System of Care Values and Principles

In full partnership with family, youth and the community Highland Rivers Health supports the core values and guiding principles of the child and adolescent system of care model: youth-driven, family-guided and culturally competent.

Core values

The system of care model is an organizational philosophy and framework that involves collaboration across agencies, adults, families and youth for the purpose of improving services and access, and expanding the array of coordinated community-based, culturally and linguistically competent services and supports for youth, families and adults with a serious emotional disturbance. The system of care philosophy is built upon these core values:

1. Guided by the individuals (adults, youth, families) receiving services, with the strengths and needs of the individuals determining the types and mix of services and supports provided.

2. Community based, with the locus of services as well as system management resting within a supportive, adaptive infrastructure of structures, processes, and relationships at the community level.

3. Culturally and linguistically competent, with agencies, programs, and services that reflect the cultural, racial, ethnic, and linguistic differences of the populations they serve to facilitate access to and utilization of appropriate services and supports and to eliminate disparities in care.

Guiding principles

1. Ensure availability and access to a broad, flexible array of effective, community-based services and supports for adults, children and families that address their emotional, social, educational and physical needs, including traditional and nontraditional services and natural and informal supports.

2. Provide individualized services in accordance with the unique potentials and needs of each individual, guided by strengths-based, wraparound service planning and an individualized service plan developed in true partnership with those being served.

3. Ensure that services and supports include evidence-informed and promising practices, as well as interventions supported by practice-based evidence, to ensure the effectiveness of services and improve outcomes.

4. Deliver services and supports within the least restrictive, most normative environments that are clinically appropriate.

5. Ensure adults, families, other caregivers and youth are full partners in all aspects of planning and delivery of their own services and in policies/procedures governing care for all individuals in their community, state, territory, tribe and nation.

6. Ensure that services are integrated at the system level, with linkages between service providers, agencies and programs across administrative and funding boundaries and mechanisms for coordination system-level and integrated care management.

7. Provide care management or similar mechanisms at the practice level to ensure that multiple services are delivered in a coordinated and therapeutic manner and meet individuals’ changing needs.

8. Provide developmentally appropriate mental health services and supports that promote optimal social-emotional outcomes for adults, children and families in their homes and community settings.

9. Provide developmentally appropriate services and supports to facilitate the transition of youth to adulthood and to the adult service system as needed.

10. Incorporate or link with mental health promotion, prevention, and early identification and intervention in order to improve long-term outcomes, including mechanisms to identify problems at an earlier stage and mental health promotion and prevention activities targeting children/adolescents and all individuals in the community.

11. Incorporate continuous accountability and quality improvement mechanisms to track, monitor, and manage the achievement of system of care goals; fidelity to the system of care philosophy; and quality, effectiveness, and outcomes at the system level, practice level, and individual, child and family level.

12. Protect rights of individuals receiving services and promote effective advocacy efforts.

13. Provide services and supports without regard to race, religion, national origin, gender, gender expression, sexual orientation, physical disability, socio-economic status, geography, language, immigration status, or other characteristics, and ensure