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Transforming NJ’s System of Care Through Collaborative Efforts

A system of care is a big picture approach to how, when, and where services and supports are offered. The System of Care approach to service delivery for children began in the 1990s as communities were looking for ways to improve the well-being of children with serious emotional and behavioral disorders. It is important to note that not all states have Systems of Care on a statewide level, as some are local or county-based (see Resources).

Initial Efforts: Originally, the State of New Jersey had a vision for a single point of entry for children’s mental health needs. Stakeholders, such as state human/social services departments and divisions, providers, family organizations such as the Statewide Parent Advocacy Network and the NJ Parents Caucus, families, and advocacy organizations such as the Association for Children of NJ (now Advocates for Children of NJ) sought to streamline the various silos of services available to children with mental illnesses. This culminated with the State of New Jersey establishing the Department of Children and Families (DCF) in 2006.

DCF is the first Cabinet-level department in New Jersey devoted exclusively to serving and safeguarding the most vulnerable children and families of our state. This also means that children’s services were now housed in one department, creating an ease of access for stakeholders and consumers.

Consolidation of Efforts: The New Jersey Children’s System of Care (NJ CSOC) is a division of the New Jersey Department of Children and Families. Previously known as the Division of Child Behavioral Health Services, the vision of NJ CSOC first began as a federal grant program in 1999. In 2006, along with input from families, NJ CSOC was transitioned to be a part of DCF, and was expanded to provide services statewide.

The New Jersey Children’s System of Care partners with PerformCare, a company that has served as the Contracted System Administrator for NJ CSOC since 2009. PerformCare provides 24/7 access for families, and coordinates care for over 50,000 of New Jersey’s children a year.

Some of the services to which NJ CSOC PerformCare can help families connect include: Care Management Organizations (CMO); Family Support Organizations (FSO); and Mobile Response and Stabilization Services (MRSS)

Care Management Organizations (CMO) are county-based, nonprofit organizations, responsible for face-to-face care management and comprehensive service planning for youth and their families with intense and/or complex needs. The CMO uses a wraparound approach to planning for each youth and provides a single point of accountability for the services and the supports needed to maintain stability.

Family Support Organizations (FSO) work collaboratively with PerformCare, Care Management Organizations, state agencies, and other providers to offer face-to-face family support to families and ensure that the System of Care is responsive to the needs of children and families.

FSOs work closely with families to provide support from their own shared experiences, offer guidance on ways to maximize available resources, make connections to other community supports, and facilitate advocacy to make sure a family’s needs are heard. The NJ Alliance of Family Support Organizations, NJs Federation of Families for Children’s Mental Health State Organization, provides support to the network of 15 FSOs.

In New Jersey, information and support for parents is available at the county level and can be accessed at www.njfamilyalliance.org. The site is available in several languages via a dropdown in the top left corner.

Mobile Response and Stabilization Services (MRSS) are available for all children in crisis situations related to their behavioral or emotional needs, and/or intellectual or developmental disabilities.

MRSS staff will respond to the crisis, in person, within one hour of a call to PerformCare. Typically, the crisis is occurring in the home, but if it occurs outside the home and a parent is able to be present, MRSS staff may be available to assist in person.

With the input of the family and, when possible, the youth, MRSS staff help address the immediate crisis, identify family strengths and needs, and work to develop a plan to address the cause of the behavioral crisis.

Current Trends: The NJ CSOC has always provided supports to youth with behavioral health challenges in the community as well as to those involved with child protective services.

In recent years, NJ CSOC also began serving children with developmental and/or intellectual disabilities and their families, and providing coordinated access to substance abuse treatment services for eligible youth. By consolidating these services in one division, it creates an ease of access for families in need.

One of the most promising recent developments at NJ CSOC is the formation of a Family Leader workgroup. Parents, guardians and caregivers volunteer on this workgroup to represent the voices of other families involved in the System of Care. Family Leaders bring system issues to the attention of PerformCare’s leadership, which is in turn shared with NJ CSOC to ensure that the family perspective is included in service delivery decisions.

Families can also obtain information from the NJ CSOC Youth and Family Guide, which is available in both English and Spanish at http://www.performcarenj.org/families/youth-family-guide.aspx.

Transition: NJ CSOC serves youth until their 21st birthday, with a few exceptions. While services and interventions are designed to maximize the strengths and abilities of the youth and families served, NJ CSOC recognizes that a substantial number of youth will require ongoing supports as adults.

Transition to adult services for behavioral health and substance use is handled by the New Jersey Division of Mental Health and Addiction Services (DMHAS). DMHAS is the state mental health authority that plans, monitors, evaluates and regulates New Jersey’s mental health and substance abuse prevention, early intervention, treatment and recovery efforts. You can visit the DMHAS website at www.state.nj.us/humanservices/dmhas/home.

New Jersey’s Division of Developmental Disabilities (DDD) provides public funding for services and supports that help New Jersey adults ages 21 and older with intellectual and developmental disabilities live as independently as possible. Services and supports are available in the community from independent providers, and in 5 state-run developmental centers. Additional information on DDD can be found at www.nj.gov/humanservices/ddd/home.

By having a vision and bringing together various stakeholders, NJ CSOC has developed into a more streamlined system for families. Listening to the voices of families has helped with continuous quality improvement.

Lauren Agoratus is the parent of a child with autism/kidney disease. She is the NJ Coordinator of Family Voices, the national network that works to keep families at the center of children’s health care for children with special healthcare needs; in NJ, Family Voices is housed at the Statewide Parent Advocacy Network (SPAN), www.spanadvocacy.org. SPAN is also the home of the state’s Family-to-Family Health Information Center. Lauren can be reached at (800) 654-SPAN or by email at familyvoices@spannj.org. Families can find free help in their state at www.familyvoices.org/states.php. Tatsiana DaGrosa is a Parent Group Specialist for the START Project (Statewide Technical Assistance Resource Team) at SPAN where she helps parents start and run local special education support and advisory groups. She also served as an SSRP (Superstorm Sandy Resiliency Project) Family Resource Specialist.

Special thanks to Matthew Franke, Senior Communications Specialist at PerformCare, for his review and revisions on this topic.

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