Funders focus on disconnected youth in the District

By Rebekah Seder, Program Manager

At the last Children, Youth, and Families Working Group meeting, members focused on the mental health needs of teens – particularly youth in the juvenile justice or child welfare systems, parenting teens, and youth otherwise disconnected from their families, schools, or needed services. Judith Sandalow, executive director of the Children’s Law Center, Dr. Lee Beers, director of the Healthy Generations Program at Children’s National Medical Center, and Mark Sweeney, executive director of the Capital Region Children’s Center, discussed the critical need for high quality mental health services for youth, the gaps in service in D.C., and the role the philanthropic community can play in improving the system.

The Healthy Generations Program at Children’s National Medical Center, which provides integrated and comprehensive medical, mental health, and social work services for teen parents and their children, and Capital Region Children’s Center, which provides mental health wraparound services to children and families, are recognized as providing high quality, evidence-based services with positive outcomes for their clients. However, due to funding limitations, their reach is limited to hundreds of families rather than the thousands of District children and families in need.

All three speakers emphasized the importance of early intervention in treating mental health issues, and the positive impact that quality, community-based treatment can have on the life of young adults. Unfortunately, of the estimated 11,000 kids in D.C. in need of mental health services, little more than half receive any services at all. Moreover, existing Medicaid reimbursement guidelines do not allow for services to be delivered in the evidence-based manner that is most effective for teens – for instance, through home visits or by providing mental health services in the same location and at the same time as medical services.

According to the speakers, there is a clear role for the philanthropic community to play in reforming the children’s mental health system in D.C. One of the biggest challenges facing the medical and nonprofit providers supporting disconnected youth is the sheer complexity of the bureaucracy of the city’s Medicaid program, which covers over 75 percent of children in D.C. While there are a number of strong and replicable programs already serving youth, there is a dearth of quality service providers, and far too many young people go without needed services.

Large scale impact requires an increase in public, in addition to private, funding, and this can’t be achieved without systemic reform of the Medicaid system in D.C. Many of the bureaucratic barriers are technicalities that with sufficient political will could be changed. By lending its support to advocacy efforts for reform, the philanthropic community would have a much greater impact on improving the lives of youth in the District.


WRAG members: Summaries of past meetings on children’s mental health are available here.

Funders explore early childhood mental health

By Rebekah Seder, Program Coordinator

This month, the Children, Youth, and Families Working Group dove deeper into its children’s mental health agenda, with a discussion of issues surrounding the mental health of children from birth to age three and their primary caregivers, and the services and supports needed to help families create a healthy environment for themselves and their young children.

Tamara Halle, a child psychologist and researcher with Child Trends, gave an overview of research into the impact of early childhood years on an individual’s social and emotional competency throughout life, emphasizing that the bonds between children and their parents or other caregivers set the stage for later social interactions. For this reason, problems that affect the bonds between children and their caregivers, such as poverty, homelessness, substance abuse, or maternal mental health issues, can have a significant impact on children’s emotional well-being.

Maria Gomez, founder and CEO of Mary’s Center, discussed the relationship between poverty, maternal depression, and children’s mental health, and the critical importance of very early assessment and intervention in mitigating the impact of mental health issues in young children and their mothers. In her experience, addressing a woman’s mental health before her child is born is the best way to ensure that children don’t develop similar issues of their own in later years. Mary’s Center, which does mental health assessments on all of its clients, has found that almost 100% of pregnant women they serve show signs of depression, and that 80% of mental health issues are related to poverty. This highlights the interrelated nature of mental health and economic security: as Gomez noted, if parents are healthy and feel good about themselves, they are stronger parents and better able to move their families out of poverty. Gomez strongly believes that all publicly funded health centers should include basic mental health assessments as a component of the medical services they provide.

Members also heard from Marti Worshtil, Executive Director of the Prince George’s Child Resource Center, about the Center’s simple, but highly effective, intervention program for young children in childcare settings who display behavioral issues. The program provides a social worker to do an assessment of the child and their childcare provider, works directly with the child and family, trains their childcare providers on how to more effectively engage the child, and provides referrals to community agencies. The program has succeeded in reducing the preschool expulsion rate from six to 1.2 children out of 1,000, and its biggest obstacle moving forward is the very high demand for its services.

There is an important role for philanthropy in promoting children’s mental health in the region. As Gomez emphasized, there is a need for greater outreach services to engage people in the community who need mental health services, as well as workforce training and improvement of mental health workers. In addition, philanthropy can play a key role in advocating for systemic integration of health, mental health, and other services to ensure that people can easily receive the support that they need.

CYF Takes an In-Depth Look at Mental Health Services Across the Region

At a recent meeting, the Children, Youth, and Families Working Group were given a detailed look at children’s mental health systems in each state. The District and Virginia both suffer from unnecessarily complex systems made worse by inefficiency, bureaucracy, and fragmentation. Maryland, on the other hand, operates a stronger, integrated system that more effectively serves its residents and could serve as a model for those who advocate for systemic reform in other jurisdictions.

Margaret Nimmo Crowe, coordinator of the Campaign for Children’s Mental Health at Voices for Virginia’s Children, described confusion in Virginia where the mental health system falls under the purview of three different cabinet secretaries. The system’s structure creates extreme service gaps – particularly in crisis response and outpatient treatment services.

In the District, Shannon Hall, executive director of the D.C. Behavioral Health Association, described a similarly dysfunctional system. While the majority of the city’s children are insured by Medicaid, the city under-invests in community-based mental health services and instead relies heavily on expensive residential treatments. Hall said that 50% of District children requiring mental health treatment don’t receive it. Most funding is spent on reactive rather than preventative services. Many wards of the city’s juvenile justice system don’t receive essential mental health treatment until they’ve already been committed to the system; earlier treatment might have changed their outcomes.

Maryland, in comparison, has developed a much stronger system for meeting the mental health needs of children. Dr. Al Zachik, the director of the Office of Child & Adolescent Services at the Maryland Department of Health & Mental Hygiene, explained that comprehensive, publicly-funded services are provided through the Mental Hygiene Administration. In stark contrast to D.C. and Virginia, families with complex and intensive needs receive assistance from Care Management Entities, which serve as “clinical homes” that coordinate care across agencies and providers and develop home- and community-based alternatives to costly hospital care.

While systemic reform is needed to sufficiently address the mental health needs of the region’s children and families, Margaret Crowe shared some thoughts on how philanthropy can help start to improve the region’s mental health systems:


WRAG members can view the speakers’ presentations online here to learn more about the mental health systems in each jurisdiction.

Supporting health care reform *implementation* (Children, Youth & Families)

Attention grantmakers focused on children, youth, and families:

The new health reform legislation will greatly expand access to care for children and parents (and childless adults) by expanding eligibility for public health insurance programs and providing refundable tax credits to purchase insurance through the Exchanges. However, many legal immigrant children and families face waiting long waiting periods before becoming eligible for public programs and undocumented adults will not be eligible.

You have a critical role to play in ensuring that all eligible families are enrolled by tapping into community-based networks and helping guide the development of information technology and tools. You can also support state-based advocacy efforts to extend benefits to ineligible families or support other community-based systems of care. Please join us on May 27 to learn more:

May 27, 10am (WG event): Health Reform: What Does It Mean for Our Region?
Open to funders and invited guests
Location: Public Welfare Foundation, 1200 U Street NW

Alan Weil, executive director of the National Academy for State Health Policy, will explain the important role of philanthropy during the legislation’s implementation. Discussion to follow.

My testimony at last week’s budget hearing

by Mary Hallisy, Carter and Melissa Cafritz Charitable Trust

On April 19 I testified on behalf of WG’s Children, Youth & Families Working Group at a budget hearing in support of reform efforts at the Department of Youth Rehabilitation Services. Also testifying at the hearing were the mother, aunt, and grandmother of the teenage girl who was killed two weeks ago, and the mother of one of the boys killed in that same tragic event. Their comments were powerful. Grief, anger and frustration filled the room.

After they spoke it was my turn. I decided to ask that my prepared testimony be accepted into the record and speak personally for a couple of minutes. I tried to respond to the grief, offered my sympathies, and stressed the need for early intervention in the lives of troubled youth. I concluded by reaffirming our support the reform efforts of DYRS, asked for the Council’s financial support and for movement on Marc Schindler’s confirmation.

> Testimony of Washington Regional Association of Grantmakers Before the Human Services Committee Budget Oversight Hearing (April 19, 2010)

WG is urging support for a youth transition center

To read the letter of support from Washington Grantmakers to DC Councilmember Tommy Wells, chair of the Committee on Human Services, click here.

Summary: After five years in the making, the critical pieces are in place to make a Youth Transition Center a reality for DC youth aging out of the foster care system. As part of the 2010 budget process, WG’s Children, Youth and Families Working Group is advocating for full funding for the one-stop center. Without this essential safety net, hundreds of our youth will not have the support they need to become independent adults. Washington, DC has one of the nation’s highest percentages of youth in foster care that age out of the system without the resources needed to succeed. For those who face this perilous outcome, the Transition Center can be their lifeline to a better future.

Built on a foundation of positive youth development, the Center would provide:

  • Individualized support services for finishing high school and enrolling in college, connecting to jobs and housing, understanding financial management, and accessing health care.
  • Group trainings that allow for peer-to-peer and interactive learning and build youth skills in self advocacy, leadership, health and wellness, and life skills.
  • Hours of operation convenient to youth’s schedules, as well as a hotline for quick help.
  • Genuine commitment to youth by involving them on the Center’s staff and boards.

Goodbye to Oak Hill, Hello to “New Beginnings” [News, 5/28/09]


Oak Hill Youth Center closes today (Justice for D.C. Youth, 5/28) – “For too long, Oak Hill represented the abusive and inhumane confinement of hundreds of D.C.’s youth and an ineffective approach to reducing juvenile delinquency,” says JDCY’s Director, Shani O’Neal.

“New Beginnings Youth Development Center” opens on Friday (Campaign for Youth Justice email, 5/28) - DYRS is opening a new, smaller facility, “New Beginnings” which reflects a more effective approach to working with young people…Please join us: Friday, May 29th;  Official opening of the New Beginnings Youth Development Center; 10:00 a.m. to 11:00 a.m.; New Beginnings Youth Development Center, 8400 River Road, Laurel, MD 20724

Background:
- Leading the way in D.C.: A public-private partnership for juvenile justice reform (WG Daily, Sept. 2007)

Washington Grantmakers testifies in support of reform efforts in D.C.’s juvenile justice system (WG Daily, Dec. 2007). Mary Hallisy, former chair of WG’s CYF Older Youth Task Force:

“[W]e strongly believe that it is in the best interest of both our youth and our community that this reform effort moves forward. We will continue to work with DYRS and with nonprofit organizations like those here today to help provide the opportunities our youth need to succeed…”  


WG speaks out on summer youth employment programs


With the summer right around the corner, WG raised its concerns about how DC intends to operate its Summer Youth Employment Program this year and in the future. Joining the Brookings Institute and DC Alliance for Youth Advocates, members of WG’s Children, Youth and Families Working Group sent a letter to the DC Council applauding the city for setting a bold goal for a robust summer program – enrolling 24,000 students for a ten-week program – they have concerns about the program’s goals given the current budget realities. Among their recommendations are:

  • Consider a broader goal of enhancing year-round programs focused on “disconnected youth” – young people aged 16-24 out of school and out of work – rather than such a major investment in a short-term program
  • Modify this year’s program – reduce the number of hours worked or shorten the duration of the program – in an effort to remain within the budget
  • Provide the Department of Employment Services enough time to develop and support a uniform, high-quality program with well-defined employment-related outcomes for FY 2010

To read the full letter of support, click here.

Maximizing Limited Dollars: Supporting Anchor Organizations

A Model from WG’s Children, Youth and Families Working Group

The tension between rising needs for basic services and plunging foundation assets is very much on the minds of Washington Grantmakers members.  Many of our convening groups have held in-depth discussions about individual foundation positions and short-term strategies.  In December, WG’s Children, Youth and Families Working Group took the conversation a step further.

Recognizing the likelihood that some organizations will not secure the necessary funding to survive, the group agreed to develop a list of criteria that could help funders identify “anchor organizations” – organizations that provide essential services and are most capable of making the adjustments necessary to succeed in this economic climate.

The criteria are intended to be used as a tool to provide a framework for evaluating organizations in this difficult economic reality.  While these criteria are youth-oriented, we thought our members would find them useful in guiding their funding decisions in the months ahead.

An anchor organization should:

  • Address and fill an essential community need
  • Possess the capacity to adapt and survive
  • Be open to and capable of collaborating with more vulnerable organizations
  • Possess strong leadership at the Board and Executive levels, and effective management and administrative services
    • Have a developed leadership succession plan
  • Be able to meet its stated goals and achieve identifiable impact
  • Fill a geographic need or community niche
  • Have a back-up plan in the event of reduced funding
  • Provide cross-cutting services lauded by the community
  • Work from youth development/asset-based model and employ a holistic approach
  • Help to ensure coverage for all youth and work to fill age gaps
  • Provide a spectrum of appropriate services
  • Have a strategy or component for serving youth’s families

If you are interested in the process and proposed next steps, please click here for a full report.

WG testifies about recent changes at the DC Children and Youth Investment Trust

by Carolynn Mambu, Director of Public Policy, Washington Grantmakers

Concerns about recent leadership changes at the DC Children and Youth Investment Trust Corporation spurred Washington Grantmakers (WG) to submit testimony for a recent hearing of the DC City Council Committee on Human Services.

Members of WG’s Children, Youth and Families Working Group (CYF) have collaborated closely with the Trust since its inception. In its testimony, CYF expressed support for the Trust as an independent intermediary, and stated: “We are troubled that recent Board appointments will cause the Trust to be perceived as a political entity rather than an independent intermediary.” (Click here to review the full testimony.) CYF recommended that the Council appoint at least one member from the philanthropic community to the board to lend grantmaking expertise and to serve as a liaison to the philanthropic community. 

While several witnesses provided testimony, including incoming Executive Director Millicent Williams, the absence of several key administration officials caused Committe Chair Tommy Wells to recess the hearing until further notice.

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