Children's System of Care

The system of care philosophy is the foundation of the delivery of services and supports. In Wisconsin, this philosophy includes the core values of:

• Family and young adult voice and choice
• Community based.
• Culturally and linguistically responsive.
• Unconditional.

Family and young adult voice and choice means families and young people are supported in determining the types of services and supports provided, and they are involved in decision-making roles in system-level policies, procedures, priorities.

Community based means that to the extent possible services and supports are provided in community settings, like homes, schools, and primary care offices, with the responsibility of managing the system of care grounded in community level structures, processes, and relationships.

Culturally and linguistically responsive means that services and supports are adapted to the diversity of the child and their family to ensure equity in access and quality.

Unconditional means that all partners in the system of care work toward meeting the needs of a child and their family even when faced with challenges and setbacks.

The system of care infrastructure includes the policies and processes that manage the delivery of services and supports and quality improvement efforts, including rules regarding funding and finances, partnerships across agencies, workforce development, partnerships with children and families, and data collection.

The system of care features a range of services and supports to promote the health, safety, and well-being of a child and their family. This includes early intervention, home- and community-based treatment interventions, along with inpatient and residential interventions with linkages to community services.

Services and support provided to a child and their family should be based on the unique needs of the child and family. The child and family should be part of the planning process to determine which type, level, and intensity of services and supports would be most beneficial.

Services and services should be based on best practices for addressing the physical, emotional, intellectual, cultural, and social needs of the child and family

Wisconsin Children’s System of Care Summit Companion Guide (PDF)
This document includes the event agenda, summaries and reflections on data collected regarding the state of Wisconsin’s Children’s System of Care, a presentation on the history of children’s system of care activities in Wisconsin, and an article on the national evolution of the system of care approach.

The Evolution of the System of Care Approach (PDF)
This document provides updates on the array of services and support, infrastructure, and philosophy components that make up the system of care framework.

The System of Care Framework: Inspiring Hope & Healing for Children, Youth, Young Adults, and Their Families Presentation (PDF)
This document is the slide deck presented by Gary M. Blau, Ph.D., the senior advisory advisor for children, youth, and families in the Substance Abuse and Mental Health Services Administration’s Office of the Assistant Secretary. Blau was the keynote speaker at the Wisconsin Children’s System of Care Summit.

Many of the sessions on day one of the Children’s System of Care Summit were recorded.

Recording 1

• Opening remarks from the event organizers (Starts at 00:00:00 mark)
• Presentation of the Children’s System of Care Week proclamation (Starts at 00:14:38 mark)
• Remarks from the DHS Office of Health Equity (Starts at 00:17:45 mark)
• Recorded remarks from the DHS Office of the Secretary (Starts at 00:18:55 mark)
• Remarks from the Wisconsin Department of Public Instruction (Starts at 00:23:02 mark)
• Presentation on the history of children system of care activities in Wisconsin (Starts at 00:33:18 mark)
• Presentation on the system of care framework and how to inspire hope and healing for children, youth, young adults, and their families (Starts at 01:10:00 mark)

Recording 2

• Reflection on the information presented by the opening speakers (Starts at 00:00:00 mark)
• Presentation of the Wisconsin Children’s System of Care 2023 Champion Award (Starts at 00:07:49 mark)

Recording 3

• Presentation on the overview of the components of a system of care (Starts at 00:00:00 mark)
• Presentation on system of care survey results – overview (Starts at 00:18:37 mark)
• Presentation on system of care survey results – services and supports (Starts at 00:23:48 mark)
• Presentation on analyzing the services and supports survey results (Starts at 00:30:14 mark)
• Storyteller segment on services and supports (Starts at 00:42:43 mark)
• Presentation on system of care survey results – infrastructure (Starts at 01:09:47 mark)
• Presentation on analyzing the infrastructure survey results (Starts at 01:17:35 mark)
• Storyteller segment on infrastructure (Starts at 01:28:15 mark)

Recording 4

• Presentation on system of care survey results – philosophy (Starts at 00:01:29 mark)
• Presentation on analyzing the philosophy results (Starts at 00:09:33 mark)
• Storyteller segment on philosophy (Starts at 00:19:20 mark)

Objective
The funding and policy strategies of agencies at the federal, tribal nation, state, and county levels are aligned to meet the needs of all children, young adults, and families in Wisconsin.

Key results

• The Children Come First Advisory Committee makes recommendations for at least 10 (no more than 10) funding and policy system changes based on data from the Wisconsin Children’s System of Care Summit, listening sessions, surveys, and other sources that will improve access to services for children and families and improve the efficiency of service delivery for tribal nations, counties, and service providers.
• The Children Come First Advisory Committee will conduct a self-analysis of system partners on the Children Come First Advisory Committee, identify gaps, and intentionally seek out system partners to strengthen the committee that can best serve in a children’s system of care advisory capacity.
• The Children Come First Advisory Committee develops strategic partnerships and an intentional communications structure with 10 key partners and organizations who are not members of the Children Come First Advisory Committee but have mutual interests in improving Wisconsin’s Children’s System of Care.
• Create or identify a decision-making entity that would be capable of evaluating the system and implementing change to reduce regulatory, financial, and governance barriers. Acknowledge our systemic challenges that have resulted in funding, governance, and service delivery processes that do not support the type of care or efficiency that we strive for.
• The application for a Children’s Mental Health Initiative grant in 2025 will provide opportunities to identify and evaluate the impacts of various funding, policies, state, and local partnerships, etc.

Objective
All Wisconsin children, youth, and their families will have the highest quality collaborative integrated health and wellness system, emphasizing and including education and outreach, prevention, screening, and early intervention strategies.

Key results

• The Children Come First Advisory Committee will foster and prioritize opportunities for collaborative partnerships with primary care to achieve:
  • Increased membership of primary care physicians within the Children Come First Advisory Committee to cultivate a holistic approach to health care.
  • Expand outreach opportunities for the Child Psychiatry Consultation Program within primary care settings to enhance mental health support and services for children youth and their families.
• To effectively address the needs of children, youth, and families, the Children Come First Advisory Committee will actively identify opportunities for exploration, shared learning, and collaboration with primary care, integrative health, facilities, and other essential partners to promote a holistic approach to health care.
• The Children Come First Advisory Committee will create a workgroup to make recommendations for policies that increase access and support an integrated health, mental health, and wellness system for children, youth, and families in Wisconsin by:
  • Conducting a comprehensive review of integration models for health and mental health services and analyzing their efficacy.
  • Identifying resource requirements and maintaining adaptability to inform the development of an optimal and sustainable integration model for Wisconsin.
  • Performing a thorough strength analysis of existing prevention and screening activities, identifying successful initiatives, resources, and community engagement strategies.
• Children Come First Advisory Committee members will draft comprehensive communications outlining completed initiatives and proposing forthcoming actions to pertinent groups and partners, ensuring transparency, alignment, and engagement across Wisconsin’s Children’s System of Care.

Objective
Assure the right service for the right need at the right time in the crisis continuum. Funding is aligned across federal, state, counties, and tribal nations. All families will be heard, receive crisis responses with necessary linkage and follow-up, and have a safe place to get help.

Key results

• The Children Come First Advisory Committee supports the development of a psychiatric residential treatment facility as evidenced by the submission of letters of support/recommendation.
• Using current data cost analysis for youth crisis stabilization facilities, the Children Come First Advisory Committee will provide recommendations and advocacy for funding within the legislation.
• The Children Come First Advisory Committee will identify and define the respite care continuum and (map/guidance services and funding) support how that is defined in Wisconsin.
• The Children Come First Advisory Committee develops, promotes, and updates a toolkit for the respite care continuum that can be used to describe respite care from least restrictive to most restrictive settings with information about funding streams and access to services included.
• The Children Come First Advisory Committee leverages its collective resources to ensure the promotion of a crisis continuum that enhances resources for a mobile response specific to youth.
• To enhance the usage of Medicaid linkage and follow-up, the Children Come First Advisory Committee identifies comparable programs and other stabilization models that may include peer support and other helping hands.

Objective
Effective peer support is available to every youth, young adult, and family involved with Wisconsin’s Children’s System of Care.

Key results

• A study to identify evidence-informed practices and key factors that contribute to successful efforts to provide peer support in other states will better inform partners in Wisconsin’s Children’s System of Care regarding peer support. These results and examination of the strengths and challenges that exist in Wisconsin will inform the development of a plan to increase access to peer support within Wisconsin’s Children’s System of Care.
• Preparation of an application for a Children’s Mental Health Initiative grant in 2025 will include a focus on increased access to peer support. The application should include piloting elements of the peer support study/plan proposed above. Grant funds will support the implementation of the pilot in the tribal nations/counties that participate in the grant and the evaluation of their effectiveness.
• Concurrent with the grant-related efforts to increase the availability of peer support, Wisconsin’s Children’s System of Care partners will increase the understanding of the terms peer specialists and peer support. Clarification of these terms will lead to a better understanding of how the outcomes for children and families can be improved.
• The Children Come First Advisory Committee will identify components of Wisconsin’s Children’s System of Care infrastructure by which the peer support work, including that being done through the pilot, can be shared, and addressed. It would be a vehicle for communication between the grantee tribal nations/counties and other parts of the system. And perhaps most importantly, would contribute to the cross system work to minimize barriers to effective and timely provision of peer support.
• The Children Come First Advisory Committee will recommend approaches to ensure that the provision of support and services are based on family and youth underlying needs and priorities, developed by the child and family team, and that subsequent changes in the plan including discharge are mutually agreed upon.

Objective
A competent, confident, collaborative, and diverse workforce that reflects families served across Wisconsin.

Key results

• The Children Come First Advisory Committee empowers local coordinating committees to identify and leverage resources effectively, thereby enhancing the workforce's capacity to address the diverse needs of children, youth, and families within their communities.
• The Children Come First Advisory Committee advocates for the establishment of standards of practice aimed at facilitating career advancement pathways to optimize the workforce's potential to address the comprehensive needs of children, youth, and families.
• The Children Come First Advisory Committee collaborates with the Governor’s Task Force on Healthcare Workforce which is charged with developing strategies to effectively address the shortage of healthcare workers across the state.