Inter-system Collaboration Research Articles

Responding to intimate partner violence (IPV) in Ontario, Canada: A closer look at police involvement

Over the past 20 years, Ontario child welfare agencies have seen an exponential increase in referrals for exposure to intimate partner violence (IPV) for children. Using a mixed methods approach, this paper examines the causes and consequences of the exponential increase in the incidence rates of IPV exposure between 1993 and 2013, providing important context for a maltreatment type that is not well understood in Ontario. The incidence of investigations related to IPV was derived and compared across cycles of the provincially representative Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993, 1998, 2003, 2008, and 2013) and informational interviews were conducted with the primary referral source of IPV-related investigations, police departments, to understand the increase in referrals. Short term service dispositions were also compared across cycles. After the nearly two-fold increase of investigations for all maltreatment types in Ontario between 1998 and 2003, IPV investigations are the only type of maltreatment that continued to increase. In 2013, IPV was the most investigated and substantiated form of maltreatment, without a corresponding increase in the number of cases receiving ongoing services. The continued growth in the proportion of child welfare investigations for exposure to IPV that do not receive ongoing child protection services is a significant concern for Ontario. Intersystem collaboration between police, child welfare, and community services is needed to reduce repeated re-referrals and meet the needs of families experiencing IPV.

PRETTY GOOD PRACTICES: GERIATRICS WORKFORCE ENHANCEMENT PROGRAMS AND LIFELONG DISABILITIES

Growing old with lifelong disabilities is a recent reality that is catching healthcare providers unprepared. While there’s little extant federal or state public policy on aging with lifelong disabilities, and aging, disability, and healthcare systems lack a history of intersystem collaboration, Geriatrics Workforce Enhancement Programs (GWEPs) can lead the way in developing curricula, training, policy, and standards to respond. The GWEPs can intervene to create meaningful intersystem knowledge and skills and better prepare providers. Two GWEPs are filling the best practices void, operationalizing de facto public policy and “pretty good” practices to improve care for individuals with lifelong disabilities. In metro Richmond, VA, the GWEP at the Virginia Geriatric Education Center (VGEC) has built on the successful Area Planning and Services Committee on Lifelong Disabilities (APSC) intersystem partnership to provide this expertise. In Rhode Island, the RI Geriatric Education Center (RIGEC) has aligned its GWEP Alzheimer’s disease supplemental funding with other federally funded programs to build dementia capability into the systems that support adults with intellectual or developmental disabilities (I/DD). RIGEC incorporated expertise previously gained through the University of Rhode Island’s CMS-funded LivingRIte Innovation, which established pilot centers to support individuals with I/DD living with dementia and other chronic conditions, through novel person-centered approaches. This symposium examines how the two GWEPs expanded upon a foundation of previous efforts to serve older adults with lifelong disabilities, the methods by which they built and fostered effective networks, the resulting system improvements, and suggested strategies to move from “pretty good” to best practices.

COMMUNITY NETWORKS ADDRESSING AGING WITH LIFELONG DISABILITIES

Adults aging with lifelong developmental disabilities (I/DD: Down syndrome and other intellectual disabilities, cerebral palsy, etc.) continue to pose a challenge to the Aging Network, developmental services, and healthcare systems. Some funded projects, model programs, and episodic initiatives have helped advance intersystem collaboration but there is still scant federal or state public policy specific to aging with lifelong disabilities. The Area Planning and Services Committee (APSC), a product of three consecutive AoA grants on building and testing intersystem cooperation/collaboration between these systems, is a partnership of community based organizations and academe operating in metro Richmond since 2003. Its successful hands on, interdisciplinary management process has implemented needs assessments, statewide training, staff development, dementia awareness, etc., and been a model for the Virginia Geriatric Education Center (VGEC) Plenary overseeing all GWEP programs. The APSC history informs VGEC GWEP’s incorporating I/DD content into faculty development programs, microlearning, ECHO, and other practitioner training.

Upstream Predictors of the Need for Developmental Education among First-year Community College Students

ABSTRACT Objective/Research Question. How do student- and school-level factors measured in the final year of high school contribute to the odds of a student being assessed to need remediation in Math during the students’ first community college enrollment? Methods. The present study draws on five years of linked secondary and post-secondary administrative records and includes the academic records for 18,814 students attending 228 high schools across 24 jurisdictions in Maryland. We used a series of multilevel models (MLM) to address the research question. Results. Using MLM, we identified both student and school-level factors, drawn from the final year of high school, which relate to the odds of needing math remediation in their first year of community college. Of note, student-level academic performance in high school had a larger influence on the odds that a student would need remedial education than socio-demographic factors. In addition, receiving English language learner services and graduating from high school in the fifth-year functioned as protective factors linked to a reduced likelihood of needing math remediation. Conclusions/Contributions. Community colleges are functionally dependent upon secondary schools to prepare the student body for college level coursework. As such, preventing the need for remediation among community college students will not be resolved within institutional siloes and will most probably require some degree of inter-system collaboration. The findings from the current study presents opportunities for early identification and suggest possible targets for intervention intended to reduce the likelihood that high-risk students will need remedial coursework when they arrive at community college.

The Transitioning Families Therapeutic Reunification Model in Nonfamilial Abductions

AbstractThe existing literature on abduction reunification is limited and evolving. Although guidelines for model service approaches exist, few programs address the unique challenges of reunifying children and families following abduction. This article delineates a family‐based reunification model that has assisted families affected by abduction since 2006. Model components include a team‐centered approach, a stage‐oriented reunification process, and pitfalls and strategies related to intersystem collaboration. We present the value of a family‐systems, solution‐focused, trauma‐informed, and case‐specific approach to therapeutic reunification following child abduction. Evidence that is contrary to the popular notion of Stockholm's syndrome is also marked. Research on the efficacy of therapeutic reunification is essential for the growth of systems equipped to address the dynamic needs of these families. Accordingly, suggestions for evaluation research are proposed.

Youth with disabilities in the United States Child Welfare System

Existing literature suggests that youth with disabilities are known to be at increased risk of maltreatment in the form of abuse and/or neglect. Little is known, however, about the experiences of youth with disabilities who are living in foster care or who are supervised by child protection authorities. This study establishes a baseline estimate of the prevalence of youth with disabilities living in foster care, documents reasons for child protection system involvement, identifies placement types while youth are in care and explores case outcomes. This cross-sectional, exploratory study draws on data from the 2012 Adoption and Foster Care Reporting System (AFCARS) for foster youth in 50 states, the District of Columbia and Puerto Rico. A sample of youth with disabilities (N=36.492) and a comparison group without disabilities (N=601.539) were identified. Findings about demographics, reasons for child removal, foster care placements, permanency planning goals and case outcomes are presented. Findings have implications for the prevention the removal of youth from caregivers, the need for family supports to prevent foster care involvement, the promotion of community inclusion of foster youth while in foster care and the need for inter-system collaboration at the transitional age stage.

Improving Communication Across the Independent Living/Mental Health Divide

Keywords: Centers for Independent Living, mental health, psychiatric disabilities, physical disabilities, inter-system collaborationCenters for Independent Living (CILs) increasingly recognize the importance of providing effective services and supports to individuals with psychiatric disabilities. While those with psychiatric disabilities turn to their local CIL for the same types of assistance as do others, serving people with psychiatric disabilities may suggest the need for CIL staff to communicate and/or collaborate with their local mental health (MH) authorities, mental health clinical and rehabilitation providers, and/or mental health peer-run service programs. Productive contact across the CIL / MH divide, however, is often difficult, reflecting both mutual unfamiliarity and long-standing tensions. CILs are often unsure how much their staff should know about mental illness (that is, about symptoms, diagnosis, medication, treatment, and rehabilitation alternatives), how closely they should work with traditional mental health treatment and rehabilitation providers, and how to connect to the expanding network of mental health peer-run services and supports. This article reviews these questions in the context of the tension between the mental health and independent living paradigms, and provides initial recommendations for improved communication and collaboration across the IL/MH divide.

Assessing Gaps Between Policy and Practice in Medicaid Disenrollment of Jail Detainees With Severe Mental Illness

Assessing Gaps Between Policy and Practice in Medicaid Disenrollment of Jail Detainees With Severe Mental Illness

Intersystem Collaboration: A Statewide Initiative to Support Families

Intersystem Collaboration: A Statewide Initiative to Support Families

Critical Themes of Intersystem Collaboration: Moving from a “Can We” to a “How Can We” Approach to Service Delivery with Children and Families

ABSTRACT Human service agencies are increasingly encouraged to collaborate to support a more comprehensive, integrated, and responsive service delivery model for vulnerable children and their families. This paper describes specific facilitators and barriers emerging from the thematic analysis of interviews conducted over a two-year period with staff in counties that implemented a statewide inter-system collaboration project. The following facilitators were observed: accessible and available resources, flexible funding structures, organizational structures that encouraged partnerships and teams, participants open and committed to working together, and management supportive of front line efforts. Factors that hindered the collaboration effort included unavailable or inaccessible resources, unclear administrative guidelines and corresponding difficulty in defining the target population, philosophical differences between participants, and competing demands on time and funds.