T2 Trauma Transformed

Program Description

With seed funding from an infrastructure SAMHSA grant, 7 San Francisco Bay Area counties and East Bay Agency for Children launched Trauma Transformed in October 2015. Trauma Transformed is the only regional center and clearinghouse in California dedicated to promoting a trauma informed system of care. Trauma Transformed strives to transform the overlapping regional county systems into a coordinated, trauma-informed, youth-guided, family driven system of care. By providing trainings and policy guidance to systems of care professionals and organizations, Trauma Transformed is dedicated to reducing the re-traumatization of youth and families and the professionals who serve them. Participating sectors: social services, behavioral and physical health, juvenile justice, education, and early childhood. Objectives: • Operate a resource clearinghouse for regional workforce • Maintain a regional model of coordinated services for foster children placed out of county and for children served by multiple systems within a county • Develop and coordinate Trauma-Informed Systems training resources for dissemination to providers, consumers, and county staff across all sectors • Support counties to select, implement, share, and sustain effective and meaningful trauma-informed practices and policies • Above all, promote youth and family partnerships in all work and the public systems to advance meaningful system change

Creativity

Children and youth shouldn’t experience further trauma from their engagement with the system of care charged with providing help and healing. Yet this occurs. Trauma Transformed is based on the belief that efforts to transform fragmented systems of care into effective ones are best led by direct care practitioners and consumers most impacted by these systems. Trauma Transformed strives to alleviate consumer – and workforce – suffering by increasing the public impact of science and improving the systems of care that children and families rely when at their most vulnerable. The ACE study and movement toward trauma-informed care has shifted the paradigm. Trauma-informed care lives at the crossroads of health integration work and spans the gaps between science, policy, and practice. Trauma knowledge offers a shared vision and roadmap for recovery. By bringing diverse teams together, across disciplines and counties, Trauma Transformed is a powerful incubator for regional system transformation.

Leadership

Trauma Transformed is rooted in implementation science and includes a variety of strategies, tools and resources to increase capacity of competency drivers to implement our models and sustain them within the workforce and systems. We developed a readiness assessment of organizations interested in our model and a leadership model of engagement to ensure buy-in and sustainability. Once readiness assessment is completed we strategize with leadership on capacity needs of their organizations and design initial implementation strategies. Tools, resources and visual aids were created and are disseminated to support development, onboarding and growth of each of type of participant. Ultimately these resources will be housed on the digital clearinghouse for wide access. Program Director Jen Leland and key stakeholders have presented the regional model not only within the region to all sector’s leadership but also to California Departments of Education and Justice.

Sustainability

The children’s behavioral health directors of the participating 7 counties originally conceived this project, applied for SAMHSA funding, and comprise the project’s Oversight Committee along with T2 Director and EBAC’s CEO. SAMHSA funding terminates in September 2018. The Oversight Committee has discussed sustainability options including defining activities core to sustained impact and available funding sources. The current financial sustainability plan includes each county annually contributing a share of the project’s core operating costs in an amount proportional to county size. Funds from foundations, academic partnerships, and other public entities will be secured to underwrite specific projects, i.e., Genentech and Kaiser made multi-year commitments to the TIS101 training dissemination project. Sustainability and implementation science are integral to T2 which builds personal and systems relationships between counties for staff performing common work (convening Medi-Cal billing staff across counties) and within counties but across sectors (child welfare workers collaborating with probation officers) .

Replicability

A key principle of Trauma Transformed is dissemination – dissemination within individual sectors, each participating county, among regional and cross sector workgroups and cross county workgroups. As such, the practice and coaching implementation tools are available to other organizations and regions interested in creating communities of practice to strengthen the trauma-informed basis of their system of care for their clients and workforce. Materials developed and available include organization Trauma Informed Agency Assessment (TIAA) processes; Trauma-informed Systems 101 training curricula (including commitment to change pledge forms) and train the trainer processes; Guidelines for Policy, Care Coordination, Oversight, and Advisory committees effective collaboration. Minimal coaching is required to utilize our tools through we have created the necessary supporting curricula, templates and toolkits for other systems and regions to begin this innovation collaboration.

Results/Outcomes

Care Coordination Team of subject matter experts, policy advocates, and child welfare, behavioral health and billing department staff defined the complex drivers that sustain service gaps for youth accessing care outside their home counties. Analysis of barriers to uninterrupted service generated initial recommendations. Leveraging the implementation modeled by SFDPH which trained its 9,000 employees, Trauma Transformed built the infrastructure for sustained dissemination of a standard 3-hour Trauma Informed Systems training to all regional county staff (“from janitors to judges”) across all sectors. First 9 month results: 6 new lead trainers, 48 new trainers, 37 trainings held, 1,384 staff trained across 25 departments within 6 counties. Regional Policy Team developed initial regional policies: • Stipend for Consumer Leaders • Trauma Informed Consumer Advisory Charter • Organizational Growth Map • Racial Justice in Hiring 34 youth/adults with lived experience across the region comprise the advisory board. Web-based resource clearinghouse launched.