Readiness to Learn: Understanding the Value and Impact of Coordination of Services Teams in Schools
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A Coordination of Services Team (COST) is a multidisciplinary team of school staff and providers who coordinate learning supports and resources for students. Teams meet regularly to review student referrals and link them to prevention and intervention services that support social emotional and behavioral health. This workshop will share findings from an inquiry of the impact of COST in Alameda County schools, offer a framework for measuring the outcomes of care coordination efforts, and present a case study profiling one schools’ implementation of the COST model. Participants will also engage in small groups to discuss the implications of this study and how they could strengthen and expand care/service coordination efforts in their own schools.
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Readiness to Learn: Understanding the Value and Impact of Coordination of Services Teams in Schools
- 1. Readiness to Learn: Understanding the Value and Impact of Coordination of Services Teams in Schools California School-Based Health Conference May 9 – 10th, 2019
- 2. About Us* *We do not have personal financial relationships to commercial interests to disclose. Kristina Bedrossian Managing Director Bright Research Group www.brightresearchgroup.com Irene Barraza, M.A., LMFT Behavioral Health & Wellness Coordinator Center for Healthy Schools and Communities www.achealthyschools.org
- 3. • Provide a brief overview of the Center for Healthy Schools and Communities, and the Coordination of Services Team (COST) model • Share findings from an inquiry about the value of COST to school leaders, administrators, and teachers • Share best practices, lessons learned, and “what to expect” when implementing COST or similar models • Apply these findings and lessons learned to strengthen efforts at your schools Purpose of this Session
- 4. We envision a county where all youth graduate from high school healthy and ready for college and career. Center for Healthy Schools and Communities
- 5. Alameda County, California Population: 1,578,891 School Districts / Schools : 18 / 389 Number of Students: 222,681 Free/Reduced Lunch Percentage: 45% College graduates, persons 25 and over: 42.4% Median household income: $72,399 Source: American Community Survey, 2013.
- 6. Results Focus Families are supported and supportive. Environment s are safe, supportive, and stable. Systems are integrated and care is coordinated and equitable. Children succeed academicall y. Children are physically, socially, and emotionally healthy.
- 7. Strategies by Region TRI-CITIES 1 School Health Centers 44 School-Based Behavioral Health Initiative 5 Youth & Family Opportunity Hubs NORTH COUNTY 7 School Health Centers 12 School-Based Behavioral Health Initiative 1 Youth & Family Opportunity Hubs MID-COUNTY/EDEN AREA 4 School Health Centers 62 School-Based Behavioral Health Initiative 6 Youth & Family Opportunity Hubs OAKLAND 16 School Health Centers 82 School-Based Behavioral Health Initiative 7 Youth & Family Opportunity Hubs TRI-VALLEY 8 School-Based Behavioral Health Initiative 3 Youth & Family Opportunity Hubs Alameda County Center for Healthy Schools and Communities
- 9. • Create a regular forum for reviewing the needs of individual students and the school overall. • Collaborate on linking referred students to resources and interventions. • Support students academic success and healthy development. A COST is a multidisciplinary team of school staff and providers who:
- 11. What is your school’s approach to coordinating learning and health/wellness supports for your students (if any)? What are you hoping to learn in this session? Pair Share Activity
- 12. COST Study
- 13. About the COST Study Key Research Questions • What is the value of COST to Alameda County’s schools? What is the value to school administrators and teachers? • What are the best practices, lessons learned, and challenges when implementing COST? What can schools expect when they try this Methodology • Survey of COST Coordinators (n=111) • District Health and Wellness End of Year Reports (n=14) • Deep Dive Focused Study on Three Schools • Data Review • Key Informant Interviews • COST Observations
- 15. San Leandro High School’s COST Team Composition
- 16. • COST provides a process and approach for implementing the California Department of Education’s MTSS framework at school sites. • COST allows administrators to make timely, data-driven resource decisions. • COST expands teachers’ capacity to support students who have academic and behavioral challenges in the classroom. • COST allow schools to proactively identify students with academic, mental health or other social emotional needs and coordinate the necessary care, services, and supports. What is the value of COST to Alameda County’s schools? Early warning indicators used to refer students to COST • 5+ absences • Chronic absenteeism • 3+ F’s on report cards • Identified as homeless • Any disciplinary action
- 17. Students Served in 200 Schools with COST Teams in the 2017 – 2018 School Year
- 18. Best Practices and Lessons Learned from Implementing COST
- 19. • The COST Coordinator role is most often held by: • COST Specialists (full-time position) • Principals or assistant principals (stipend) • School counselors or teachers (stipend) • School-based mental health providers (stipend/grant) • Dedicate appropriate staff time to role (78% spend <10 hours per week, but 16% spend 20-40 hours) • Expect transition of the role, document your school’s approach • Support through external training and technical assistance resources The success of a COST team relies on a strong and supported COST coordinator.
- 20. • Some efforts start as District priority and get propagated throughout schools • Others start at an individual school site and spread throughout the district • San Leandro Unified School District’s MIIS Maps COST teams are most effective with the buy-in and support of school site leadership and district-level administrators. San Leandro High School’s COST
- 21. • Average team ~9 members • 93% had a school administrator on the team • 42% meet once a week; 41% meet every two weeks • Agenda: School-wide issues, news, concerns, trends New student referrals Review action steps from previous meeting • Case conferencing format for referred students 5-8 minute multi-disciplinary discussion about student (academic, discipline, clinical services, knowledge of student’s family, etc.) Recommendations for referrals or follow-up items COST should have regular standing meetings with a standard agenda and case conferencing format.
- 23. • Teachers are not referring students to COST (or they are not making appropriate referrals) Solutions: Common referral form; repeated trainings and refresher trainings; early warning indicators • Students may be referred for academic, emotional/behavioral, or health/basic needs, and COST may not have enough information or capacity to recommend appropriate interventions. Solutions: Parent Facilitators or Peer Advocates; SST referral; Resource allocation Common Challenges
- 24. • COST teams need to track data on students they are referring, while ensuring confidentiality and privacy. Solutions: COST Tracker; Connection to Student Information Systems • COST teams report having adequate academic supports and interventions available, but Tier 2 and Tier 3 behavioral interventions were often too limited, and/or had strict eligibility requirements. Solutions: Data analysis; advocacy and education; principal engagement; engaging community-based providers Common Challenges, continued...
- 25. Outcomes of COST Adoption School Systems Teachers Students Families & Administrators
- 26. Breakout Reflection: Student Success Story Brian* was referred to COST in 9th grade by a teacher due to concerns with his academics and classroom behavior. In reviewing his student history, it was discovered that Brian was a transfer student who had recently been placed in the custody of a relative and had been out of school for two years. The COST team decided to hold a Student Success Team (SST) meeting, which identified that Brian was one grade level behind in reading and math. Classroom observations were conducted in which it was noticed that Brian frequently became mentally fatigued by the middle of the day because he was not accustomed to the rigors of being in a school setting. Brian’s guardian was provided with information to aid them in supporting his success as a student and a plan was made in partnership with his guardian to get Brian’s academics up to grade level. As changes were implemented, Brian’s focus and energy improved. It was through the COST process that resources were provided and utilized to help Brian progress in school, and provide support to him early on in his attendance at his new school. *The student’s name has been fictionalized, and the school is not identified to ensure confidentiality.
- 27. • What coordinated supports or teams do you have in place to identify and support students like Brian? • How can you strengthen your school’s efforts using the practices and lessons learned in today’s session? Guiding Questions
- 28. COST Toolkit Prepared by Alameda County Center for Healthy Schools and Communities Available online at: schoolhealthworks.org Readiness to Learn: A School-Based Model for Strengthening Health & Wellness Supports for Students Prepared by Bright Research Group for CHSC Publication forthcoming, and will be available at schoolhealthworks.org and www.brightresearchgroup.com Resources
- 30. Thank you! Questions? Comments? Irene Barraza, M.A., LMFT Irene.Barraza@acgov.org Kristina Bedrossian Kristina@brightresearchgroup.co m
Editor's Notes
- Share a few sentences about ourselves, our agencies, and our business relationship/engagement
- Since 1996, the Center for Healthy Schools and Communities has worked to improve health and education outcomes for Alameda County youth by building school-based health and wellness opportunities. Our work extends beyond simply placing health services on school sites; it is rooted in purposeful, responsive collaborations with youth, families, schools, and surrounding institutions. Together with our partners, we have created a continuum of supports and opportunities in schools that supplement the core instructional programs by promoting student wellness and removing barriers to learning.
- Progressiveness of board of supervisors Support of public institutions $67 Million of annual investments in school-based, school-linked health and wellness continuum 15,000,000 annual HCSA investment 52,000,000 annual leveraged investment: MAA, 3rd party billing, epstd, grants/philanthropies, partner service delivery.
- Many Alameda County children, youth, and families still live, attend schools, and work in low opportunity neighborhoods that have profound and long-term impacts on their health, education, and economic well-being. Our placed-based strategies focus on developing strong partnerships to leverage our investments with our partners’ additional resources to create supports and opportunities in schools and neighborhoods. Because the unique needs and set of partners vary countywide, we have organized our placed-based strategies based on the 5 regions in which school districts organize themselves (Special Education Local Planning Areas). These regions cross supervisorial boundaries. Young people’s health and academic success are deeply connected. Healthy students learn better and education contributes to longer, healthier lives. Our health and education systems should be connected too. By collaborating across sectors, we can reduce the profound and persistent inequities in our communities, and create structures of opportunity that work for every child and family. Progressiveness of board of supervisors Support of public institutions $67 Million of annual investments in school-based, school-linked health and wellness continuum 15,000,000 annual HCSA investment 52,000,000 annual leveraged investment: MAA, 3rd party billing, epstd, grants/philanthropies, partner service delivery. Launched in 2009 to create a shared model for building and financing school-based behavioral health systems across the county Partnership between: Alameda County Health Care Services Agency: Center for Healthy Schools and Communities and Behavioral Health Care Services 18 school districts 20 community-based behavioral health providers
- Beginning in 2005, this collaboration has included the development and implementation of Coordination of Services Teams, or COST. Now a nationally recognized best practice, COST is being used in schools and districts across the county, and continues to expand in number and quality. COST, and the strength-based approach it promotes, not only increases student access to services, but enhances young people’s connection to the school and community, helping all of the adults in a child’s life to better understand and support them A Coordination of Services Team (COST) constitutes a strategy for managing and integrating various learning supports and resources for students. COST teams identify and address student needs holistically and ensure that the overall system of supports works together effectively. COST uses a centralized, easy-to-use referral system so that anyone in a school community can refer or self-refer students most in need of additional supports. COST then provides a structure for school staff, administrators, and school-based providers who may normally work in separate areas to come together to discuss the strengths and needs of students who need support. Together they develop tailored interventions that utilize the full scope of resources available in the school and community.
- A Coordination of Services Team (COST) constitutes a strategy for managing and integrating various learning supports and resources for students. COST teams identify and address student needs holistically and ensure that the overall system of supports works together effectively. COST uses a centralized, easy-to-use referral system so that anyone in a school community can refer or self-refer students most in need of additional supports. COST then provides a structure for school staff, administrators, and school-based providers who may normally work in separate areas to come together to discuss the strengths and needs of students who need support. Together they develop tailored interventions that utilize the full scope of resources available in the school and community. Refer to COST toolkit – available on-line: How to start one, what if my school doesn’t have the same structure, how is it different than an SST or other student-focused meeting, who to invite, agenda for meeting, etc
- Refer to COST toolkit – available on-line Collaboration Service Link Holistic view of needs
- Irene lead- Pair share, report out, and charting if possible 5 minute pair share, 5 minute report out
- Survey had 31 items. # of schools and districts represented Deep Dive 3 schools: Jackson Ave Elementary (new 1-2 years), Newark Middle (emerging 2-3 years), and San Leandro High (4-5 years)
- Went through a couple of iterations – lead and administrator; Each site in SLUSD is different – tend to vary based on primary/secondary
- 7 districts have COST at all schools 75% of students referred to EI/T; 25% to Prevention Services
- Available in toolkit: Intro to COST for staff Referral Form Cost Tracker
- One change in SLUSD, and other districts: Added Tier 1-3 strategies and asked referring ppl to check-off what has been tried; One school, the teacher could request in-class support as part of COST Use all resources on team – assess needs across Tiers, not immediate need for individualized service Utilize relationships already in place to reach out for consent and additional information – no cold-calls Administrator buy-in and use of COST referral at teacher/parent meetings, disciplinary meetings, academic advising, etc
- What would have happened to Brian at your school? What coordinated supports or teams do you have in place to support students like Brian? How can you strengthen your school’s efforts using the practices and lessons learned in today’s session?