CA Strategic Plan Recommendations Public Support Youth Involvement & Development Access to Care Service Coordination Families Communities Schools Data     Outcome Areas Injury Prevention Mental Health and Suicide Nutrition & Physical Activity Alcohol, Tobacco & Other Drugs Teen Pregnancy & STI’s Oral Health Environmental & Occupational Health Out of Home Youth – Resources on Mental Health	Service Coordination | Overview   Coordinate service delivery systems for teens   This is Chapter 2, Recommendation 4 of California's adolescent health strategic plan. To view the full plan, click here. Each time a teen accesses health care or services of any type, there is an opportunity to link him or her with other services or support systems. Teens and their families should be able to access a broad array of services from multiple entry points. These entry points might include recreation programs, social service agencies, public health clinics, schools, or the juvenile justice system. Linkage with the educational system is particularly important because it offers the potential to reach youth and families before, or soon after, the first signs of difficulties occur.48 Improving the integration of services involves changing conditions for service providers and improving coordination at the administrative level.           Barriers to coordination among service providers     The human service system lacks resources at all levels, resulting in limited time to devote to each client. For medical providers, pressure to see a large volume of patients makes it difficult to conduct the type of comprehensive assessments that are needed. Similarly, social workers have notoriously high case loads; teachers have large classes; and school nurses cover multiple schools. The system is stretched in all directions and cannot function to its full potential.           Once teens make contact with any service system, comprehensive needs assessments are an essential first step in providing integrated services. However, some providers lack the skills or comfort level to venture beyond their realm of expertise. Most training programs—whether in medicine, education, or law enforcement—do not prepare practitioners to address the full range of adolescent needs. Teachers have not been trained to identify signs of eating disorders; general practitioners have little preparation for discussing sexuality with teens; and law enforcement officers do not learn to screen for mental illness.           Moreover, in some settings, there are limited incentives for practitioners to conduct comprehensive screenings. Some adults who work with teens are reluctant to uncover problems because, without referral relationships or a collaborative team approach in place, they fear the responsibility for addressing the problems will fall exclusively to them. Finally, providers in many communities lack information about additional resources available to adolescents. Without this information, their ability to make appropriate referrals is limited.           Barriers to coordination at the state and county levels     Lack of an overall plan at the state level to create a network of health, social and educational services to support adolescents leaves communities to cobble together a patchwork of independent interventions. Health services, for example, are funded primarily through reimbursement for discrete services, providing no impetus to craft broader systems of care that meet the needs of adolescents in a comprehensive manner. Similarly, services run by school districts and community agencies are funded through many separate and uncoordinated grants.           In large measure, this situation results from the fact that the government agencies that administer the vast majority of health and social service funds are not structured in a way that facilitates the efficient delivery of services to youth. Funding for youth services is often fragmented into many narrow categories by statutory language at the federal and state levels, limiting public funds to similarly narrow uses. When funding comes in disease- or issue-specific categories, such as HIV, substance abuse, or nutrition, programs tend to be developed in isolation from each other. Many counties and service providers would like to create more cohesive service systems, but often fight an uphill battle when faced with bureaucratic restrictions dictating how money should be spent or how services should be provided.           Improving this situation at the state level would require state agencies to engage in joint planning and coordination of programs. Yet there are few incentives for state programs to do so. Similarly, at the local level, there is considerable room for planning and coordination in most counties. Although counties are constrained by requirements at the state level, they have some ability to blend funding and/or create administrative structures that improve service coordination. Counties participating in the Youth Pilot Project (AB 1741) have been able to waive certain regulations to better coordinate services for some youth. With private funders playing an increasingly important role in the health field in California, increased communication between public and private sector funders also is needed to improve service coordination.           Strategies           1. Create connections between services and service providers.     Expand use of strategies for care coordination such as case management, “one-stop shopping,” family resource centers, school-based health centers, and a continuous medical home concept. Develop local provider and referral guides for issues common in adolescence. Promote a culture among service providers in which collaboration is the norm so that more service providers meet on a regular basis, apply for funding jointly, coordinate their services, and maintain referral relationships.           2. Coordinate administrative structures.     Create mechanisms at the state and local levels to authorize departments/agencies to change statutes. Waive regulations to improve coordination and effectiveness of youth-serving programs and systems. Identify opportunities to support service integration by: conducting inventories of youth-serving programs and funding streams; identifying successful practices in service integration at the national, state, or local level; and identifying opportunities for interdepartmental coordination and key barriers to change. This process should involve top-level administrators, build in incentives to increase participation, and reduce competition and fear of change. Develop a more coordinated approach to planning and funding youth services by strengthening communication between public agencies and private funders. Create administrative and fiscal incentives for local demonstration projects and other innovative efforts in coordination and collaboration. Assist local agencies in developing accounting procedures that enable them to blend funding while providing accurate financial reports for separate funding Source.           3. Fund and support a system of local adolescent health coordinators.     Use local coordinators to promote best practices and coordinated approaches to adolescent health. Some of their functions might include disseminating information to policymakers and practitioners, convening stakeholders, serving as liaisons to the state, and participating in policy development.     Click here to view references

About Us | Events | Sign-up | Publications | Feedback | Order Publications | Home