System of care glossary - Principles, Terms, and Acronyms
Accessible - (system of care principle) if services are accessible, then they are affordable, located near the population to be served, and offered during evenings and weekends. Services are family friendly through an "open door," with as little restriction as possible. The system can handle demands for service without long waiting lists.
Accountable - (system of care principle) if service providers are accountable, then they answer to a people respresenting the community and/or a "watchdog" advocacy group and are responsible to the funding agency or agencies for meeting requirements of the grant. The system uses data and evaluation responsibly to demonstrate teh value of teh program at all levels.
ADHD - (Attention Deficit-Hyeractivity Disorder) - A common diagnosis given to children that are unable to pay attention in school or other activities, act like they are "driven by a motor", and/or are easily distracted and impulsive. These behaviors impact the child's home, school, friendship, and overall functioning. The disorder is often treated with medication and counseling.
AIR - American Institue of Research
"The Branch" - A short term usually used to refer to the Child, Adolescent and Family Branch, which is the specific section within the Center for Mental Health Services (CMHS) that is responsible for administering the Circles of Care Grant and within the CMHS tribal service grantees. (See also NICWA community development specialist). CAFB - Child, Adolescent and Family Branch
CCC - Council of Collaboration and Coordination
CLC - Cultural and Linguistic Competence
CMHS - (Center for Mental Health Services) - One of three centers within the federal Substance Abuse Mental Health Service Administration, which offers grant programs including Circles of Care and the Comprehensive Community Mental Health Services Program for Children and Their Families grant programs. This center leads federal efforts to treat mental illnesses by promoting mental health and by preventing the development or worsening of mental illness when possible.
CMHS Project Officer - The person the Circles of Care project director contacts for questions about grant requirements, budgets, budget modifications, quaterly reports, annual re-application procedures, notification of key personnel changes, and other issues related to fulfilling grant responsiblities.
CMS - (Center for Medicare and Medicaid Services) - The federal agency within the Department of Health and Human Services that is responsible for serving Medicare and Medicaid benficiaries through contracting
CMHS - Center for Mental Health Services
CoC (Circles of Care) - A three year planning and evaluation grant offered to Indian tribes and urban Indian programs through the Substance Abuse Mental Health Services Administration (SAMHSA) for the purpose of developing model systems of care for children's mental health in Indian communities.
CoCETAC Staff Members - The people to contact for questions and assistance with evaluation tools such as the Service System Description, Community Needs Assessment, Feasibility Assessment, Outcome measurements Plan, evolution of the planning process, negotiating with Institutional Review Boards, evaluatior site-visits and other issues related to the evaluation aspect of the grant.
Commissioned Corps - This specialized career system of over 6,000 health professionals is lead by the U.S. Surgeon General and is one of the seven uniformed services of the United States. Operated within the Department of Health and Human Services (DHHS), it employs health professionals who may be assigned to federal agencies such as Indian Health Service (HIS), state or local agencies such as NICWA in accomplishing the DHHS mission.
Community-based - A system of care principle that promotes programs that offer services within the child's home community by providing a network of services for youth and their families. The unique values and strengths of the community are utilized to guide those services and the system to fit the needs of the community.
Coordinated and Collaborative - A systems of care principle that promotes direct service level, care providers and the family working together to create a plan of care that meets the child's needs. Organizations including mental health, education, juvenile justice, child welfare, and other natural helping systems work together toward a common goal or vision. Open communication allows each person to play a unique role in the combined effort and avoid "turf issues" among professions.
Culturally Competent - A principle of the system of care movement defined by individual service providers who are capable of working effectively in situations of cultural difference and agencies or systems as a whole who are able to work effectively with cultural differences through a complete set of practive skills, attitudes, policies, and structures that value diversity.
DHHS (Department of Health and Human Services) - The principle agency in the federal government for protecting the health of all Americans and providing essential human ervices, especially for those who are least able to help themselves.
DOJ (Department of Justice) - The federal department whose mission is to enforce the law and defend the interests of the United States according to the law, to provide federal leadership in preventing and controlling crime, to seek just punishment for those guilty of unlawful behavior, to administer and enforce the nation's immigration laws fairly and effectively, and to ensure fair and impartial administration of justice for all Americans.
DSM-IV - (Diagnostic and Statistic Manual, fourth edition, text revision) - The book used by mnetal health professionals, which defines and classifies the full range of mental disorders, provides a common language, and is used to diagnose mental illness for the purpose of reimbursement.
Encounter Rate - A special negotiated rate for Medicaid payments that is availabel to IHS and tribally contracted health programs to help cover the cost of providing services. The rate is paid for one health "encounter" or service per day regardless of which type of service is provided. A federal Memorandum of Agreement (MOA) between IHS and FCHA that allows the funds to bypass the state portion of the Medicaid system.
Family Focused - A systems of care principle that says help must be designed for the specific needs of each individual child within their family. The focus of services is on supporting and strengthening the family. Families play an active role as partners at all levels in the system from service delivery to program planning.
Federation of Families - A well-established national non-profit organization based in Washington D.C. which provides and sustains leadership for a broad and deep neationwide network of family-run organizations. The organization focuses on being a potent force for change on behalf of children with mental health needs and their families. They are passionate advocates at the national level for the rights of these children and families and partner with a variety of federal, state, and local organizations to assure that family voices fromt he level of the child to the politician are "at the table" from the level of the child to the politician.
Graduated Sites - Grantee communities who are no longer funded by CMHS grants, such as the first round of the Circles of Care Grantees who were funded 1998-2001.
GFA (Guidance for Applicants) - A document published by the federal government that provides direction for organizations to apply for federal funding opportunities. This document identifies the program goals and objectives, the target population, eligibility for applicants, use of funds, and instructions on writing the narrative and application dates.
HCFA (Health Care Finance Administration) - The former federal agency within the Department of Health and Human Services that was responsible for serving Medicare and Medicaid beneficiaries through contracting and administering legislation. Since July 2001, the agency has become the Center for Medicare and Medicaid Services (CMS).
HIPAA (Health Insurance Portability and Accountability Act of 1996) - This law is designed to protect health insurance coverage for workers and their families when they change or lose their jobs. It limits the application of pre-existing condition clauses and imposed requirements concerning mental health parity. HIPAA section of Privacy and Security Rules also requires the establishment of new policies and procedures to ensure patient confidentiality.
ICWA (The Indian Child Welfare Act) - The federal law passed in 1978 that was designed to protect the most valuable resource in American Indian and Alaska Native communities - their children. The act sets standards and guidelines to prevent the unnessary removal of Indian children from their homes and guidelines for placing children in Indian homes when removal is necessary. It also gives tribes the right to intervene in issues of child welfare.
IHS (Indian Health Service) - The federal agency that is under the Department of Health and Human Services, whose primary mission is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. The Behavioral Health Program at Headquaters East is a key partner with CMHS in the Circles of Care initiative.
Individualized - A principle of the systems of care movement that says services must be uniquely tailored to meet the specific needs of each individual child and family. Caregivers utilize the child and family's unique strengths to develop care plans. Great care is taken to avoid placing children in program "slots" based on service availibility and funding streams.
Inter-Agency - A principle of the systems of care movement that says services must be provided by more than one agency to meet the broadest range of needs and offer broadest range of services possible for children and their families. Signed memoranda between agencies are often used to formalize these efforts.
Intertribal Voices of Children and Families - An Native American operated, private non-profit organization based in North Dakota that was established in 2001 as a family advocacy group for Native American families of children with severe emotional disturbances. Their long-range goal is to establish local chapters across the country and to train parents to be better advocates for their children.
IRB (Institutional Review Board) - An independent board of professionals lay citizens who must approve research that involves "human subjects," whose purpose is to ensure that people will be treated ethically and that the design of the research does not violate any person's rights. These boards are operated locally and often associated with a university or an Indian Health Service area office.
Least Restrictive - A system of care principle, which states that children and adolescents must be served in as normal an environment as possible. Interventions are those that provide the needed services and, at the same time, are minimally intrusive in the normal day-to-day routine of the child and family. The goal is to maintain as many children as possible in their own homes.
Medicaid - A jointly funded federal-state health insurance program for certain low-income and needy people. It covers approximately 36 million individuals including children; the aged, blind, and/or disabled; and people who are eligibile to receive federally assisted income maintenance payments.
MOA or MOU (Memorandum of Agreement or Memorandum of Understanding) - A formal document signed by the directors of at least two different organizations in order to define how those organizations agree to work together to meet a common goal. This document often outlines the sharing or exchange of resources (funding, personnel, space, or services) and clarification of roles, responsibilites, and procedures.
NICWA (National Indian Child Welfare Association) - An Indian-operated, private non-profit agency based in Portland, Oregon that is contracted through the Center for Mental Health Services to provide technical assistance to Circles of Care grant communities and tribal grantees that have received the six-year Comprehensive Mental Health Services for Children and Their Families service implementation grants.
NICWA Community Development Specialist - The people to contact with questions and for assistance with issues related to program development such as specialized training in system of care related issues or integration of cultural resources; questions and assistance related to community development, and family involvement in the implementation of grant goals; and for questions about grantee meeting logistics.
NOFA (Notice of Funding Availibility) - A document published by the federal government that provides direction for organizations to apply for federal funding opportunities. This document identifies the program goals and objectives, the target population, eligibility for applicants, use of funds, and instructions on writing the narrative and application dates.
OJJDP (Office of Juvenile Justive and Delinquency Prevention) - An office within the Department of Justice whose mission is to provide national leadership, coordination, and resources to prevent and respond to juvenile delinquency and victimization. The office supports states and local communities in their efforts to develop and implement effective and coordinated prevention and intervention programs and improve the juvenile justice system. The office is one of the federal partners in the Indian Children's Mental Health Initiative.
PHS (Public Health Service) - The federal personnel system within the Department of Health and Human Services made up of both a Commissioned Corps and Civil Service professionals and support staff, which supports the mission fo the Department through a federally supported public health system.
Promising Practices - This usually refers to a set of books that CMHS sponsors on different topics related to systems of care as it is being applied in communities across the country. They are designed to highlight the practices of agencies that seem to be "promising" of success. A book was written on the accomplishments of the first round of Circles of Care grantees. A Special issue of the Journal of the Natinonal Center for American Indian and Alaska Native Mental Health Research, Volume 11, No. 2 (2004) was published summarizing the learning of teh second round of Circles of Care grantees.
PTSD (Post-Traumatic Stress Disorder) - A diagnosis made in children or adults that is a result of child abuse, experiencing or witnessing other traumatic events such as violence, that a person continues to relive in their minds. It is characterized by disturbing memories, recurring nightmares, sleep problems, and avoiding situations, which may remind them of the event(s). Children will often "act out" the event or show distressed behavior.
Relational Worldview (RWV) - A theoretical model developed by NICWA's director, Terry Cross, which continues to be refined in practive by NICWA staff and is a reflection of the Native concept of balance as the basis for health. This model serves as a philosophy and approach to providing technical assistance by community development specialists.
SAMHSA (Substance Abuse Mental Health Service Administration) - a federal agency under the Department of Health and Human Services charged with improving the quality and availibility of prevention, treatment, and rehabilitative services in order to reduce illness, death, disablity, and cost to society resulting from substance abuse and mental illnesses.
SCHIP (State Children's Health Insurance Program) - SCHIP, created by the Balanced Budget Act of 1997, allows States to expand health insurance to children whose families earn too much to qualify for Medicaid, yet not enough to afford private insurance. All states are participating in this State-Federal partnership.
SED (Severe Emotional and Behavioral Disturbance) - A term describing serious mental illness in children that may include depression, behavioral issues, and impaired functioning in a number of areas of life. The Circles of Care grant program allows communities to define this term in a way that fits the culture of the community.
SoC (Systems of Care) - This abbreviation is sometimes used to refer to the tribal grantees that have received the six-year service implementation grants through SAMHSA's Comprehensive Mental Health Services for Children and Their Families grant programs.
Stakeholders - People who have an interest, or "stake," in success of the local Circles of Care initiative such as staff members; agency directors from mental health, child welfare, schools, juvenile justice, health services; concerned community members; traditional healers; council or board members; parents or relatives of children with emotional disturbance; children or youth who have suffered with emotional disturbance; state or county agency directors and other potential individuals.
System of Care - A method of delivering comprehensive mental health services that helps children and adolescents with mental health problems get the full range of services in or near their homes and communities. These services must be tailored to each individual child's physical, emotional, social, and educational needs. In system of care, local organizations work in teams to provide these services and avoid children "falling between the cracks,"
TA (Technical Assistance) - The process of empowering people to develop and operate effective sustainable programs through the use of consultation, training, facilitation, resource development and evaluation. These services are based on an organization's needs with the aim of meeting their program or project goals.
TA Plan - The formal process and document that is cooperatively developed between the Circles of Care project director and their assigned NICWA community development specialist in order to guide specific requests for TA services and meet the unique needs of the community in meeting the project goals. NICWA staff use the Relational Worldview as a basis for assessing and planning TA services.
TANF (Temporary Assistance to Needy Families) - A program created by the Welfare Reform Law of 1996. TANF became effective July 1, 1997, and replaced what was then commonly known as welfare: Aid to Families with Dependent Children (AFDC) and the Job Opportunities and Basic Skills Training (JOBS) programs. It offers families temporary financial assistance and Medicaid insurance while they are preparing to find work. States run the programs with federal funds through DHHS.
Target Population - The population, or group of people, who are to be served by a program. In the Circles of Care grant, this group is defined as tribal and urban Indian children and adolescents under the age of 22 years and their families, who are at risk of or are experiencing severe emotional or behavioral disturbance. The child is affected in their level of functioning in some way and it is expected to last more than a year if untreated.
Wraparound - This refers to tribal programs that have taken over control of providing services that would usually be provided by IHS, in order to exercise their tribal sovereignty rights and provide services in a way that the tribes see fit for the communities. The federal law that allows for this contracting was passed in 1972 as Public Law 638, the Indian Self Determination Act.