From DHW Director Dave Jeppesen: DHW’s Living Strategic Plan: A year of progress toward protecting children, youth, and vulnerable adults

May 27, 2022
DHW Director Dave Jeppesen

The Department of Health and Welfare (DHW) has engaged with our Strategic Plan as a “living” document. Each week, the senior leadership team discusses real-time updates. This work is informed by subject matter experts and the staff throughout the department.

As part of Strategic Goal 2, the department is committed to serving Idahoans by ensuring that:

• All children who experience abuse or neglect have safe and permanent homes, as quickly as possible

• Adults with serious mental illness and addiction can receive behavioral healthcare services

• People with developmental disabilities who have severe behaviors receive services that are person-centered, trauma-informed, and delivered in the least restrictive environment possible

• We improve the treatment and support provided to children and youth with functional impairment, and to their families

This blog post highlights and celebrates some of the key achievements from the second of four goals in our Strategic Plan. Throughout May and June, this blog series will continue with a focus on the third and fourth strategic goals.

Making progress toward Strategic Goal 2: Protect children, youth, and vulnerable adults

Objective 2.1: Ensure children who have experienced abuse or neglect have safe, permanent homes by increasing in-home safety services to prevent the entry of children into foster care by July 1, 2022, and improving children in foster care’s time to permanency by 10 percent, by July 1, 2023.

  • Children who have experienced abuse or neglect need to have safe, permanent homes. DHW staff have been working to expand both the quality and quantity of in-home safety services. In-home safety services focus on keeping children safely with their families to avoid the trauma that results when children are placed in out-of-home care. This work has begun in Region 1 (Benewah, Bonner, Boundary, Kootenai, and Shoshone counties) and Region 5 (Blaine, Camas, Cassia, Gooding, Jerome, Lincoln, Minidoka, and Twin Falls counties), and will continue to be expanded throughout the state.
  • The department is working to develop evidence-based services for in-home and foster care cases. Evidence-based services have been shown, through rigorous evaluation, to improve outcomes for children and families. The department’s Family First Team has selected seven evidence-based services to develop throughout the year: Parent Child Interactive Therapy, Homebuilders, Familias Unidas, Brief Strategic Family Therapy, Motivational Interviewing, Parents as Teachers (PAT), and Nurse Family Partnerships (NFP).
  • The department is working on a risk assessment tool for families that identifies needed planning and/or service provisions to be delivered through in-home prevention case management. The tool is called Family Advocacy Support Tool (FAST). It will monitor safety and risk and target needs and services. An implementation workgroup has formed, which includes DHW staff from the Division Behavioral Health and Child Welfare Program, front-line staff, the Praed Foundation, and parents with lived experience.
  • The department has successfully designated more than six Idaho facilities as Qualified Residential Treatment Programs (QRTP). These treatment centers work with youth struggling with psychological, behavioral, and/or substance use issues to provide live-in services for those who are too ill or require services that are not available in a less secure or less restrictive environment.
  • To support child welfare, the department has set a goal of improving the retention rate for child welfare social workers. The Idaho Legislature expressed support of this initiative through the approval of 24 new child welfare positions, as well as a 7 percent increase for some social workers. However, staffing challenges persist, and the department continues to develop new strategies to recruit and retain staff.

Objective 2.2: Develop and implement a behavioral healthcare system in Idaho that provides the services that people need, when they need them, through implementation of the YES implementation plan and the IBHC strategic action plan by July 1, 2024.

  • The Idaho Behavioral Health Council’s completed strategic action plan was submitted in July 2021. This plan is focused on improving the entire behavioral healthcare system. The department is leading the work of six of the nine prioritized recommendations from the approved plan.
  • The department is also working to implement the Youth Empowerment Services (YES) plan to improve the children’s mental health system. This progress is measured by an improvement of the cumulative Child and Adolescent Needs and Strengths (CANS) score. The CANS score can help providers and families measure improvement toward goals and see how needs and strengths change. In July 2019, the score was 23.37 percent. As of March 2022, the CANS score increased to 35.58 percent. As the department continues to introduce new services for these children, we anticipate more improvements.
  • The department has organized a service system between Children’s Mental Health, Medicaid, and Child Welfare programs, as directed by the Legislature. This work has included focus groups with families, law enforcement, and hospitals. The system has been enacted and the team continues to meet as needed to assist with complex cases throughout the state.
  • A cross-divisional team is working toward a better service coordination system for Idahoans with developmental disabilities and mental illness. This is intended to improve customer experience as measured by the establishment of a Customer Effort Score.
  • The department and stakeholders are on track to implement a 988 system/Behavioral Healthcare crisis line by July 16, 2022. The system will provide access to emergency behavioral healthcare services to Idahoans experiencing a behavioral health crisis. The Idaho Legislature has supported progress on this work through funding approvals.

Objective 2.3: Establish a long-term system of care for individuals with developmental disabilities who exhibit severe behaviors by July 1, 2022.

  • A cross-divisional project team has been established to develop the new treatment model for people with developmental disorders and complex needs.
  • To build support for initial execution of the long-term system of care, the department has developed and implemented a communications plan with staff and key stakeholders.
  • The project team has launched new treatment model design elements. These include a signed contract with the Center for START to provide best practice training and implementing participant outcome tools to gather baseline data for the future model.
  • On Jan. 31, 2022, I presented a budget request to the Idaho Legislature to propose funding for the new treatment model, including development of buildings, and changes to the Medicaid Management Information System. The requests were subsequently funded.

You can follow the DHW’s work toward our mission and read more about our Strategic Plan on our website.

I hope you have a safe and healthy Memorial Day weekend. Please remember that our offices will be closed on Monday, in observance of the holiday.