PO26-002 Trauma Health SOW.docx

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 for why the work should remain with NU/MHSPP.

Technology shall be used when practical to minimize in-person meetings and travel costs when possible. For purposes of this Contract, Videoconferencing, Teleconferencing, Zoom, WebEx and Video(ing) are used interchangeably. The following is a list of the projects:

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

2. Trauma Training and Consultation (TTC)

3. Technical Assistance for Residential Treatment and Residential Performance Measures (RTPM)

4. Technical Assistance for Service Provider Administration (SPA)

5. Intensive Placement Stabilization Evaluation (IPSE)

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

7. Data Collection and Administration (DCA)

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

9. Asthma Management Project (AMP)

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

11. Systems-Focused Review of Child Protective Services

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

13. YouthCare Evaluation

14. SAFE Practice 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 supervisors, Permanency Services child welfare specialists and supervisors, the Integrated Assessment program, the QRTP Independent Assessment program, the Intensive Placement Stabilization program, and the Wraparound program. NU/MHSPP will consult with the CANS developer to facilitate DCFS efforts to make revisions, update training materials, and develop decision support tools, as needed. NU/MHSPP will coordinate with other relevant stakeholders to ensure consistency with other initiatives, such as implementing the SAFE Practice Model, the Child Well-Being Indicators, and Illinois Connect. Specific deliverables include:

a. NU/MHSPP will regularly meet with the DCFS project contact(s) and, as needed, representatives from the different CANS implementations and stakeholders from other relevant initiatives to discuss version control, training and certification, post-certification use, and potential de-implementation.

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

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

f. NU/MHSPP will work with the CANS developer for training and certification of NU/MHSPP staff as CANS trainers and 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 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 in 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 Child Welfare Contributing Agency (CWCA) leadership for more than 10 years, and served as an administrator for various DCFS initiatives, including its CANS implementations, for more than 10 years.

2. 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.

3. 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:

i. Producing and distributing quarterly and as-needed RPM performance reports at the contract- (or agency-) and systemwide levels, including progress on measures: (a) Maltreatment in Residential Care, (b) Negative Discharge Rate, (c) Favorable Discharge Rate, (d) Time to Favorable Discharge, (e) Re-Entry to Residential Care, and (f) additional measures addressing priorities of the FFPSA and Monitoring Redesign for congregate care settings, as time and resources permit.

ii. Refining and enhancing RPM reports in collaboration with the Child Welfare Advisory Committee (CWAC) Data Test Workgroup as needed.

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

iv. Participating in monthly calls with DCFS to review and refine RPMs and address reporting issues.

v. Providing as-needed trainings, webinars, and other training materials on RPMs to monitoring staff and residential provider staff; and

vi. 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 or quarterly summaries of notable trends in congregate care administrative data (including information about both residential and ILO/TLP placements) 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 12/31/25.

iii. Producing monthly reports, including: (a) Independent Living Option/Transitional Living Program (ILO/TLP), (b) Shelter Report; (c) Agency List; and (d) Out of State Report, until these reports can be embedded into PowerBI by OITS.

iv. Producing weekly INI Report for Jill Tichenor and the Monitoring Unit, until this report can be embedded into PowerBI by OITS.

v. Facilitating timely transition to new data system through data testing and support.

vi. Supporting the transition of reporting on administrative/placement data from manual reports to automated reports ; and

vii. Generating new reports to address special topics/questions, as requested.

viii. Assisting monitoring in utilizing the new tools and capabilities in the new data system , including generating data and developing new reports. This may include in-person trainings or webinars.

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) and REDCap Compliance.

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.

4. 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 and other key stakeholders.

ii. Collaborating with the IL Department of Innovation & Technology (DoIT) to produce DPP and SPIDER utilization and quality of service reports as requested by DCFS

iii. Collaborating with DCFS and DoIT 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 provider 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 DoIT.

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, SPIDER, and BEACON databases and webtools by:

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

ii. Triaging DPP and SPIDER webtool end-user issues to appropriate DCFS/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 (DoIT, third party vendors) in mapping DCFS contracted services and non-contracted services to a master human services taxonomy selected by DCFS.

Justification: NU/MHSPP was a partner to the original Statewide Provider Database (SPD) and its current iteration, SPIDER. As a result, NU/MHSPP was also a partner to discussions and efforts to create the DPP, including validating FFPSA prevention service provider information into DPP in SFY22 and onboarding CWCA (nee 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.

5. 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 and other staff overseeing the IPS program.

b. NU/MHSPP will provide DCFS and other staff overseeing the IPS program with reports containing information about program fidelity and outcomes that are designed to be used by DCFS to guide program administration, as well as reports needed to satisfy DCFS’ reporting requirements for the B.H. consent decree.

c. NU/MHSPP will survey a sample of caseworkers with cases receiving IPS to assess their experience and satisfaction with the program.

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

6. 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, creating reports and tracking mechanisms for dually involved youth, engaging in other analytic work designed to help prevent youth from becoming dually involved and by helping DCFS identify best practices for working with dually involved youth. NU/MHSPP staff will create and maintain databases that DCFS can use to track information about dually involved youth and youth involved in human trafficking. Specific deliverables include:

a. Receive historical and new lists of youth RUR to DCFS in the CCJTDC.

b. Clean and merge those lists with other DCFS administrative data.

c. Analyze the merged files and prepare and deliver a monthly report describing youth RUR to DCFS and provide information about change over time.

d. Analyze CYCIS and SACWIS file and prepare and deliver a monthly report describing youth who have been detained and/or incarcerated and provide information about change over time.

e. Analyze the merged files and prepare and deliver a semi-annual report that describes results of statistical analyses designed to better identify youth at risk for incarceration and/or detention.

f. Lead quarterly meetings with the project’s DCFS contact to review monthly and semi-annual reports and identify necessary changes or additions to include in subsequent versions.

Justification: NU/MHSPP staff have worked 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.

7. 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 the NU/MHSPP faculty and staff working this project to create a database of information from CYCIS, SACWIS, and other sources that is used by faculty and staff on some of the other projects in this program plan to produce those project’s deliverables, to prepare files for non-contracted projects with DCFS permission, and preparing files for delivery to other University partners at DCFS’ request. Specific deliverables include:

a. Convening a quarterly 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 until this responsibility has transitioned to DCFS or DoIT.

i. Facilitate the DCFS PowerBI User Group until this responsibility has transitioned to DCFS or DoIT.

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 cannot 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 impede 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.

8. 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 Deputy Director for the Division of Clinical Practice to support their efforts to establish a clear mission and vision for the Division, revise clinical staffing protocols, and implement 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 other relevant staff 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 and the Psychiatry and Psychology Program Director to support their efforts to manage secure care and the secure care assessment program. Deliverables include providing a quarterly report combining information about secure care assessments with CYCIS/SACWIS information to help identify youth at risk for secure care.

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, and 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.

9. Asthma Management Project (AMP):

NU/MHSPP will continue to provide the existing asthma management program to eligible youth in care and collect information that can be used to monitor the program’s implementation and evaluate its impact. Activities will include project leadership, strategic partnership, data surveillance, communication, and program evaluation. Specific deliverables include:

a. Provide asthma management program services to all qualifying youth in care to reduce emergency department visits and hospitalizations due to poorly controlled asthma. Services will include asthma education for foster parents and care teams, home visit assessments and risk evaluations, and developing individualized asthma management tools to improve care and reduce disparities.

b. Lead monthly meetings that will include the NU/MHSPP Faculty Lead, the project’s DCFS contact, and other strategic partners that the project’s DCFS contact requests to attend. Leading the meeting includes scheduling, developing an agenda circulated beforehand, and taking notes that include planned next steps.

c. Provide the project’s DCFS contact with a monthly report that can be used to monitor youth in the program. This report will include information for each child enrolled in the program and document the child’s identifying information, as well as the date of program enrollment, date of program discharge, reason or type of program discharge, date(s) of the delivery of various program components, date(s) of emergency room visits due to asthma, if any, and dates(s) of hospitalizations due to asthma, if any. This report will be updated, securely transmitted, and reviewed monthly with the project’s DCFS contact. If the DCFS contact requests revisions during the monthly review, they will be included in the next month’s report.

d. Deliver a quarterly report compiling information from items a – c into a cumulative program implementation description and outcomes summary. In addition to the information in items a-c above, the quarterly report will also include 1) the number of client referrals (# accepted, # denied, # not eligible upon further review), 2) the number of clients completing the program (# withdrawing, reasons for withdrawal), 3)# of ED visits for children enrolled in the AMP 4) # of hospitalization for children enrolled in the AMP 5) describing what was done in the quarter and progress made addressing implementation barriers, 6) describing what was identified as a reason for clients eligible to deny entry in program, and 7) describing proposed solutions to barriers including needs for strategic or program shifts to better serve youth.

e. By the end of the first quarter of the state fiscal year, develop and deliver to the project’s DCFS contact a proposal to expand the program in the subsequent fiscal year that is responsive to the project’s DCFS contact’s stated goals for the program.

Justification: NU/MHSPP has been involved in all aspects of the Asthma Management Program since its inception. It would, therefore, be time-consuming and cost-prohibitive to transition this work to another vendor, as NU/MHSPP staff are currently the only vendors with the knowledge to continue implementing and evaluating this program.

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

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

g. Receive historical and new lists of youth in the hospital beyond medical necessity from DCFS.

h. Clean and merge those lists with other DCFS administrative data.

i. Analyze the merged files and prepare and deliver a monthly report describing youth in the hospital beyond medical necessary and provide information about change over time.

j. Analyze the merged files and prepare and deliver a semi-annual report that describes results of statistical analyses designed to better identify youth at risk for hospitalization and BMN hospitalization.

k. Lead quarterly meetings with the project’s DCFS contact to review monthly and semi-annual reports and identify necessary changes or additions to include in subsequent versions.

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.

11. Systems Focused Review of Child Protective Services:

NU/MHSPP will collaborate with the Center for the Helping Professions (CHiP) 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. Continuing to participate in and help plan team meetings with DCFS, CHiP, and UIUC.

b. Continuing to recruit and help manage the advisory board, including participating in advisory board meetings.

c. Continuing to plan, collaborate on the implementation of, and implement parts of the systems review of DCFS, focusing on implementing a “review of existing reviews” and analyses of administrative data to be used by CHiP for journey mapping.

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

Justification: NU/MHSPP faculty and staff have deep knowledge of DCFS systems, processes, and administrative data and brings this expertise to the larger CHiP team. Dr. Epstein is uniquely qualified to bring this expertise to the CHiP 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.

12. 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 JPA might need 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 and examining the impact of embedding law enforcement officers with investigators on selected .

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).

13. 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 from the project’s DCFS contact and other key stakeholders.

b. Continue refining the evaluation protocolincluding logic model, metrics, and timelines. 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.

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. Continue data collection, management, analysis, and reporting by providing quarterly reports to the project’s DCFS contact.

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.

14. SAFE Practice Model Evaluation (SAFE):

The Safety Assessment Family Evaluation (SAFE) Model is a comprehensive safety decision-making practice model and intervention framework. DCFS began implementing the SAFE Model in 2023 and began contracting with NU/MHSPP for an implementation evaluation in SFY25. 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. 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 Practice 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.