PO25-002 Northwestern SOW.docx

SOW FOR NORTHWESTERN UNIVERSITY FOR FY25

Vendor:

Northwestern University 750 N. Lake Shore Drive, 7th Floor Chicago, IL 60611

Primary Contact:

Richard A Epstein, PhD, MPH Northwestern University Feinberg School of Medicine Department of Psychiatry and Behavioral Sciences Mental Health Services and Policy Program 710 N. Lake Shore Drive, 9th Floor Chicago, IL 60611 Phone: (Office) 312-503-5454; (Cell) 615-957-7522 Email: richard.epstein@northwestern.edu

This document summarizes the scope of work to be performed by Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Mental Health Services and Policy Program (NU/MHSPP) for the Illinois Department of Children and Family Services (DCFS). Included are justifications why the work should remain with NU/MHSPP.

Due to the continuation of precautions and work practices that were originally initiated in response to COVID-19, technology shall be used when practical to to minimize in-person meetings when possible. For purposes of this Contract, Videoconferencing, Teleconferencing, Zoom, WebEx and Video(ing) are used interchangeably below. The following is a list of the 15 projects:

1. Technical Assistance for Child and Adolescent Needs and Strengths Implementations (CANS)

2. Technical Assistance for Empowering Therapeutic Practice (ETP)

3. Trauma Training and Consultation (TTC)

4. Technical Assistance for Residential Treatment and Performance Measures (RT&PM)

5. Technical Assistance for Service Provider Administration (SPA)

6. Intensive Placement Stabilization Evaluation (IPSE)

7. Technical Assistance for the Office of Delinquency Prevention and Restorative Justice (ODPRJ)

8. Data Collection and Administration (DCA)

9. Technical Assistance for Placement and Community Services (PACS)

10. Asthma Management Project (AMP)

11. Technical Assistance for Youth in the Psychiatric Hospital Beyond Medical Necessity (BMN)

12. Systems Focused Review of Child Protective Services

13. Support of B.H. Consent Decree Initiatives (BH)

14. YouthCare Evaluation (YCE)

15. SAFE Model Evaluation (SAFE)

1. Technical Assistance for Child and Adolescent Needs and Strengths Implementations (CANS):

NU/MHSPP will provide technical assistance to support DCFS’ implementations of the Child and Adolescent Needs and Strengths (CANS). NU/MHSPP currently supports implementations with Intact Family Services child welfare specialists and their supervisors, Permanency Services child welfare specialists and their supervisors, the Integrated Assessment program, the QRTP Independent Assessment program, Intensive Placement Stabilization program, and the Wraparound program. NU/MHSPP will subcontract with the University of Kentucky / Praed Foundation, which holds intellectual property rights to the CANS, to facilitate DCFS efforts to make revisions, update trainings, and develop decision support tools. Specific deliverables include:

a. NU/MHSPP will regularly meet with the DCFS project contact and, as needed, representatives from the different CANS implementations to discuss version control, training and certification, and post-certification meaningful use.

b. NU/MHSPP will continue to deliver and/or develop reports to assess implementation fidelity and track change over time for the various CANS implementations. Reports may include information that can assess training and certification, use, quality, and individual youth progress.

c. NU/MHSPP will participate with DCFS (including the Office of Learning and Professional Development, as needed) and the University of Kentucky / Praed Foundation to support CANS training and certification, including remediation activities.

d. NU/MHSPP will continue to maintain the “DCFS CANS Use Mailbox” by answering technical questions, giving final approval for caseworker supervisors to score a CANS in SACWIS, and answer any other related questions.

e. NU/MHSPP will develop materials for and convene monthly and ad hoc trainings to provide technical assistance focused on CANS meaningful use. Training and other materials will be shared by maintaining the CANS training website.

f. NU/MHSPP will subcontract with the University of Kentucky / Praed Foundation, which owns the intellectual property rights to the CANS, for (1) training and certification of NU/MHSPP staff as CANS trainers and (2) consultation about revising DCFS’ version, updating DCFS’ training and certification processes, and developing DCFS’ decision support tools.

Justification: NU/MHSPP has provided Illinois DCFS with technical assistance to support their CANS implementations since 2008. It would be impractical, cost intensive, and time consuming to discontinue ongoing work in favor of a new vendor. Additionally, NU/MHSPP staff are critical to this effort and have expertise that would be difficult, if not impossible, to replace. Dr. Richard Epstein, the NU/MHSPP faculty lead for this project, has existing professional relationships with the national CANS collaborative and an established record of providing implementation support to State child welfare systems. Dr. Epstein is deeply involved supporting DCFS’ effort to transition to a version of the CANS that is consistent with Illinois DHFS’ version of the CANS, to use the CANS for Family First Prevention Services Act (FFPSA) decision support, and to streamline systemwide assessment requirements. Similarly, the lead NU/MHSPP staff for this project, Mr. Robert Hjertquist, LMFT, has provided technical assistance for Illinois DCFS’ CANS users for many years. Mr. Hjertquist has worked directly with DCFS and child welfare systems for more than 25 years, has served as an administrator / project manager for more than 20 years, facilitated work groups with upper level DCFS and POS agency leadership for more than 10 years, and served as an administrator for various DCFS initiatives, including its CANS implementations, for nearly 10 years.

2. Technical Assistance for Empowering Therapeutic Practice (ETP)

NU/MHSPP will support DCFS’ efforts to ensure that DCFS counseling contract providers maintain and expand their knowledge about best practices for evidence-based and trauma-informed services to youth in care. In partnership with DCFS Chief Consulting Psychologist Dr. Erin Alexander, NU/MHSPP will help DCFS establish and maintain a virtual learning community. Specific deliverables include:

a. Developing materials for a quarterly meeting of counseling contract providers to deliver information about best practices for evidence-based and trauma-informed services to youth in care.

b. Convening a quarterly virtual meeting of providers with counseling contracts to deliver these materials and answer questions.

c. Exploring the creation and maintenance of a professional listserv, document storage needs, and other requirements.

d. Creating a professional listserv of counseling contracts and their individual service providers.

e. Producing and distributing a quarterly newsletter.

f. Monitoring quarterly meeting attendance and newsletter “downloads;” and

g. Follow-up with providers as appropriate to encourage participation in the learning community.

Justification: NU/MHSPP has been involved with this project since its inception, including developing the standards for evidence-based and trauma service provider credentialing (e.g., levels of training, the evidence-based practices accepted, the renewal process). As DCFS transitions this project towards developing a clinical learning community, the knowledge and experience of NU/MHSPP staff will be critical, making it time- and cost-prohibitive to change vendors, as existing standards will support these future efforts by informing learning community activities.

3. Trauma Training and Consultation (TTC):

NU/MHSPP will provide trauma training and consultation related to "Think Trauma" and other areas as outlined below. Specific deliverables include:

a. Offer Think Trauma Training and Implementation Program (TTTIP) for child welfare residential agencies, psychiatric facilities, shelters, and ILO/TLP programs who are referred by DCFS staff, to build local capacity for trauma training and trauma-informed practices across the state.

i. Offer a Training of Trainers (TOT) program for agencies to expand capacity for agency-level training and support in Think Trauma; this will include engaging agencies previously trained in Think Trauma to become re-trained if the trainers at their agency are impacted by staff turnover.

ii. Offer a training option for agencies who choose to be trained in the curriculum but do not have the capacity support the development of trained trainers at their agency.

iii. Expand the number of trainers that participate in the Think Trauma training via videoconference to support agencies maintaining a stable cadre of trainers and widespread dissemination

iv. Maintain a flexible approach to training and support based on agency needs; we originally adopted this approach to address the increased demands on agencies during the pandemic

v. Offer on-demand access to Zoom recordings of Think Trauma training sessions and consultation calls to continue to boost knowledge and to support current cohort during the training process.

vi. Training components for TTTIP will include the following:

1) Offer 2 training sessions as a part of the TOT (approximately 3-4 days per session) with up to 12 residential agencies, to take place virtually or in-person; one training session will be offered for those agencies who choose to be trained in the curriculum (but not as trainers).

2) Facilitate 2 pre-work calls prior to training and 6-8 monthly follow-up consultation/implementation support calls to support implementation of Think Trauma in practice.

3) Collect evaluation data to identify both the reach and impact of training activities on residential staff attitudes, knowledge, skills, and practices.

4) Support logistics for training activities (both in-person and virtual), consultation support calls, and development of training materials

vii. Offer Think Trauma Sustainability Community calls (up to 6 calls per fiscal year) with all residential agencies previously trained in Think Trauma through DCFS. These calls will be focused on discussing additional challenges and successes, support knowledge and practice application, provide resources, foster collaboration, and support continued implementation efforts. This Sustainability Community will offer content booster sessions for agency staff previously trained in Think Trauma.

viii. Support the application of Think Trauma with agencies in conjunction with residential monitors, as it relates to or augments their monitoring practices with agencies. This will be facilitated by:

ix. Invite residential monitors to participate in Think Trauma trainings with agencies and other staff, to increase their knowledge and understanding of Think Trauma.

x. Disseminate an Abbreviated Version of Think Trauma to residential monitors; this version will be developed by our Center for Child Trauma Assessment, Services and Systems Integration work at NU. It will be shared in conjunction with IDCFS trauma training activities. Residential monitors and residential agency staff will be invited to participate in a pilot of the Abbreviated Version if they are interested and able.

xi. Develop Think Trauma agency progress reports to track implementation efforts, and enhance communication between agencies, respective monitors, and NU team; these will be shared quarterly with agencies, their respective monitors, monitoring leadership, and the PI, Program Administrator, and Deputy in charge of the contract to help think about how it can better inform residential monitoring.

b. Develop and deliver an abbreviated version of TTTIP to DCFS Clinical Division leadership. This should include planning and development activities, initial training and booster sessions for staff who participate in the initial training who are retained, and additional initial training and booster sessions for staff hired after the initial training. Provide quarterly reports describing the implementation.

c. Provide Attachment, Self-Regulation, and Competency (ARC) Consultation to IPS agencies. Schedule and develop consultation meetings. Provide quarterly reports describing the implementation.

d. Identify collaboration and training opportunities to support trauma-informed best practices with a focus on raising awareness of the impact of historical and racial trauma and structural racism ongoing collaborative meetings with DCFS Office of Racial Equity Practice to explore current and planned efforts within DCFS and how we can share resources that both support and align this work.

Justification: NU/MHSPP staff are uniquely qualified to do this work given their nationally recognized expertise in childhood trauma and as longstanding partners in the National Child Traumatic Stress Network (NCTSN) through CCTASI, funded by the Substance Abuse & Mental Health Services Administration. Further, NU/MHSPP faculty and staff are both key developers of the new Think Trauma curriculum and master trainers of the curriculum and have extensive experience in supporting anti-racist practices and building trauma-informed systems. NU/MHSPP staff have also partnered with DCFS to assist in improving Residential Placement services for over a decade. Attachment, Self-Regulation, and Competency (ARC) is a trauma-informed model that NU/MHSPP staff have facilitated IPS agency use of for many years. Building a trauma-informed system requires understanding and addressing the adverse experiences and consequences of racism on multiple levels of the system. Our existing focus on anti-racist practices and racial justice and equity within MHSPP and in collaboration with the NCTSN over the last 2 years has allowed us the opportunity to both integrate and continue to build our expertise in this work.

4. Technical Assistance for Residential Treatment and Performance Measures (RT&RPM):

NU/MHSPP will support Residential Treatment (RT) and Residential Performance Measures (RPM) by engaging in the following activities:

a. Support the development and implementation of RPMs by:

i. Producing and distributing periodic RPM performance reports at the contract- or agency-levels: (a) maltreatment in residential, (b) discharges, (c) length-of-stay (LOS), (d) restrictive behavior management, and (e) additional measures addressing priorities of the FFPSA and Monitoring Redesign for congregate care settings, as time and resources permit.

ii. Producing and distributing quarterly and annual RPM contract- or agency-level performance reports, including summaries of system-wide progress on measures.

iii. Refining the risk adjustment (RA) strategy for RPMs in coordination with the Child Welfare Advisory Committee (CWAC) Data Test Workgroup as needed.

iv. Participating in the monthly High Performance/Data Test Workgroup CWAC Committee meeting.

v. Participating in as-needed calls with DCFS to review and refine RPMs and reporting issues.

vi. Providing as-needed trainings, webinars, and other training materials on RPMs to monitoring staff and residential provider staff, not to exceed 2 per quarter; and

vii. Participating in additional CWAC subcommittees as requested.

b. Report on administrative data for the entire congregate care population to DCFS administrative staff:

i. Delivering monthly summaries of notable trends in congregate care administrative data and leading as-needed meetings to share findings with DCFS administrative staff.

ii. Maintaining, reviewing, and updating congregate care contract data (Residential List “RL” Admin) until the Department assumes this responsibility. To help accomplish this, NU/MHSPP will facilitate meetings between the Department’s Contracts, OITS, Clinical and Child Services, and Monitoring divisions to develop a transition plan for RL Admin, with the goal of completing the transition by 12/31/23.

iii. Producing monthly reports for Independent Living Option/Transitional Living Program (ILO/TLP), including agency count, team assignment, and agency detail list until reports are embedded into PowerBI by OITS.

iv. Facilitating timely transition to the system replacing Illinois Outcomes through data testing and support.

v. Supporting the transition of reporting on administrative/placement data from manual reports to automated reports in the system replacing Illinois Outcomes; and

vi. Once item xi is complete, generating new reports to address special topics/questions, as requested.

vii. Once item xi is complete, assisting monitoring in utilizing the new tools and capabilities in the system replacing Illinois Outcomes, including generating data and developing new reports.

c. Support for Residential Monitoring and Agency data collection and reporting:

i. Supporting the DCFS Monitoring Division with data collection and reporting systems (using REDCap) in accordance with DCFS procedures and operations.

ii. Supporting/training monitoring and residential staff/management in using REDCap data and reporting systems.

iii. Refining existing data collection tools with version releases on a quarterly basis.

iv. Adding data collection tools for ILO/TLP Monitoring.

v. Developing regular and ad hoc reports to summarize data from REDCap including but not limited to reports related to Planned Discharge Date (PDD).

d. Providing ad hoc analysis related to a – c, no more than 2 per quarter.

Justification: NU/MHSPP created detailed analyses of residential performance standards that DCFS administration relates are necessary to continue, using the level of expertise provided by NU/MHSPP. Members of the NU/MHSPP team have extensive experience in residential treatment, residential data systems, and the risk adjustment model necessary to develop, enhance, and run regular reports on residential performance metrics. Additionally, the team possesses decades-long institutional knowledge of legacy data systems. The reports offer insight into youth safety and stability, length-of-stay in residential treatment, post-discharge outcomes, the quality of care provided to youth in residential treatment, and other key performance trends. These reports also promote the achievement of specific child-level outcomes, identify priority areas for investing resources, and set the groundwork to evaluate programs and services. NU/MHSPP staff also bring this expertise to multiple CWAC subcommittee meetings to address system performance and youth outcomes. Interrupting this work by changing the vendor will impact multiple processes and the delivery of information that is used by DCFS administration on a weekly, if not daily, basis.

5. Technical Assistance for Service Provider Administration (SPA)

NU/MHSPP will provide technical assistance to DCFS in its effort to have its external service providers use the DCFS Provider Portal (DPP) and Service Provider Identification and Exploration Resource (SPIDER) databases and webtools. Specific deliverables include:

a. NU/MHSPP will coordinate with DCFS leadership by:

i. Convening monthly meetings with the DCFS contact(s) and other key stakeholders.

ii. Collaborating with the DCFS Office of Information Technology (OITS) to produce DPP and SPIDER utilization and quality of service reports as requested by DCFS

iii. Collaborating with DCFS and OITS to use DPP and SPIDER information to identify gaps in services and resources, in support of statewide initiatives, including (but not limited to) the Program Improvement Plan (PIP), B.H. Consent Decree, and FFPSA as specifically requested by DCFS contact.

b. NU/MHSPP will maintain records in DPP and SPIDER databases by:

i. Validating and reconciling information about service providers to be included in DPP and SPIDER as directed by DCFS.

ii. Vetting/verifying new service provided data for inclusion into the DPP.

c. NU/MHSPP will train and support DPP and SPIDER webtool service provider end-users by:

i. Conducting live trainings for service provider DPP webtool end-users on a pilot basis and deliver finished product to DCFS for use by DCFS’ Office of Learning and Professional Development (OLPD).

ii. Conducting live trainings for SPIDER webtool end-users.

iii. Supporting service provider users with access and usage of DPP in collaboration with DCFS and OITS.

iv. Providing DCFS with information to be disseminated internally to DCFS (e.g., via DNET announcements) and externally to service provider users and the public (e.g., by asking DCFS Communications to disseminate information via its platforms).

v. Developing and maintaining user support materials and references for DPP and SPIDER service provider end users and delivering finished products to DCFS for use by OLPD.

vi. Supporting service provider end users in migrating from SPIDER to the DPP.

vii. Supporting service provider end users in becoming self-sufficient in administering their own data.

d. NU/MHSPP will support the enhancement of the DPP and SPIDER databases and webtools by:

i. Providing subject matter expertise, requirements/data definition, and operational guidance with focus on service provider data validity for service provider management as designated by DCFS, both contracted and non-contracted, and per DCFS request, other areas where SPIDER experience can guide DPP design or operations.

ii. Triaging DPP and SPIDER webtool end-user issues to appropriate DCFS/OITS/DoIT solution group.

iii. Assisting with testing of new versions of the DPP, with specific focus on service provider user experience, functional/workflow issues, and improvements, and verifying correct operation.

iv. Assisting/advising DCFS and its technical resources (OITS, third party vendors) in mapping DCFS contracted services and non-contracted services to a master human services taxonomy selected by DCFS.

v. Support for DCFS Contracts data migration to DCFS/OITS standard data systems.

Justification: NU/MHSPP was partner to the original Statewide Provider Database (SPD) and its current iteration, SPIDER. As a result, NU/MHSPP was also partner to all discussions and efforts to create the DPP, including validating FFPSA prevention service provider information into DPP in SFY22 and onboarding POS Agency end-users. NU/MHSPP health interviewers and business analysts are essential to validating information in both databases and business processes surrounding end-user use of the webtools for accessing that information. It would be time-consuming, labor-intensive, and cost-prohibitive to transition these functions to another vendor.

6. Intensive Placement Stabilization Evaluation (IPSE)

NU/MHSPP will evaluate the Intensive Placement Stabilization (IPS) program. Specific deliverables include:

a. NU/MHSPP will coordinate with DCFS staff overseeing the IPS program.

b. NU/MHSPP will provide to DCFS staff overseeing the IPS program quarterly reports with information about implementation fidelity and program outcomes. These reports will be designed to be used by DCFS to guide program administration.

c. NU/MHSPP will provide DCFS staff overseeing the IPS program reports needed to satisfy DCFS’ reporting requirements for the IPS-related elements of the workplans for the B.H. consent decree.

Justification: Dr. Epstein and his program evaluation team have expertise using DCFS administrative data for reporting and quality improvement related to the IPS program. It would be time- and cost-prohibitive to transition the responsibilities of these staff to another vendor.

7. Technical Assistance for the Office of Delinquency Prevention and Restorative Justice (ODPRJ):

NU/MHSPP will provide technical assistance to the Office of Delinquency Prevention and Restorative Justice (ODPRJ) by supporting the Associate Deputy’s efforts to engage other child-serving systems and agencies that work with dually involved youth and youth involved with human trafficking, create reports and tracking mechanisms for dually involved youth and youth involved in human trafficking, engage in other analytic work designed to help prevent youth from becoming dually involved and involved with human trafficking, identify best practices, and identify available community-based resources. NU/MHSPP staff will engage in strategic planning, create reports, develop, and facilitate trainings, presentations, focus groups, and process groups. NU/MHSPP staff will create and maintain databases that can be used by DCFS to track information about dually involved youth and youth involved in human trafficking. Specific deliverables include:

a. Convening monthly meetings between the NU Faculty Lead DCFS Contact, and any other key stakeholders, to establish and follow-up on priority initiatives.

b. Assist with ODPRJ’s annual Dually Involved Youth and Youth Involved with Human Trafficking Report and annual report to the General Assembly about youth in detention beyond their release date, as needed.

c. Compile a monthly report of information about youth in detention or incarcerated.

d. Compile a monthly release upon request (RUR) report.

e. Compile a monthly report of youth at-risk for dual involvement (P4S report).

f. Develop statistical models to predict detentions and other important outcomes.

g. Provide ad hoc reports and other resources as time allow.

Justification: NU/MHSPP staff have been working with DCFS in the ODPRJ for several years. Reports delivered by NU/MHSPP are critical to the ODPRJ functions and new workflows and would be costly and time-consuming to discontinue and move to another vendor.

8. Data Collection and Analysis (DCA):

NU/MHSPP collaborates with NU and FSM IT, DOIT/OITS, DCFS program staff, and other stakeholders to ensure maintenance of NU and DCFS computer hardware and software, permissions, and access to NU and DCFS systems and servers. These hardware, software, permissions, and access are used by NU/MHSPP staff on other projects towards those project deliverables and by NU/MHSPP staff on this project to regularly extract, transform, and prepare CYCIS, SACWIS, and other DCFS administrative data into a database that is used by other the other projects in this program plan for production of their deliverables, preparing files for other projects with Illinois DCFS permission, and preparing files for delivery to other University partners at DCFS’ request. Specific deliverables include:

a. Convening a monthly meeting with the DCFS contact.

b. Maintaining and updating data sharing agreements and other related permissions.

c. Maintaining user IDs, permissions and access for NU/MHSPP staff to Illinois DCFS systems and servers.

d. Maintaining computer hardware for access to NU and DCFS systems and servers.

e. Monitoring NU/MHSPP staff compliance with NU and DCFS training requirements, including compliance with the effort reporting system (TERS).

f. Extracting, transforming, and loading DCFS administrative data into a NU/MHSPP database. This includes data validation services and reports to remove errors and improve data quality, generating spells for youth in care, congregate care placements, and other living arrangements, among other variables.

g. Merging DCFS administrative data with information from other sources including, but not limited to, legacy data from retired Illinois DCFS administrative data sources, the retired surrogate website, REDCap, census bureau data, and other publicly available data.

h. Serve as administrator for the DCFS instance of REDCap.

i. Facilitate the DCFS PowerBI User Group.

Justification: NU/MHSPP has been using secure computer systems for extracting, transforming, and preparing Illinois DCFS administrative data into a warehouse used by the other projects in this program plan for many years. It would be time-consuming and cost prohibitive to discontinue this work. DCFS does not have the capacity to complete these functions in-house and NU/MHSPP is uniquely qualified to fulfill these functions. These functions are necessary for the other projects on this contract, as they provide the underlying data upon which the analyses and reports provided by the other projects are based. These analyses and reports provide support for important DCFS programs such as IPS and efforts to reduce the number of children in the psychiatric hospital beyond medical necessity, to give just two examples. Changing the oversight of this project could also be an impediment to DCFS preparations for Family First Prevention Services Act and B.H. Consent Decree initiatives. NU/MHSPP has longstanding and collaborative relationships with DoIT/OITS that make providing their administrators with important information easier than it would be with another vendor. NU/MHSPP staff serve as the DCFS administrator for the DCFS instance of REDCap and PowerBI User Group. Replacing this role requires an unnecessary transition of responsibilities.

9. Technical Assistance for Placement and Community Services (PACS):

NU/MHSPP provides DCFS with technical assistance to support placement and community services decisions for youth in care. Specific deliverables include:

a. Providing technical assistance to the Chief Deputy Director for Clinical and Child Services and the Deputy Director for Clinical Practice in support of their efforts to revise existing and implement a new clinical staffing protocol and other quality improvement initiatives as times as resources allow.

b. Providing technical assistance to the Chief Deputy Director for Clinical and Child Services, Deputy Director for Child Services, and the Deputy Director of Permanency Services to support their efforts to oversee DCFS’ use of Qualified Residential Treatment Providers (QRTPs).

c. Providing technical assistance to Chief Deputy Director for Clinical and Child Services to support their efforts to manage secure care. Deliverables include providing the Psychiatry and Psychology Program Director with a quarterly report combining information about secure care assessments with CYCIS/SACWIS information to help identify youth at risk for secure care, and sub-contracting with a national secure care expert who can consult with DCFS around secure care best practices.

d. Providing technical assistance to the Deputy Director for Child Services in support of their efforts to oversee DCFS’ placement decisions by:

i. Meeting regularly with DCFS Contact and submitting quarterly report.

ii. Attending regularly scheduled operational meetings including, but not limited to: (1) Meetings regarding Beyond Medical Necessity, Interim Care Centers, Legal, Release upon Request, Dually Involved Youth, YouthCare Physical Health Rounds, Therapeutic Foster Care, Residential Reconciliation, and CWAC Breakout Workgroups for Specialized Foster Care; (2) Child-specific meetings as needed; and (3) Clinical staffing and Child and Family Team Meetings as needed or requested.

iii. Educating and guiding DCFS and private agencies about how to find placements for children with significant emotional and behavioral and/or medically complicated needs.

iv. Facilitating specialized foster care, residential, and out of state placements, by collaborating with the DCFS medical director, health services and nursing team, and coordinating with DHS and YouthCare partners to provide care for medically complicated needs.

v. Serving as a support to the Clinical Division in working with specialized foster care, residential, and other specialty programs including but not limited to Project REACH, CATU, and Maryville Medically Complex.

vi. Serving as DCFS representative to external stakeholders working on developing and implementing policies and procedures for placement administration.

vii. Serving as a Senior Placement Administrator providing coaching and training to other placement administrators.

viii. Working with the Deputy Director to establish policies, procedures, and best practices for processes in the Child Services Division.

Justification: NU/MHSPP faculty and staff are uniquely positioned to provide DCFS with this technical assistance, and it would be time consuming and cost prohibitive to transition this work to another vendor. Dr. Epstein, Ms. Berg, Ms. Frank, Ms. Tichenor have deep knowledge of the structure and function of DCFS and the technical assistance they provide is critical to the Department’s operations. The data analysis staff who support this work have deep knowledge of using DCFS administrative data for quality improvement.

10. Asthma Management Project (AMP):

NU/MHSPP will partner with the DCFS Medical Director, Clinical and Child Services Division, and other stakeholders to adapt, continue implementing, and continue evaluating the Asthma Management Program developed under this scope of work in prior years. NU/MHSPP will complete analysis of collected data, disseminate results, and revise the program and program implementation plan as needed. NU/MHSPP will continue program implementation, evaluation, and dissemination. NU/MHSPP will work with the DCFS to engage YouthCare. Specific deliverables include:

a. Monthly meetings with the project advisory board to include the NU/MHSPP Faculty Lead, DCFS Medical Director, and other DCFS Clinical Division stakeholders to provide updates and for planning purposes.

b. Maintaining and updated permissions and continuing program implementation, data collection, data analysis, write-up, presentation, and dissemination of results.

c. Sharing lessons learned with the project advisory board and other key stakeholders, including YouthCare, which may be in a position to help increase program reach and sustainability.

Justification: NU/MHSPP has been involved in all aspects of the Asthma Management Program since its inception. NU/MHSPP staff are therefore the only vendors with the knowledge to adapt, continue implementing, and continue evaluating this program.

11. Technical Assistance for Youth in the Psychiatric Hospital Beyond Medical Necessity (BMN)

NU/MHSPP will provide technical assistance to the DCFS Clinical and Child Services division to support their efforts to prevent and care for youth in care who enter the psychiatric hospital and/or stay in the psychiatric hospital beyond medical necessity. Specific deliverables include:

a. Monthly meetings between NU/MHSPP Faculty Lead and DCFS Contact.

b. Quarterly and year-end reports.

c. Receiving from DCFS historical and new lists of youth in the psychiatric hospital beyond medical necessity.

d. Cleaning and merging those lists with other DCFS administrative data.

e. Organizing the merged data files to provide information about change over time in the number of these youth, describe these youth, their families, and their communities, and describe their “outcomes.”

f. Combining the merged files with information about all youth in care to examine if a statistical model can be built to help better identify youth at risk for hospitalization and being in the hospital beyond medical necessity.

Justification: The issues of youth in the psychiatric hospital being abandoned, therefore entering DCFS care, and then staying there beyond medical necessity and of youth in DCFS custody entering the psychiatric hospital and then staying there beyond medical necessity have been challenges for DCFS for many years. These issues are also part of the B.H. Consent Decree. NU/MHSPP is well positioned to provide this technical assistance. Dr. Epstein, the NU/MSHPP Faculty Lead for this project, is a licensed clinical psychologist and pediatric health services researcher with relevant clinical and methodological expertise and has been deeply involved in B.H. Consent Decree deliberations.

12. Systems Focused Review of Child Protective Services:

NU/MHSPP will collaborate with the University of Kentucky (UKY) and the University of Illinois at Urbana-Champaign (UIUC) to conduct a Systems Review of Child Protection Services designed to further advance DCFS’ mission of developing and improving a proactive system of supports for children and families in need of services. The overarching frame for the review is informed by Safety Science, a first such review for Illinois. Specific deliverables will include:

a. Participating in and helping plan team meetings with DCFS, UKY, and UIUC.

b. Recruiting and helping manage the advisory board, including participating in advisory board meetings.

c. Planning, collaborating on the implementation of, and implementing parts of the systems review of DCFS, with a focus on implementing a “review of existing reviews” and analyses of administrative data to be used by UKY for journey mapping.

d. Contributing to the development of interim and final reports to be delivered by UKY.

Justification: NU/MHSPP faculty and staff have deep knowledge of DCFS systems, processes, and administrative data and brings this expertise to the larger UKY team. Dr. Epstein is uniquely qualified to bring this expertise to the UKY team, as he already works with them in providing technical assistance to the Casey Family Programs-funded National Partnership for Child Safety, which also uses insights from Safety Science to understand problems in organizations as symptoms of deeper systemic issues in complex environments. Dr. Epstein and his team have existing relationships with DCFS that can facilitate collection of existing reviews, expertise conducting reviews of existing information, and have worked with the DCFS administrative data for many years.

13. Support of B.H. Consent Decree Initiatives (BH):

NU/MHSPP provides several types of support for initiatives related to the B.H. Consent Decree. There are multiple parts to this work. Specific deliverables include:

a. NU/MHSPP will support the Child Welfare Advisory Committee / Child Well-Being Sub-committee (CWAC-CWB) efforts to generate new information about child well-being and use that information to drive practice change by attending and participating in relevant meetings, reviewing existing literature, and designing and conducting analyses in collaboration with DCFS and other CWAC-CWB members. At DCFS request, NU/MHSPP will disseminate findings to DCFS and other system stakeholders. Also, at DCFS request, NU/MHSPP will provide DCFS administrative data to Dr. Steve Budde at the Juvenile Protective Association (JPA) as might be needed for JPA to conduct analyses for the CWAC-CWB.

b. NU/MHSPP will support DCFS efforts to develop, revise, and implement quality improvement plans for the Implementation Plan to Address Investigator Caseload part of the B.H. Consent Decree by attending and participating in relevant meetings, reviewing documents prepared by DCFS, consulting with DCFS Legal and Program Staff in their efforts to develop metrics and other reports, and by conducting ad hoc analyses for DCFS related to child protective services including, but not limited to, helping develop metrics for Consent Decree reporting, examining the impact of embedding law enforcement officers with investigators on selected teams, and the statewide elimination of cash bail.

c. NU/MHSPP will support DCFS efforts to develop, revise, and implement quality improvement plans for the Superseding Implementation Plan of the B.H. Consent Decree by attending and participating in relevant meetings, reviewing documents prepared by DCFS, and consulting with DCFS Legal and Program Staff in their efforts to develop implementation metrics and other reports.

Justification: Related to sub-part a, NU/MHSPP has been part of the Child Well-Being (CWB) Committee’s efforts to develop and implement independent measures of child well-being and oversee Immersion Sites since the work’s inception. The data files used in analyses and collaborative relationships across multiple institutions would be time-consuming and cost-prohibitive to transition to another vendor. Related to sub-parts b and c, Dr. Epstein is the only expert who is not a direct party to the Consent Decree and who has participated in all relevant meetings. Dr. Epstein is therefore the only individual who currently has the knowledge, skill, credibility, and working relationships with the Special Master, Expert panel, Plaintiff attorneys, and DCFS Legal and Program staff to engage work related to the Investigator Caseload Implementation Plan and Superseding Implementation Plan (SIP).

14. YouthCare Evaluation (YCE):

YouthCare is a specialized health plan designed cooperatively by the Illinois Department of Healthcare and Family Services (DHFS) and Department of Children and Family Services (DCFS) to provide health and behavioral health services to current and former youth in DCFS care. On February 1, 2020, YouthCare became the only Managed Care Organization (MCO) for current and former youth in DCFS care. DCFS began contracting with NU/MHSPP for an evaluation of YouthCare in SFY22 during which time NU/MHSPP established the evaluation advisory board, developed the evaluation protocol, and secured permissions to implement the evaluation. Specific deliverables will include:

a. Continue convening regular meetings of an evaluation advisory board to include representatives from DCFS and other key stakeholders.

b. Continue refining the evaluation protocol. Developing an evaluation protocol includes developing an evaluation logic model, metrics, and timelines. Regarding metrics, health and behavioral health metrics will be considered. DCFS has already expressed specific interest in behavioral health services metrics including, but not limited to, the utilization of inpatient psychiatric hospital, emergency room, care coordination, mobile crisis response, and HealthWorks services. DCFS has also expressed interest in developing metrics to examine processes such as prior authorizations and denials of service.

c. Continue maintaining and securing University, DCFS and other similar research review committee permissions. The evaluation protocol specifies data sources. In SFY22, efforts to establish Data Sharing Agreements (DSAs), Memorandum of Understanding (MOUs), or similar agreements with agencies other than DCFS, for which a DSA is already in place, were initiated. These agreements are usually submitted as supporting documents to IRB or similar approval applications. DSAs will need to be established for these data to be used and the evaluation protocol to be revised.

d. Purchase access to the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) or other similar sources of Medicaid data for use in project analyses. This is necessary because currently available information is incomplete; it does not, for example, include information about non-DCFS Medicaid-insured youth in Illinois or Medicaid-insured youth in other states, which are necessary for rigorous comparisons.

e. Contingent upon completing the activities described in sub-sections a. through c., begin data collection, management, analysis, and reporting.

Justification: P.A. 100-646 requires DCFS to report on measures of access to and quality of health care services for children enrolled in Medicaid Managed Care plans. The State’s decision to implement Medicaid Managed Care for youth in DCFS care has been controversial. In October 2020, Plaintiffs’ attorneys for the B.H. vs. Smith federal class action testified to the Illinois legislature about information they had received indicating that YouthCare had failed to solve some of the problems experienced by youth in DCFS care when trying to access healthcare and behavioral healthcare services. Taken together, the reporting requirements and controversy suggest that it is in DCFS’ best interest to contract an independent evaluation. NU/MHSPP generally and Dr. Epstein specifically are uniquely positioned to lead this evaluation. NU/MHSSP has a long track record of working with DCFS and DCFS administrative data. Dr. Epstein is the only expert who is not a direct party to the B.H. Consent Decree who has participated in relevant meetings and is therefore the only individual who currently has the knowledge, skill, credibility, and working relationship with the Special Master, Expert panel, Plaintiff attorneys, and DCFS Legal and Program Staff to engage this work. Selecting another Vendor would delay start-up and incur cost that should not be experienced with NU/MHSPP and Dr. Epstein.

15. SAFE Model Evaluation (SAFE):

The Safety Assessment Family Evaluation (SAFE) Model is a comprehensive safety decision-making model and intervention framework. DCFS began implementing the SAFE Model in 2023 and is contracting with NU/MHSPP for an implementation evaluation. Specific deliverables include:

a. NU/MHSPP will meet regularly with the DCFS liaison for this implementation evaluation.

b. NU/MHSPP will work with the DCFS liaison to establish an advisory group to plan the implementation evaluation. It is expected that the evaluation will include activities such as describing decision points and steps, collecting feedback from child welfare specialists, court personnel, and other internal and external stakeholders, and documenting fidelity, uniformity of implementation, and outcomes.

c. NU/ MHSPP will engage in implementation evaluation activities and deliver quarterly interim evaluation reports.

Justification: For the SAFE Model of safety decision-making by DCFS child protective services workers to be effective, it must be implemented uniformly and with fidelity. An independent description of implementation activities and the fidelity of those activities to the program model are necessary for documenting and adjusting implementation activities. NU/MHSPP is well positioned to provide this technical assistance. Dr. Epstein, the NU/MHSPP faculty lead for this project, is a licensed clinical psychologist and pediatric health services researcher with relevant clinical and methodological expertise. He currently oversees several program evaluations for DCFS and the provision of technical assistance in support of several DCFS implementations (e.g., CANS) that will need to be coordinated the implementation of the SAFE Model, if it is to achieve maximum effectiveness.