sharing decision-making and responsibility for outcomes with providers.
- Families and youth are organized to collectively use their knowledge and skills as a force for systems transformation.
- Families and family-run organizations engage in peer support activities to reduce isolation, gather and disseminate accurate information, and strengthen the family voice.
- Families and family-run organizations provide direction for decisions that impact funding for services, treatments, and supports.
- Providers take the initiative to change practice from provider-driven to family-driven.
- Administrators allocate staff, training, support and resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and families.
- Community attitude change efforts focus on removing barriers and discrimination created by stigma.
- Communities embrace, value, and celebrate the diverse cultures of their children, youth, and families.
- Everyone who connects with children, youth, and families continually advances their own cultural and linguistic responsiveness as the population served changes.
Characteristics of Family-Driven Care
- Family and youth experiences, their visions and goals, their perceptions of strengths and needs, and their guidance about what will make them comfortable and steer decision making about all aspects of service and system design, operation, and evaluation.
- Family-run organizations receive resources and funds to support and sustain the infrastructure that is essential to insure an independent family voice in their communities, states, tribes, territories, and the nation.
- Meetings and service provision happen in culturally and linguistically competent environments where family and youth voices are heard and valued, everyone is respected and trusted, and it is safe for everyone to speak honestly.
- Administrators and staff actively demonstrate their partnerships with all families and youth by sharing power, resources, authority, responsibility, and control with them.
- Families and youth have access to useful, usable, and understandable information and data, as well as sound professional expertise so they have good information to make decisions.
- Funding mechanisms allow families and youth to have choices.
- All children, youth, and families have a biological, adoptive, foster, or surrogate family voice advocating on their behalf.
What is Youth-Guided Care?
SAMHSA, The Department of Health and Human Services, Substance Abuse and Mental Health Services Bureau has defined youth-guided care. “Youth are our true experts and primary consumers of systems of care services. We respect their voice, and youth are equal partners in creating system change at the individual, state, and national level.”
MORE INFO: SAMHSA – Systems of Care