OUR MISSION At BBCBC our sole purpose is to provide the highest quality child welfare, substance abuse and mental health services to children, adults, and their families }within their communities through a managed network of accredited providers.
OUR VISION Our vision is to create local ownership and effective integration of the child welfare and substance abusemental health systems in each of our 18 communities. By doing so, we believe that the quality of life for children, adults and families we serve will dramatically improve, resulting in personal independence and stronger communities.
CORE VALUES We focus on the following Core Values to guide us in our work: • Empower all persons served • Respect the caregivers of children • Be innovative and dedicated to excellence • Be ethically, socially and culturally responsible 525 N. Martin Luther King Jr. Blvd. | Tallahassee, FL 32301 • Promote family and personal responsibility Phone: 850-410-1020 | Fax: 850-410-1076 • Partner with community and faithbased organizations to foster open and collaborative relationships TDD: 1-850-575-3518 • Earn the trust and respect of our partners, customers and the public by providing exceptional BIGBENDCBC.org customer service, while practicing sound fiscal stewardship • Employ an analytic and systemic approach to planning and performance management • Facilitate a work environment that encourage professional growth and development FOLLOW US!
@Big Bend Community Based Care @BigBendCBC @BigBendCBC From Our CEO & President
On behalf of the Board of Directors and our faithful team, we are pleased to present our Gift of a Forever Family annual report. We are excited and humbled to share the many stories of families, communities and professionals that contributed to 2,046 adoptions since 2006.
We are blessed to have unique community partnerships lifting our adoptive and foster parents to new heights and caring for precious children in the best way imaginable. Together they exceeded the goals set by our community and by our great State and are vigilant in making sure that no child waits for a place to call home.
We were honored to spend Christmas Day together with two new families and Chief Judge Sjostrom commencing and finalizing the first ever public adoptions on Christmas Day in the State of Florida!
We want to share our stories of togetherness and community strengths. In addition to our team members, we will highlight the selflessness of our volunteers, local businesses and community partners in faith.
We are and remain grateful to serve the people of the Big Bend and we are excited to see what 2018-2019 holds for our community, children and their forever families. TOGETHER we are strengthening families and empowering communities one day, one week, one month and one year at a time.
Mike Watkins Jeffrey Pic Chief Executive Officer President Big Bend Community Based Care Big Bend Community Based Care
BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 3 Opioid Lawsuit
According to the Centers for Disease Control and Prevention are being presided over by the U.S. District Court Judge Dan (CDC), drug overdose deaths continue to increase in the Polster in the Northern District of Ohio. United States, and in 2016, there were 2,798 opioid-related overdose deaths in Florida—a rate of 14.4 deaths per 100,000 Mike Watkins, CEO of Big Bend Community Based Care and persons—compared to the national rate of 13.3 deaths per President of the Florida Association of Managing Entities 100,000 persons. As reported by the National Institute (FAME) said, “We refuse to stand by while the makers and on Drug Abuse, “…Florida has seen a dramatic increase in distributors of these harmful and highly addictive drugs cost the number of deaths, particularly among those related to Florida taxpayers billions of dollars each year – not to mention synthetic opioids. In 2016, there were 1,566 synthetic opioid- the horrible loss of life and the harm they cause to related deaths compared to 200 in 2013.” Florida families.”
In April, 2018 Big Bend Community Based Care and four other Clearly, there is already a shortage of funding for behaviorial Behavorial Health Managing Entities filed a lawsuit in federal health services in Florida, and the opioid crisis has added to court in Tallahassee to join a national legal action against some the demand for services. Watkins said, “The filing represents of the biggest drug manufactures and distributors in the world our best effort to vigorously pursue justice on behalf of those to try and recover billions of tax dollars spent on Florida’s we serve and recover the cost of providing badly needed opioid crisis. The lawsuit was merged with over 200 other behavioral health services on behalf of the taxpayers of lawsuits from around the country against the manufacturers this state.” of Oxycontin, Percocet, Vicodin and others. All the lawsuits
4 BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 Community Engagement
In late 2017, BBCBC began focusing efforts on an initiative to Legislature during the 2018 Legislative Session, and Executive actively promote positive relationships within the community, Order 18-81 by Governor Rick Scott on March 26, 2018, which included clients we serve, our provider network, BBCBC has been laser-focused on school safety initiatives with and stakeholders. In addition, we advocated for successful Sheriffs, Superintendents,Network Providers, Legislators, implementation of services and new initiatives where they and other stakeholders. intersect with both professional organizations and individuals. In addition, we began working with the Florida Department Our efforts began with Sheriffs and School Superintendents of Health and county health departments in the 18-county throughout the BBCBC 18-county catchment area to determine catchment area to increase behavioral health services within level of behavioral health and child welfare services needed these counties. We also initiated contact with the Florida in their jail and school facilities. We followed-up these initial College System regarding mental health safety and workforce meetings by bringing the Sheriffs, Superintendents and the needs for more counselors. Finally, we opened lines of provider network together to determine how to best meet the communication with the Florida Veterans Foundation and service needs in their respective counties. Florida Department of Veteran Affairs to discuss how BBCBC can assist more veterans with behavioral health services. After the shooting at Marjory Stoneman Douglas High School on February 14, 2018, the enactment of the Marjory Stoneman Douglas High School Safety Act (SB 7026) by the Florida
BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 5 Substance Abuse Prevention Activities
This last year Big Bend Community Based Care and its Network Provider Partners increased prevention activities with youth and adults throughout the Northwest Region serving in more counties and schools than ever before. There has been an increased emphasis on reaching children and youth with Evidence Based Programs that increase life skills and coping strategies for youth in the school setting reaching both middle and high school students and their parents. There has also been a concerted effort to increase the awareness of drug use and prevention especially regarding abuse of opioids and other prescription drugs while not losing sight of prevention of underage drinking and tobacco use.
NUMBER SERVED BETWEEN 7/1/16 AND 6/30/17
FUNDING SOURCE YOUTH ADULTS UNKNOWN TOTAL Federal Block Grant 37,601 8,867 10,870 57,338 FL Prevention Partnership Grants 2,224 638 301 3,163 FL Partnerships For Success Grant 331 18 490 839 TOTAL 40,156 9,523 11,661 61,340
NUMBER SERVED BETWEEN 7/1/17 AND 6/30/18
FUNDING SOURCE YOUTH ADULTS UNKNOWN TOTAL Federal Block Grant 79,108 9,524 15,295 103,927 FL Prevention Partnership Grants 2,485 64 300 2,849 FL Partnerships For Success Grant 485 262 782 1,529 FL State Targeted Response to the Opioid Epidemic Grant 244 0 5 249 TOTAL 82,322 9,850 16,382 108,554
Bay Coalition on Drugs and Chautauqua Healthcare Services Alcohol, in collaboration with promoted an Opioid Town Hall in BBCBC, hosted a prevention Walton County event titled “Not My Child”
6 BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 Prevention Partnership
Donna Richardson from the Prevention Partnership of Bay District Schools was selected for the Air Force’s Distinguished Educator’s Tour by the 331st Recruiting Squadron.
She was one of only 25 educators were selected across the United States with two being selected from Florida. She will tour Air Force installations September 11-14, 2018. She says, “I am so honored to have this opportunity to represent the Prevention Partnership of Bay District Schools.”
Air Force Recruiters are thrilled we are in the classrooms, as an early intervention with the Botvin’s LifeSkills Program, to educate students regarding the dangers of drug use and how to build effective drug resistance skills. By strengthening the development of personal self-management skills, building general social skills, and reinforcing the fact that the choices they make as an adolescent can greatly affect their future, the Air Force can become one of many viable career options.
BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 7 Serving Children Safely in Their Homes
Safety Support Services are designed to manage or control Circuit 2, Habilitative Services to serve Calhoun, Holmes, danger threats to enable children to safely remain in their Jackson and Washington Counties and Life Management homes while Child Protective Investigators (CPI) continue to Center to serve Bay and Gulf Counties. Services include crisis assess the home or while Case Managers involve the family management, home visiting, monitoring contacts and resource in treatment services to support caregiver behavior changes support. Since December 2017, 44 families and 85 which results in safe home environments. After seeking input children have been served. In 96 % of the cases, from our Child Protective Investigation and Case Management the children have been able to remain safely in partners, BBCBC developed program specifications and their homes. sought provider for in home safety support services. Contracts were awarded to ECHO to serve
Training
BBCBC’s Training and Development team continued they complete pre-service to work with our partners to ensure the needs of training. Pre-service training providers are met and quality services are provided enhancements include having to the families we serve. To develop a more additional expert speakers, targeted approach for in-service training, quarterly increased court preparation meetings were instituted to review quality assurance and improved information information and to gather input from stakeholders. regarding local providers and Stakeholders included representatives from case partners. “Phase 2” training management organizations, Quality Parenting will include additional skill Initiative (QPI) staff, foster home licensing and and knowledge training, recruitment staff, placement staff, Managing Entity assignment of a training staff and quality assurance staff. In-service training specialist for each trainee and focused on customer service and engagement, a case file assessment to help quality home visits, conditions of return, youth create individual development mental health and human trafficking. plans. The team is excited to put these enhancements in The team also led workgroups to develop place this coming year. enhancements for case management’s pre-services training curriculum and recommendations for required “Phase 2” training for case managers after
8 BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 Crisis Intervention Team Training
BBCBC partners with The Florida Sheriff’s Association to coordinate Crisis Intervention Team (CIT) trainings for law enforcement officers. The program was developed after a shooting involving a gentleman with mental health issues in Memphis, Tennessee. CIT trains officers how to respond to mental health crises. It promotes officer safety and the safety of the individual in crisis. CIT is designed as a community partnership between law enforcement, behavioral health providers, families, and individuals with lived mental health disorder experience. The officers toured area Baker Act receiving and detox facilities, as well as learned about available community resources.
DURING FY 17-18, THERE WERE THREE 40 HOUR TRAININGS INVOLVING OVER 30 OFFICERS. THEY WERE HELD IN CIRCUIT 14, FOUR IN CIRCUIT 1 & SIX IN CIRCUIT 2.
BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 9 F.I.T. Success
Shannon is a 35-year old mother who was originally referred engage with her FIT services by participating in individual to the Family Intensive Treatment (FIT) Program following counseling and peer support services, as well as her other the removal of her infant son. At the time of her enrollment, court-ordered services, including mental health evaluations Shannon had already had her four oldest children removed and therapy as well as medication management and from her care and they were either in the care and custody supervised visitations with her son. Shannon was also able to of their fathers or in the process of being adopted by family obtain and maintain employment while in residential treatment, members. Shannon came into the FIT program with an as well as acquire affordable housing upon her completion. extensive substance abuse history beginning at the age of 18, Shannon was transferred to the Aftercare Component of FIT in as well as a history of trauma, domestic violence and untreated July 2017 and the focus shifted to maintain positive patenting mental illness. Shannon also came into the program motivated and relapse prevention. Shannon successfully completed her and determined to be reunified with her son and maintain stay at Salvita on September 1, 2017 and moved into her own positive relationships with her daughters. apartment.
After enrollment in the FIT Program in March 2016, Shannon Since completing residential treatment, Shannon has began working with her primary counselor, Alison Dumas, and continued to work with her FIT Team in order to maintain her her Peer Support Specialist, Latina Reaves-Mitchell, to address sobriety and continue on her recovery journey by building her substance use and begin building her natural supports. natural supports, becoming an active participant in the 12- Unfortunately, Shannon did not have a history of positive Step community, and maintaining her stable employment and relationships and she continued housing. In addition to everything to surround herself with unsafe that Shannon does to take care of people. About a month after herself, she is also now the primary starting the program, Shannon caregiver for her youngest son. relapsed and made the choice Shannon was legally reunified with to surround herself with positive her son on September 26, 2017 and supports by calling her FIT was physically reunified on October Team and Dependency Case 23, 2017. One of the reasons Manager and asking for help. that Shannon had an extended This relapse did lead to a court- reunification plan was due to order for residential treatment concerns about her ability to meet and while Shannon was initially her son’s medical needs. Shannon’s hesitant to go, she did agree. son was diagnosed as Failure to In June 2016, Shannon began Thrive and also exhibited a number residential treatment at Mothers of delays and struggles. Prior to in Sobriety, where she remained reunification, Shannon was given until December 2016, when she the opportunity to attend her son’s voluntarily moved into Salvita, a medical appointments, weight- residential transitional program. checks and therapy appointments While in residential treatment, in order to learn about his struggles Shannon continued to actively and how to best meet his needs. (continued on page 10)
10 BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 Shannon attended various appointments, usually relying on support system and is thankful for the bond that they have public transportation to do so, in order to be there for her son. with each other and with her son. Shannon also continues Currently, Shannon’s son is thriving and has begun walking and to work and has moved up to a supervisory position at her talking, his weight has stabilized, and he is an all-around happy, place of employment. Shannon has made strides in budgeting healthy child. and is currently saving money to reinstate her license and purchase a vehicle so that she no longer has to rely on public Today, Shannon is able to provide for her son and even helps transportation. Shannon has remained clean and sober since with her four oldest daughters. Shannon has rebuilt trust her relapse in 2016 and has not had a single urinalysis or hair and relationships with her daughters and their caregivers follicle test come back positive for substances or alcohol. As and is able to spend time with them and continues building of August 10, 2018, Shannon has successfully completed the those relationships. Shannon has also built a surprisingly FIT Program and we are confident that she will continue to strong and lasting relationship with her son’s former foster succeed using the tools that she has learned and the supports family. Shannon identifies the foster mother as a part of her that she has built.
I want to personally thank my friends and colleagues who donated over $2,600 to provide foster parents funding for summer camps, trips to the lake and family outings. I ran the Green Beret Challenge Saturday to remind myself how hard life can be for our kids and our parents. There were multiple times that I faced adversity and extreme exhaustion such as the half-mile endurance challenge with a wooden yoke across my back tied to two sand bags weighing over 100lbs. Each step I saw the face of a kid and knew I wouldn’t give up on him. Again, I appreciate your support very much. I look forward to talking to each of you soon about the event and sharing stories of the kids we helped!
Mike Watkins
BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 11 SOARing in Care Coordination and Housing and was socially isolated and living with his terminally ill father Care coordination ensures service linkage by building with no resources. The team got to work building trust and relationships with community providers and engaging in rapport and assessing immediate and long-term goals. As a purposeful interactions with individuals who are not yet result of this assessment, it was determined he was eligible connected with services. Housing is an important component for SSI benefits. He began receiving benefits 56 days from his of care coordination. When an individual has stable housing, filing date. Now, he has Medicaid, access to preventative health it decreases episodes of decompensation and visits to acute and treatment services and is on the road to recovery. care facilities. It can also decrease the likelihood of criminal justice involvement. The client is stable in their treatment, which fosters recovery.
Another struggle for individuals receiving care coordination services is maintaining an adequate income to be self- sufficient. Many of the individuals served are without income and unable to maintain employment due to their illness. SOAR (SSI/SSDI Outreach, Access, and Recovery) has proven to be an effective model in securing income for individuals who meet the eligibility requirements for SSI/SSDI. The Managing Entity partners with its Network Providers to assist the priority population with applying for SSI/SSDI using the SOAR model.
Apalachee Centers, Homeless Project SOAR specialist utilized the SOAR process to assist an individual who had experienced homelessness for over 10 years. Prior to going to prison, the individual had SSI, but like the majority of those who have served time, when released, he found himself in destitute circumstances as he had lost his benefits. Lakeview Center’s LEAP (Linking, Engaging, Advocating/ Since then, the individual had been trying to regain his SSI Accessing and Planning) Team has been working with a but has faced extensive difficulty in doing so. After being 21 year old female who was homeless and pregnant. The team denied, he felt like everyone had given up on him. The SOAR assisted her with a SOAR application. Transition Voucher funds Specialist was persistent in advocating for him and working were used multiple times to keep her housed and safe. After collaboratively with community service providers. He was 2 years of homelessness, she obtained housing through a approved for SSI benefits and is now has stable housing. referral to Opening Doors NWFL’s I-Care program. She had the baby on Christmas Eve 2017 and is now stable and Life Management Center has also had success when assisting receiving benefits. a young man who had a history of severe mental illness. Additionally, he had been in the Crisis Stabilization Unit (CSU)
12 BIG BEND COMMUNITY BASED CARE | ANNUAL REPORT 2017-2018 Financials
BBCBC operated the 2017/2018 with a budget of approximately $98 million. BBCBC continued to focus on the most efficient and effective administration of funds received to ensure the accomplishment of vision and mission and was able to maintain adminisistrative serve expenses at a rate less than 3% while continuing to receive many contractual program mandates without any additional administrative dollars. BBCBC has been able to consistently maintain administrative expenses at a reasonable level for over ten years.
BBCBC moves into the 2018/2019 fiscal year with continued focus on the effective integration of the child welfare and substance abuse-mental health systems and implementation of Florida Department of Children and Families’ core initiatives as well as the additional Managing Entity program mandates associated with the National Opioid Crisis and School Safety issues. BBCBC will apply to the Department of Children and Families Risk Pool to offset the significant increase in out of home care costs associated with a significant rise in children entering care. This will be the first time that BBCBC has appled to the Risk Pool in over ten years.