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By Phyllis Hanlon
In June, Massachusetts launched a Coordinated Family-Focused Care
(CFFC) initiative. The program's intent is to provide comprehensive,
family-driven, community-based care to children and families, guided
by their individualized needs. The launch was realized following
three years of planning and building infrastructure.
According to Abigail Josephs, special assistant to the Commonwealth's
Health and Human Services (HHS) secretary Ronald Preston, the initiative
is being overseen by the Massachusetts Behavioral Health Partnership
(MBHP) and weds the efforts of the state departments of mental health,
medical assistance, education, social services and youth services.
Suzanne Fields, manager of the MBHP, reports this pilot is based
on a number of programs, most notably the wraparound process out
of Milwaukee. She says that as of September 1, 26 families had enrolled
in CCFC and full capacity of 250 is anticipated by the end of December.
Fields says Brockton, Lawrence, New Bedford, Springfield and Worcester
were chosen through a "natural selection process," (i.e., communities
most in need of services), as sites for the pilot. She emphasizes
that services through the CFFC are available only to families living
in one of these designated communities.
CFFC is also modeled on the Cambridge and Somerville- run Massachusetts
Mental Health Services Program for Youth (MHSPY) and the Worcester
Community of Care (WCC). "Both have demonstrated solid outcomes,"
says Fields. "These programs are designed for kids stepping down
or coming out of residential care or at risk for residential care.
They provide supports to keep the child in the community."
Anthony Irsfeld, Ph.D., clinical director of the WCC, notes that
the current program and the new initiative differ somewhat but embrace
the same fundamental principles. Both are strength-based programs,
he says, and don't attempt to apply the same solution to each problem.
Additionally, the Worcester program will serve as a model that
reaches beyond the region. "The WCC is being evaluated as part of
a national program," says Irsfeld. Families involved at the local
level will see national measures relating to children's functions
in a variety of areas, he says.
CFFC will undergo fine-tuning as data is collected and evaluated,
says Fields. A steering committee, as well as researchers, will
assess real-time information and make adjustments as needed. Several
outcome measures will be evaluated including child functioning,
community tenure, hospitalization rates, residential placements,
school attendance and performance, juvenile justice involvement
and family, youth and state agency satisfaction and cost effectiveness.
Fields cites fiscal factors and residential placement as two concerns
that will determine the future of this type of systems of care process.
"Data show mixed results whether there is a cost savings to this
program. Certainly the initial cost is higher. We hope that by keeping
kids at home, we will save money, but that's not the priority,"
says Fields. "The priority is providing appropriate and adequate
services for kids in a home setting."
Since the 1990s, many such pilots have been funded nation-wide,
according to Fields. "This is the real direction all mental health
programs are taking."
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