The Ally

February 2018

The Families As Allies Newsletter





Friends of MS State Hospital Legislative Luncheon
February 14, 2018 
12:00 PM 
Galloway United Methodist 
305 N. Congress Street
Jackson, MS 39201
Call Mississippi State Hospital at (601) 351-8000 for tickets and information 

Mental Health Day at the Capitol
February 15, 2018 
1:00 PM - 4:00 PM
The State Capitol 
400 High Street
Jackson, MS 39201

Disability Awareness Day
February 21, 2018 
8:00 AM - 2:00 PM
The State Capitol 
400 High Street
Jackson, MS 39201


In Families Own Words...

"Thank you for coming to our aid without hesitation, and on very short notice, when nobody else would."
Family of young child

"Families as Allies
is a great group of people here to help those in need of learning their child's rights and what the parents' rights are in their child's education!"
Father of teenager

"I have learned a lot from this organization. And that makes me want to give back and help other families."
Part-time family partner


A big THANK YOU to all of you who helped us welcome in 2018 at Families as Allies' New Year Open House on Thursday, January 11. 

Every family who is part of our organization, every partner from our child serving systems, every policy maker, and every community supporter who unites with us around our mission- to make sure families are partners in their children's care-  brings us closer to making our vision- that all children will have the opportunity to reach their potential and succeed- a reality. It was wonderful to start the new year in such a meaningful way with all of you.

The food and friendship were terrific. Another highlight was gathering feedback from our guests on What's Working, What's Not Working, and What's Needed in some of our child serving systems and with Families as Allies. This is the same format we use in town halls with families throughout the state and we use this feedback to guide our work, in partnership with all of you, throughout the year.

This is what you told us about the different systems that serve children and about us.

The Healthcare System
What's Working:
More focus on preventative health, Advocating, Primary access point for many families, Reaching families
What's Not Working:
More community involvement, Generalizing people, Insurance companies and hospital pricing relationship
What's Needed:
Suicide risk screeners in ER, Funding (more services), Affordable plans (x2), Doctors that work together more, More community knowledge, Better trained workers

The Mental Health System
What's Working:
Family support, Preventative care is being recognized, Preventions services (Tara is super!)
What's Not Working:
Tedious paperwork, Timely access to community-based programs, Putting people with mental illness in prison/keeping them in the system, Foster kids moved from one CMH district to another cannot get bridge medication from former MHC before getting new appointment
What's Needed:
Funding (x5), More caseworkers, Education - less stigma for public, More compassionate workers!

The Education System
What's Working:
Making improvement, Accepting outside help, Place where most children can identify and address concerns
What's Not Working:
Effective behavior plans, Schools making Special Ed determinations without doing evaluations, Overpaid administrators, Hiring people based on who you know, Student achievement, The curriculum 
What's Needed:
Funding (x2), Qualified evaluators and educators, More grants to get text books and lap tops in JPS, Social and emotional screeners in schools, Community involvement throughout the year, Certified and qualified teachers, More collaboration between systems, Educator and community efforts, Exceptional Education services, Better incentives and treatment of our highly qualified teachers

Families as Allies
What's Working:  
Great collaboration, Your current team is wonderful, the Love, You're doing a great job, You guys!
What's Not Working: No responses
What's Needed: 
More staff (x3), funding

Do you have any thoughts about What's Working, What's Not Working or What's Needed in any of these systems or with Families as Allies?  Please share your ideas in the comment section.  We want EVERYONE'S input to guide our work in 2018 so that we can all work together to make things better for our children in the upcoming year. 
Also - let us know if you would like to help host a family town hall or training in your area in 2018.  Our most successful events are often those that we do in collaboration with other groups so that families benefit from the work of more than one organization. 


From Executive Director, Joy Hogge.....

Each year, bills are introduced that can affect our children. I encourage you to learn as much as possible about proposed legislation that you think is relevant to your family. 

I also urge you to evaluate how  family-driven bills are. Family-driven means "families have a primary decision-making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation.

House Bill 985  establishes a Children's Cabinet, made up of the Heads of the State Agencies that serve children as well as a Youth Court Judge and appointees of the Lt. Governor and the Speaker of the House. It combines several currently existing committees and councils in an attempt to increase efficiency.

Children's Cabinets are common in other states. They allow agencies to better coordinate with each other and to be accountable to the Governor for that coordination. Louisiana and Georgia are two southeastern states with well-established Cabinets. Maryland's Children's Cabinet developed this  comprehensive strategic plan

Governor Bryant has supported the formation of a Children's Cabinet for several years. The Technical Assistance Collaborative's Independent Assessment of the Children's Behavioral Health System ( TAC Report) recommends  (page 93) that Mississippi form a Children's Cabinet. It also references the Governor's office's plans to commission a study to determine the best way to set up a Cabinet.
HB 985 requires the Cabinet to meet monthly, to assume the duties of several other currently existing councils and to take on a number of comprehensive overarching tasks. This is the statute establishing Louisiana's Cabinet as a basis for comparison.  I appreciate that it emphasizes helping children stay in their homes and communities.

HB 985 does not define how the recommendations of the Cabinet will be implemented or how the Cabinet will get information from and coordinate with families, the public and those actually working with children, although it is implied that the Cabinet will directly supervise the MAP Teams.
It is also not clear how the Cabinet will be family-driven. At least four councils with family representation are eliminated and their duties transferred to the Cabinet, which has no family representation. Some of the eliminated councils are federally mandated.

Louisiana ensures broader family and stakeholder input and assistance with implementation into its Cabinet via an  Advisory Board and Georgia has broadened the  membership of its cabinet to reach the same goal. Both approaches include parents in the same manner all other members are included.

I appreciate that the House Family and Youth Affairs Committee added a children's mental health sub-committee inclusive of families to the Cabinet in response to our concern that this bill is not family-driven, but this mechanism for families and other stakeholders to have input is not in place for the many other areas affecting children.

I encourage you to thoughtfully consider HB 985 and what it means for your family. It has passed out of Committee on the House side and will be voted on by the whole House next week.  You can learn more about the  Mississippi State Legislature here and how a bill becomes a law at this  link.  If you are not sure who your legislator is, you can find out at this  site.

In July 2016, the Mississippi Department of Mental Health contracted with Families as Allies to learn what happens when families access services for their children in the mental health and education systems.  Families as Allies spent the next year gathering data from over 400 families throughout the state via phone interviews, surveys and town hall meetings.

On Thursday, January 25, Henry Moore, who facilitated the Town Halls, and I presented the findings to Attorney General Jim Hood's Mental Health Task Force. Sandra Parks from the Department of Mental Health then shared how the department plans to use the information.
The most striking and persistent theme from the data was that families value school-based services and want them to be both coordinated with mental health care and also focused on helping children do well in school. 

This emphasis on real world outcomes and putting services where people are is consistent with national trends of integrated care and building a system of care for mental health rather than focusing on a singular system. 

Other notable findings were that families want to be partners in their children's care, including policy development. They also want more information about psychiatric diagnoses and medications and better support when their children are in crisis.

Families as Allies has spent the past three years enhancing our data capacity. We are committed to being data-driven and using evaluation to improve our own work as well as that of the systems that serve our children. We welcome partnerships from like-minded organizations and state partners. Our children's lives are too precious and resources too scarce to not work together to ensure a responsive and efficient service system.

To read the report that was presented to the task force click here

This blog post was originally published on January 12, 2018 in the Children's Mental Health Network Friday Update in response to a series of articles in ProPublica
The rest of the story.... words that rang through my mind as I read "Doing Less with Less: Mental Health Care in Mississippi"  
a Pro Publica article written by Sarah Smith. 

Ms. Smith provides a snapshot of Mississippi's mental health care system characterized by a dearth of qualified providers, policymakers divided along political lines, and crippling funding cuts.

To actually experience Mississippi is much more like a being in a movie than in a snapshot: a movie with an unknown ending, filled with unexpected plot twists and very human characters who cannot be easily divided into good and evil.

I know. I have lived in Mississippi for 23 years. For 17 of those years, I have raised a wonderful son who I am not sure has ever gotten the kind of support I wish he had. For the last six years, I have been the executive director of Families as Allies, the state chapter of the Federation of Families. Every day I work with families across the state who also struggle to find what they want for their children.
Mississippi often lives up to its stereotypes. It is the poorest state in the union. Corruption scandals occur with eerie regularity. It had the highest rate of slave ownership, and institutional racism permeates almost all of its nooks and crannies. It staunchly defends states' rights and resists federal intervention, yet for every tax dollar it sends to the federal government, it gets $2.34 in return.

Some days I hate Mississippi. Some days it makes me want to tear my hair out. But every day I love the people. The resiliency, the gut-level honesty, and the sense of community are hard to describe but very real to experience.

To truly understand Mississippi, one must fully accept its paradoxes, strengths and bitter truths. To do otherwise risks responding to a snapshot that only captures a moment in time, but does not provide the necessary depth and context to grasp the state's reality.

Any issue in Mississippi's mental health system must be viewed in this context: in spite of its strapped resources, Mississippi spends disproportionately more on institutional care than almost any other state in the country.
Most states have moved the majority of their services to the community, recognizing that people with mental illness do better when they can work, go to school and be with their family and friends while they receive care. Arkansas, very similar to Mississippi in demographics and geography, has done just this and now has only one state-run facility for people with mental illness. Mississippi has six state-run facilities, all of which remain open even as the number of beds within them shrink.

This begs the question: Why is Mississippi so reliant on institutional care at the expense of providing more services in the community? As a state, we need to both honestly examine who is most  benefiting  from such a system and also face some hard facts:
  • Mississippi didn't close, and even continued to build, state-run psychiatric institutions after all states were federally mandated in 2000 to develop a plan to transition people in facilities to the community. 
  • The number and location of the state-funded facilities means that almost all state elected officials have a fair number of constituents with a vested interest in those facilities. 
  • The Mississippi Department of Mental Health remains one of the largest employers of State employees and historically has been very effective at mobilizing employees to contact legislators when institutional funding is threatened. 
  • Medicaid funding, which contributes three federal dollars for every state dollar spent, is not maximized to help people with mental illness live in the community and assist with our budget shortfalls; instead, state dollars that cannot be matched are used to fund facility-based care.
  • The Justice Department is suing Mississippi for unlawfully segregating people with mental illness in institutions, a suit that is likely to be prolonged and expensive, with no guarantee that it will result in improved services.
  • Over-reliance on institutional care makes it more difficult for people such as Tyler Haire, whose tragic story Ms. Smith describes in a related article, to get beds in facilities because resources are already deployed to support people who could likely be served in less restrictive settings.
It was within this complicated context that the legislative funding cuts that Ms. Smith described occurred. It should also be noted that in the same 2017 legislative session, two taxpayer-funded assessments of our mental health system that were completed as a result of negotiations with the Justice Department finally became available to legislators after a two-year battle to make them public. Those reports had implications for the services, structure, and funding of the mental health system. To simply propose restoring funds to our system without addressing the systemic reform needed is short-sighted.
The good news, and the rest of the story - perhaps the real story - is that Mississippi policymakers began addressing the systemic reform needed after the difficult conversations that began in the last legislative session. Governor Phil Bryant, a self-described conservative Republican, came forward to meet with families from our organization. Lt. Governor Tate Reeves, another conservative Republican, made public statements about the importance of everyone being able to live in the community. Attorney General Jim Hood, the only statewide elected Democrat, formed a bipartisan mental health task force. Legislators from both sides of the aisle began talking about community-based care. The board and executive leadership of the Department of Mental Health reached out to groups they hadn't traditionally partnered with, including Families as Allies, and also started in earnest to look at ways to move funds to the community.
It feels like a transformative start, but right now it is just a start. All of these leaders need to put aside their political interests to come together with each other, with people receiving services and their families, and with everyone else who wants to be at the table to look at how we create a truly responsive system of care in Mississippi. They also need to delve into the already available recommendations and consultant reports that describe how to do this.

After needed reform is determined and planned for, we can then look at the type and amount of funding needed to support such a system. Engaging in funding battles and questions outside of the context of system reform, or allowing others to put us in that  positon , simply places us back in the same battle stances we've hidden behind for far too long. We need to put aside our partisan wrangling and demand transparency and accountability from our elected leaders, the media, and each other.
Governor Bryant began his meeting with families by saying the reason we were there was because he "didn't want to go to any more funerals" of children who died from overdoses or suicide. All of our conversations about mental health need to be driven by the importance of each and every life while still acknowledging our difficult history, the challenges we face, and the need to work together across the aisle and beyond our familiar battlefields.
We owe that to Tyler Haire, and to every child and every adult in Mississippi affected by mental illness.