A system of care is a way of doing business and benefits young people, with serious emotional disturbances (SED). A system of care brings together the consumer, the family, professionals from interrelated fields and community members in a coordinated network that provides services to meet the young person’s mental health needs within the consumer’s neighborhood.
The mission of Allegheny County DHS System of Care Initiative is to empower consumers, families, and communities to manage and advocate for their needs and realize their dreams.
The System of Care Initiative is consumer / family focused-driven, strengths-based and culturally competent.
In Allegheny County, there are three programs in the System of Care Initiative: Starting Early Together (SET) program for children birth to 6 years of age, Community Connections for Families (CCF) for youth from 6 to 14 years and Partnerships for Youth Transition (PYT) for youths and adults from 14 to 25 years.
The System of Care Initiative is based on the following values which were defined by a team of individuals who have an interest in the success of the System of Care Initiative. The team included youth, family members, system partner professionals and community members. All services and supports developed in the System of Care Initiative must be true to these values in order to accomplish the vision and mission.
Consumer/Family Focused & Driven
Services and supports must always focus on what the youth/family believes is best for them and what works for them.
Collaboration
Services and supports are chosen and delivered based on planning that involves everyone who has a stake in the success of the process.
Safety (Consumer, Family, Community)
Services and supports are chosen and delivered to make sure the consumer, their family and their community are safe and well.
Individualized
Services and supports are designed to match and respond to each consumer's culture, strengths, priorities, and needs.
Community-Based /Least Restrictive
Services and supports are accessible and provided in the home community of the consumer. Every effort is made to keep consumers in their homes or in the least restrictive environment.
Strengths-Based
Partnerships, services and supports reflect the identified strengths and needs of each consumer. Strengths are continually assessed, appreciated, utilized and celebrated.
Culturally Competent
Services and supports reflect the unique values, beliefs, traditions, preferences, and practices of the consumer, their family and community.
Relentless Advocacy
Advocacy is expressed by a community and system committed to a consumer. No consumer falls through the cracks. No one ever gives up on a consumer.
Outcome-Based
Clear and measurable outcomes are used to guide the delivery and completion of services to consumers and to improve the quality of the system of care.
Cost-Effective/Cost-Responsible
A combination of formal and informal resources is continually reviewed to make sure dollars are used responsibly. Consumers and families help to decide how funds will be spent to best meet the needs of all participants.
Education/Vocation
All consumers are entitled to an education that best meets their needs and utilizes their strengths.
Physical and Mental Well-Being
Services and supports make sure the best possible physical and emotional care is being provided based on the consumer's preferences and needs.
Serious Emotional Disturbance (SED)
SED refers to mental health problems of children and youths that severely disrupt daily life and functioning at home, school, or in the community. SED affects one of every ten young people at any given time. Without help, such mental health problems can lead to school failure, alcohol or other drug abuse, family discord, violence, or even suicide.
What Causes SED?
We don’t know all the causes of mental health problems in young people. We do know that both environment and biology can be involved.
Examples of biological causes are genetics, chemical imbalances and damage to the central nervous system. The medical profession refers to these as neurobiological brain disorders.
Many environmental factors can put children at risk. For example, children who are exposed to violence, abuse, neglect, lead poisoning, or loss of loved ones through death, divorce, or broken relationships are more at risk of mental health problems. Other risk factors include rejection because of race, sexual orientation, religion, or poverty.
Starting Early Together (SET)
SOC Making Waves Outcomes Report July 2008
On October 1, 2005, the Allegheny County Office of Behavioral Health was awarded a System of Care cooperative agreement to develop, implement, and sustain a network of accessible, collaborative and comprehensive services for children, ages birth through six years, with serious emotional disturbances (SED) and their families. The program is in Braddock/North Braddock/Rankin, East Hills/Penn Hills, North Side, and South Pittsburgh serving 100 children and their families each year.
The services will be community-based, responsive to the culture of the respective communities, cost-effective and sustainable. The most natural avenues will be used for delivery of these services including child care centers and family day care homes, houses of worship, community groups, faith-based organizations, relatives and friends.
Through the new grant, Allegheny County intends to strengthen coordination of services for children and families at the community and County levels, and increase the use of evidence-based practices in mental health and early intervention for young children, where they are available. Additionally, increases in service access and use will be sought specifically for children in foster care, children whose parents have mental health issues and children whose parents are teenagers.
Children with a known mental health diagnosis, a suspected diagnosis, or are at significant risk for a serious emotional disturbance without intervention are included in the population of concern. Children eligible for enrollment in Starting Early Together (SET) System of Care must:
- Live in, or spend time in Braddock/North Braddock/Rankin, East Hills/Penn Hills, North Side, and South Pittsburgh.
- Have a diagnosable serious emotional disturbance.
- Be unable to function in the family, school or community or in a combination of those settings, or require multi-agency intervention involving two or more agencies providing family mental health, child care, child welfare, or pediatric care, services.
- Have a disability that is expected to last one year or has been present for at least one year.
SET Community Partners
East Hills/Penn Hills
2320 Wilner Drive
Pittsburgh, PA 15221
Fax: 412-244-1323
Team Leader - Erin Beardsley
412-244-0654 ext. 506
North Side
1300 Brighton Road
Pittsburgh, PA 15212
Fax: 412-246-0680
Team Leader - Kelly Woessner
412-246-0675 ext. 106
South Pittsburgh
500-502 Brownsville Road
Pittsburgh, PA 15210
Fax: 412-481-2701
Team Leader - Karen Carlson
412-481-2760 ext. 306
Tri-Boro (Braddock, North Braddock, Rankin)
99 Miller Avenue
Rankin, PA 15104
Fax: 412-271-1789
Team Leader: Judith Benn
412-271-1742 ext. 206
Community Connections for Families (CCF)
CCF Final Outcomes Report
CCF Outcomes Report 5-04
CCF Outcomes Report 11-03
CCF is a system of care program that serves children and their families with serious emotional disturbances (SED) in five partner communities- East End, Hill District, McKeesport, Sto-Rox and Wilkinsburg. Since being created using a federal SAMHSA grant awarded in 1998, CCF has served children six to 14 years, who are involved in two or more child-serving systems and who reside within one of the target CCF service areas.
Services provided by CCF are voluntary and free of charge. The CCF Service Coordinator works with the child and family’s team to ensure that all necessary services to support the child and family in their home and community are put into place. In addition, the CCF Service Coordinator and the family form a team to create and monitor a service and support plan tailored to the unique strengths and needs of the child. This plan guides how all services are provided. Teams are often made up of people from other child service systems that work with the family, as well as other friends or family members identified by the family.
The Family Support Specialist supports families by providing information, advocacy and emotional support. Each CCF partner community offers a support group for children and youth with SED and their families.
CCF’s goal is to improve coordination and service integration by overcoming the system fragmentation that impacts children and youth with SED and their families. CCF also incorporates informal supports (cultural/spiritual supports, community memberships, etc.) into the service planning process.
CCF Community Partners
East End
134 S. Highland Avenue
Pittsburgh, PA 15206
412-363-1702
Fax: 412-363-6399
Program Supervisor 412-363-1702 ext. 1413
Hill District
2004 Grove Place #433-434
Pittsburgh, PA 15219
Fax: 412-232-0987
Program Supervisor - Oliver Coleman
colemanor@upmc.edu
412-232-0983
McKeesport
687 O’Neil Boulevard
McKeesport, PA 15132
Fax: 412-673-9318
Program Supervisor - Christine McClellan
cmcclellan@familyresourcesofpa.org
412-363-1702 ext. 1305
Sto-Rox- CCF & PYT
710 Thompson Avenue
McKees Rocks, PA 15136
Tel: 412-331-2434 ext. 24
Fax: 412-331-6763
Program Supervisor - Raquel Hoover
rhoover@forstorox.org
412-331-2434 ext. 24
Wilkinsburg- CCF & PYT
747 Wallace Avenue
Wilkinsburg, PA 15221
Fax: 412-871-2253
Program Supervisor - Brandy Howard
bhoward@wilkinsburgschools.org
412-871-2113
Community Connections for Families on HumanServices.net
Partnerships for Youth Transition (PYT)
PYT Outcomes Report 12-05
PYT is a system of care program that serves young adults ages 14 to 25 years who have emotional or behavioral health needs. Since its creation, made possible through a federal SAMHSA grant awarded in 2002, PYT has helped young adults in Sto-Rox and Wilkinsburg to transition into adulthood by addressing prolonged dependency on social services, education, employment, housing, health insurance, physical health, daily living skills and financial planning as well as the real risks for school failure, unemployment, involvement with police and correctional systems.
PYT helps youth and their families overcome the system fragmentation that often prevents them from getting the help they need. PYT Service Coordinators partner with young adults to work with local youth-serving agencies and organizations, as well as others, to deliver a seamless, highly flexible array of services and supports youth and their families (youth-driven).
PYT Community Partners
Sto-Rox- CCF & PYT
710 Thompson Avenue
McKees Rocks, PA 15136
Tel: 412-331-2434
Fax: 412-331-6763
Program Supervisor - Raquel Hoover
rhoover@forstorox.org
412-331-2434 ext. 24
Wilkinsburg- CCF & PYT
747 Wallace Avenue
Wilkinsburg, PA 15221
Fax: 412-871-2253
Program Supervisor - Brandy Howard
bhoward@wilkinsburgschools.org
412-871-2113
Integrated Systems of Care (ISOC)
The Allegheny County Integrated Systems of Care (ISOC) targets families that are currently active in the child welfare system, who have children and youth ages six to 18 who are at risk for out-of-home care and who have a child who may have a mental health diagnosis and/or mental retardation/developmental disability disorder.
ISOC provides an opportunity for youth, families and communities to work together to help families manage and advocate for their needs, realize their hopes and dreams while keeping children and families together and safe, work together to decide what would help their family instead of having the decision made by legal authorities and service providers and preserve families whenever possible and assure permanent homes for children.
ISOC gives families a chance to come together to talk about their problems and successfully find an answer using a plan they set up themselves.
ISOC provides families to an array of links to services such as, intensive in-home services, informal community supports, mental health services (includes 24-hour crisis counseling), drug and alcohol services, child development and educational services, hunger services, emergency shelters and housing for the homeless, energy assistance, non-emergency medical transportation, job training and placement for youth and adults and services for individuals with mental retardation and developmental disabilities.
The mission of ISOC is give power to youth, consumers, families and communities to manage and advocate for their needs and realize their hopes and dreams while keeping children and families safe.
For more information or to make a referral please contact the Children, Youth and Family Advocate Managers
Central Regional Office
1401 Forbes Avenue
Pittsburgh, PA 15219
412-350-3600
Mon Valley Regional Office
332 Fifth Avenue
McKeesport, PA 15132
412-664-8900