SPOA

Stepping Forward with SPOA

The New York State Office of Mental Health (NYS OMH) has charged local governments with developing local strategies for prioritizing their highest risk children and families and reducing out-of-home placements. These local strategies are referred to as Single Point of Accountability (SPOA). During the fiscal year 2000-2001 NYS OMH reviewed the submissions of counties who had developed their SPOA models. They released a progress report of these models for other counties to assist them in designing their SPOA initiative. This effort between NYS OMH and local government, in the spirit of collaboration, strives to move towards a more responsive, accountable, and coordinated service system in the community.

NYS OMH guidelines allow local government flexibly in designing their SPOA model while meeting these 5 criteria. They must:

1. define this high-risk priority population,
2. develop a screening process to identify these children and families,
3. complete a comprehensive functional assessment and service plans that are individually tailored to the strengths and needs of the child and family,
4. develop an organized process to make residential, case management, home and community- based services waiver and family- based treatments coordinated and accessible, and
5. account to NYS OMH the effectiveness of their SPOA strategy through the collections of outcome-based measures.

In reviewing the many models submitted to NYS OMH, a number of commonalities became apparent including:

· An already existing Coordinated Children’s Services Initiative (CCSI) process that became an integral part of their SPOA model
· Identification of the need for a local government staff position to coordinate this new initiative, and
· The use of existing mechanisms currently involved in service coordination. Some models used a current coordinating committee like CCSI Tier I to be their SPOA overseeing committee and some created alternative committees employing many of the same members already serving on coordinating committees.

CCSI, an interagency initiative currently operational in 52 counties in New York State, strives for interagency collaboration through local decision making structures that support coordinated care approaches. CCSI embraces the Child and Adolescent Service System Program (CASSP) principles. A decade ago Westchester County pioneered a service delivery paradigm shift from a mom-family focused, medical model approach to a CCSI family focused, strength-based value system.

Westchester County incorporates all new programs as part of this overall “system-of-care” approach. According to Carol Hardesty, Program Director, Community Support Services for Children and Youth in Westchester County, “CCSI is an overriding philosophy and process, not a program. A CCSI philosophy embraced by a county in the delivery of services must demand the CASSP principles are the ground rules for everything else they do.”

With these new initiatives, the significant challenge for families and family advocates is to ensure that the CCSI philosophy, driven by the CASSP principles, is incorporated into the SOPA model in your county. In order to assure this outcome families and advocates must:

1. become familiar with their county’s SPOA model, the SPOA Coordinator, the overseeing committee, and the key players on the committees;
2. insist that the SPOA model is driven but the CCSI philosophy that has already been proven to be successful in reducing out-of-home placement for high risk kids involved with multiple systems;
3. ensure that the overseeing SPOA committee “gets the CASSP philosophy” by demanding family representation, beyond the family being served, on all decision-making bodies in the SPOA process. The ongoing use of family support services to assist families navigate this new service delivery initiative must be included.

If you want to learn more about the process you can contact your regional parent advisor, your local family support program, or your county mental health department

CASSP Core Values
1. The system of care should be child centered and family focused, with the needs of the child and the family dictating the types and mix of services provided.
2. The system of care should be community based, with the locus of services as well as management and decision making responsibly resting at the community level.
3. The system of care should be culturally competent, with agencies, programs, and services that are responsive tot eh cultural, racial, and ethnic differences to the populations they serve.