Attachment B - YARH-3 Provider Stakeholder Meeting

[Speaker: Kelsey]

We’ll begin shortly. Before we do, I want to let everyone know we’ll be recording this meeting just so we have an accurate account of what’s said today. We only plan to use the recording internally. [START RECORDING.]

Welcome to the third meeting of the YARH Provider Stakeholder Work Group! We really appreciate you taking the time to provide us with your thoughts and feedback.

Today we’re going to gather your input and ideas on engagement challenges and strategies for Colorado’s Pathways to Success program, which ACF chose to include in the YARH-3 summative evaluation. We’ll ask for your feedback in a variety of ways, using the WebEx chat feature and open discussion.

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Who’s here?

Mathematica

1. • •Kelsey Chesnut, stakeholder engagement  

   • •Megan Shoji, task lead, stakeholder engagement 

   • •Morgan Woods, stakeholder engagement 

   • •Andrew Burwick, deputy project director 

   • •Rosalind Keith, implementation study design lead 

   • •Missy Thomas, survey director 

Project officers

1. • •Mary Mueggenborg, Office of Planning, Research, and Evaluation 

   • •Catherine Heath, Children’s Bureau 

Colorado Pathways leadership

1. • •Trevor Williams, Colorado Department of Human Services 

   • •Lanae Davis, Center for Policy Research 

   • •Denise McHugh, Spark Community Foundation 

   • •Derek Blake, Colorado Department of Human Services 

Stakeholders

YARH Provider Stakeholder Work Group members

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YARH Provider Stakeholder Work Group

Beth Horwitz

1. • •All Chicago Making Homelessness History 

Jack Theuerling

1. • •Cincinnati Children’s Hospital 

Jennifer Vidrine

1. • •ICF 

Jonah DeChants

1. • •Colorado State University 

Kaylene Quinones

1. • •Westchester, Bravelife Initiative 

Meredith Hicks

1. • •Independent consultant 

Tymothy Belseth

1. • •University of Texas, Austin 

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Today’s Goals

[Speaker: Kelsey]

I'm going to start by briefly orienting us to the goals of today's meeting, then I’ll ask the CO team to provide a brief overview of the strategies they currently use to engage youth in Pathways. Then we'll spend the bulk of our time gathering your ideas about strategies the Colorado team might use to strengthen youth engagement in Pathways.

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Inform program engagement strategies for YARH-3 summative evaluation

 

Pathways Serves High-Risk Youth
Enrolled Youth Report an Average of 4.9 Risk Factors

 

Icebreaker

In the chat window, share one effective, cool, promising, or go-to program engagement strategy for this population.

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[Facilitator: Kelsey]

With that population in mind, I want to start us all off with a quick icebreaker. I’ll give everyone one minute to share in the chat window one effective, cool, promising, or go-to program engagement strategy for this population.

[Show everyone how to get to the chat window]

[After 1 minute] Thanks everyone – now I’ll give you all a chance to read through the ideas that people put in [give people 20-30 sec]. Does anyone have follow-up questions, or see an idea they’re particularly excited about? [If no one is responding, summarize them or pick a couple to highlight]

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Gather your ideas for addressing two types of engagement challenges

1. 1.Situational challenges to engaging youth in Pathways 

2. 2.Challenges with engaging specific youth populations 

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[Speaker: Kelsey]

Thanks everyone. We’ll move now into our discussion, where we’ll gather your ideas for addressing two types of engagement challenges on the mind of the Colorado Team:

1. 1.Situational challenges to engaging youth in Pathways program activities, such as a lack of transportation or a loss of communication, and 

2. 2.Challenges related to engaging specific youth populations, such as younger youth or youth in more rural areas. 

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Pathways Program

Overview

[Speaker: Kelsey]

Next, I’m going to turn it over to the CO team to briefly share some background on the Pathways program model, including its core components, enrollment process, and engagement strategies. Then we’ll ask for your thoughts on some specific program engagement challenges.

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Pathways core components

Navigators

1. • -Caseloads of 10 or fewer youth 

   • -Weekly contact with youth 

   • -Provide case management services 

Coach-like engagement

1. • -Youth-driven: Encourages youth to set their own goals, plan, and pace and to be their own advocates 

   • -Primary activities: Listening, asking powerful questions, providing encouragement, approaching youth with curiosity rather than judgment, setting achievable challenges, and gently holding youth accountable 

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[Speaker: CO Team Member]

Pathways has two core components: (1) Navigators and (2) Coach-like Engagement. These are the key ingredients to achieving a model that’s youth-driven, goal-oriented, and allows enough flexibility to meet the unique needs of each youth. We’re presenting these to give you some context and background on the Pathways program, but since these are a part of the core model, they are not up for discussion or changes.

(1) Navigators have caseloads of 10 or fewer youth (compared to an average of 32 youth per child welfare case worker). And they maintain weekly contact with each young person on their caseloads. They provide case management services to youth. Case management services include assessing their needs; helping them set goals in the target outcome areas [housing, education, employment, permanent supportive connections, and health and well-being]; and supporting them in achieving their goals. Navigators provide case management services through the lens of coach-like engagement.

(2) Coach-like engagement is a solutions-focused, strengths-based, and youth-driven case management model.

• •To be youth driven, it honors youth as creative, resourceful, and capable. So it encourages them to identify their own needs; set their own goals, plan, and pace; and be their own advocates 

• •The primary activities of coach-like engagement include: Listening, asking powerful questions, providing encouragement, approaching youth with curiosity rather than judgment, setting achievable challenges, and gently holding youth accountable. 

In addition, several tools and resources are available to Navigators to support their work and provision of coach-like engagement, including assessment and planning tools, flexible funds, warm referrals, and housing vouchers.

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Current Pathways strategies

Source: Reflections from Colorado Team and Navigators

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Enrollment	Engagement
•Request referrals for eligible youth who are screened for risk of homelessness  •Train referral partners in what Pathways is, how it can benefit youth, and how it differs from typical services  •Coach-like engagement is developmentally appropriate and attractive model for this population  •Navigators communicate the benefits of coach-like engagement	•Demonstrate commitment to youth by being persistent and non-judgmental  •Help youth move forward at their own pace  •Weekly contact with youth  •Attend appointments with youth (warm hand-offs)  •Authentically advocate for youth through:  Coach-like engagement  Youth-driven goals  Providing flex funds to achieve goals  •Help youth address housing needs

[Speaker: CO Team Member]

This slide lists current strategies what that we use to (1) support youth enrollment into the program and (2) to support youth engagement with the program.

• •To enroll youth, Chafee workers who are Navigators, child welfare workers, and Runaway and Homeless Youth providers refer all Chafee-eligible youth ages 14-21 to be screened for risk of homelessness using the Pathways screening tool (in the evaluation, youth will be offered Pathways if they are eligible for Chafee services in a county that is participating in the study (all youth have histories of child welfare involvement and had an open case at age 14), and they report at least one risk factor on the Pathways screening tool (which screens for elevated risk of future homelessness)). 

• • •To build buy in to the program, we train referral partners on what Pathways is, how it can benefit youth, and how it’s different from usual Chafee services.  

• •Coach-like engagement is critical getting youth interested and ready to engage in the program because it is a developmentally appropriate and attractive model for this population.  

• •Navigators are also able to effectively communicate with youth about the benefits of coach-like engagement in the context of the program, which again helps youth get interested in enrolling. 

In terms of engagement, Navigators:

• •Demonstrate their commitment to youth by being persistent and non-judgmental and recognize that youth need to move forward at their own pace as trust is developed. 

• •They also have weekly contact with youth (which prior to COVID was primarily in person) and attend meetings and appointments with youth to ensure warm hand-offs.  

• •It’s also important for Navigators to explicitly and authentically be an ally and advocate for youth in every interaction through: coach-like engagement, youth-driven goals (instead of what professionals want youth to achieve), and providing the flex funds to achieve those goals. 

• •Last but not least, Navigators help youth address housing needs, for example, through housing vouchers or other supports to ensure youth are stably housed. However, they did stress that ‘housing’ should not be used as the ‘hook’ to engage youth,  because other important goals, like education, employment, and permanent connections, can be lost. For example, some youth perceive that once they have housing, they don’t need anything else, which impacts engagement in Pathways.  

Again, since many of these strategies are part of the core model, they are not up for discussion or changes.

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Addressing Pathways Engagement Challenges

[Speaker: Kelsey]

Thanks [CO team member] Now, we’ll discuss strategies the Colorado team might use to strengthen youth engagement in Pathways. Specifically, we’ll gather your ideas for addressing two types of engagement challenges on the mind of the Colorado Team:

1. 3.Situational challenges to engaging youth in Pathways program activities 

2. 4.Challenges related to engaging specific youth populations 

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Situational challenges with engagement

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Typical challenges	Current mitigation strategies
Loss of communication	Continue to contact youth using existing information, check-in with providers and permanent connections, welfare checks at known addresses or youth gathering places
Last minute lack of transportation	Provide flex funds to for bus cards or to fix vehicle and/or Navigators come to the youth / provide rides
Loss of vital documents	Navigators work with youth to replace vital documents and strategies to maintain them
“Cold Call” referrals	Navigators find a provider still in touch with youth to assist with engagement
COVID-19 pandemic	Mix of in-person and virtual meetings
Lack equipment for virtual meetings	Community resources; Flex funds

[Speaker: CO Team Member]

We met with Navigators to discuss some typical situational challenges [listed in left column] related to engaging youth in Pathways program activities. The strategies that we currently uses to mitigate these challenges are listed on the right. These include:

A loss of communication, usually with a change in contact information or phones being turned off/lost/stolen. In these situations, Navigators continue to try contacting youth through existing contact information, check in with providers and permanent connections, and conduct welfare checks.

A last minute lack of transportation such as car issues, not getting a bus pass on time, or getting their bus pass lost/stolen. Navigators can provide youth with flex funds to purchase bus cards or fix their vehicles, or Navigators can come to the youth or provide them with a ride.

Losing vital documents, which are essential for education, employment, health care, and housing, and often cause the length of engagement to be extended since progress toward goals may be delayed. Navigators will work with youth in this situation to replace those documents and come up with strategies to maintain them in the future.

Navigators making ‘cold calls’ to engage youth when Pathways receives a referral for a youth whose case is closed. Navigators often try to find a provider or someone who is still in touch with the youth to assist Pathways in engaging them.

The COVID-19 pandemic has posed several challenges to maintaining engagement with youth because of limited face-to-face meetings. Youth with high mental health needs have been particularly impacted by COVID with having to self-isolate. Currently, Navigators are offering a mix of in-person (with PPE, social distancing, meeting outside) to virtual meetings depending on the youth’s needs and comfort level.

 

Also, youth sometimes lack the equipment, like laptops, smart phones, or internet, necessary to effectively participate in virtual meetings, especially since public libraries and other community locations have been closed. Community resources and flex funds have helped to address this challenge. But based on current public health projections these, challenges are likely to continue through the fall of 2020.

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Let’s discuss! Situational challenges with engagement

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Typical challenges	Current mitigation strategies	Other ideas?
Loss of communication	Continue to contact youth using existing information, check-in with providers and permanent connections, welfare checks at known addresses or youth gathering places
Last minute lack of transportation	Provide flex funds to for bus cards or to fix vehicle and/or Navigators come to the youth / provide rides
Loss of vital documents	Navigators work with youth to replace vital documents and strategies to maintain them
“Cold Call” referrals	Navigators find a provider still in touch with youth to assist with engagement
COVID-19 pandemic	Mix of in-person and virtual meetings
Lack equipment for virtual meetings	Community resources; Flex funds

 

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Typical challenges	Other ideas?
Loss of communication
Last minute lack of transportation
Loss of vital documents
“Cold Call” referrals
COVID-19 pandemic
Lack equipment for virtual meetings

[Facilitator: Kelsey]

OK – thanks everyone. Now that you’ve had a chance to think of some ideas, we’ll take about 5/10 minutes for you to share verbally or through the chat window, and I’ll jot down notes for everyone in the table shown on the screen.

[QUESTION IF NEEDED] Based on your experience working with this population and running into some of these same challenges, what other ideas do you have for engaging youth in these situations to participate in the Pathways program?

[I hate to interrupt an interesting conversation, but I do want to get move us on to the next discussion]… I’m going to hand it back over to the CO team to discuss challenges with engaging specific youth populations.

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Challenges engaging younger youth

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[Speaker: CO Team Member]

In our meetings with Navigators, they brought up challenges related to engaging specific populations of youth in Pathways activities. One of the most salient of these is how to talk about the risk of becoming homeless with younger youth (ages 14-16), who are usually not thinking about this issue yet. Given Pathways small caseload size, demonstration sites have prioritized youth who are most at-risk of becoming homeless as they leave care, and those already out of care who are homeless versus younger youth in care who have more supports. Chafee programs also experience this same challenge when balancing the needs of younger youth in care with older youth who have emancipated from care or are about to emancipate. Serving younger youth also requires Navigators to adjust messaging and activities to be developmentally appropriate.  

• •Currently, Navigators emphasize to younger youth that they’re working on making sure the youth always has a safe and stable place to live, no matter where they’re at in life. 

• •They avoid using terms like “homelessness” and “stably housed” in an effort to have more developmentally appropriate conversations. 

[Facilitator: Kelsey]

Thanks [CO team member] DISCUSS: Knowing what you know about Pathways and this population, what advice/guidance do you have on how to engage with younger youth? ANIMATE: Is that approach effective, or do Navigators need to be more explicit? [probe with other discussion questions if needed]

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Challenges with other specific youth populations

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1. 3.Youth who may be distrustful of systems 

1. • 1. a)Legally-involved youth 

     2. b)Failed adoptions 

2. 2.Rural youth 

3. 3.Transient youth 

1. 4.Youth experiencing domestic violence 

2. 5.Youth with targeted needs 

1. • 1. a)Youth with mental health and substance use issues 

     2. b)Youth in residential care 

     3. c)Youth with intellectual and developmental disabilities 

[Speaker: CO Team Member]

Navigators also brought up challenges related to engaging these other specific populations of youth.

• •Some populations may be distrustful of other systems offering help and support, like Pathways. This includes youth involved in the legal system and youth who’ve experienced failed adoptions. Although Pathways is voluntary, some youth perceive Pathways as mandatory (despite being told it ‘really’ is voluntary) or as just one more system setting them up to fail, which prolongs the engagement phase as Navigators take more time build trust with the youth.  

• •The pace of engagement is also different in rural communities versus urban centers, because services may not be available in the youth’s ‘home’ community, and it often takes longer to do things. This can lead to youth feeling frustrated and hopeless because ‘nothing will ever change so why bother’.  

• •Some transient youth may not yet be ready for housing stability, and will move across counties in mostly ‘coach surfing’ situations until they are ready. Since Pathways is a youth-driven model, Navigators typically follow these youth across county lines unless geographically impossible and a transfer is to another demonstration site is not an option. During this time, Navigators engage them as best as possible and often work on other youth directed goals besides housing. 

• •Engaging youth who are experiencing domestic violence can be challenging because their partners may not be supportive of them either becoming or continuing to be involved in Pathways. Domestic violence is a complex issue which often makes leaving an unsafe relationship challenging for the youth as they try to balance a variety of factors such as loss of income and housing with personal safety. 

• •Lastly, youth with targeted needs, including those with mental health and substance use issues, those in residential care, and those with intellectual and developmental disabilities, may be challenging to consistently engage. 

• • •Access to developmentally appropriate treatment for youth with mental health or substance use issues may be limited especially in rural areas. 

  • •Youth in Residential Care are sometimes difficult to engage because of residential provider protocols that do not align with the Pathways ‘youth-centered’ model. When working with youth in residential care, Navigators often help youth acquire the ‘independent living’ skills necessary to live successfully in the community. 

  • •And, although there is not a specific challenge related to engaging youth with Intellectual and Developmental Disabilities, the needs of this population highlight the need to engage the service providers and systems because of the expertise required.  

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Potential solutions for challenges

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1. 4.Youth who may be distrustful of systems 

1. • 1. a)Legally-involved youth 

     2. b)Failed adoptions 

2. 3.Rural youth 

3. 4.Transient youth 

1. 4.Youth experiencing domestic violence 

2. 5.Youth with targeted needs 

1. • 1. d)Youth with mental health and substance use issues 

     2. e)Youth in residential care 

     3. f)Youth with intellectual and developmental disabilities 

 

Wrap-Up

[Speaker: Kelsey]

Thank you everyone for the rich discussion today. I know you’ve given our team a lot of food for thought! [I hate to interrupt an interesting conversation, but I do want to get us all out of here on time.]

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Next Steps

• •You: Share any additional thoughts in writing by the end of the week 

• • -Email to Kelsey Chesnut: KChesnut@mathematica-mpr.com 

• •Mathematica and Colorado teams: Use feedback to inform evaluation plans 

• • -Summarize feedback and potential implications for evaluation plans 

  • -Share with federal partners 

• •Next opportunity to contribute 

  • -Stakeholder work group meetings on initial findings and reporting (summer/fall 2022 and winter 2023) 

  • -Potential invitations for ad hoc opportunities 

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[Speaker: Kelsey]

In terms of next steps:

1. 1.We welcome any additional thoughts you want to share in writing. Please email them to me by the end of this week. 

2. 2.Mathematica and the CO team will summarize your feedback and potential implications for the evaluation plans, and then we’ll share the summary with our federal partners. 

3. 3.Your next opportunity to contribute will be stakeholder work group meetings on initial findings and reporting, tentatively planned for summer/fall 2022 and winter 2023, respectively. We’ll reach out to you before then to schedule those meetings. 

4. 4.We also may reach out to invite you to participate in ad hoc opportunities before then. 

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Any questions

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For additional information or questions

• -Kelsey Chesnut, Mathematica (Stakeholder workgroup questions) 

        KChesnut@mathematica-mpr.com

• -Cay Bradley, Mathematica (general YARH questions) 

        CBradley@mathematica-mpr.com

• -Mary Mueggenborg, Office of Planning, Research & Evaluation  

        Mary.Mueggenborg@acf.hhs.gov

• -Catherine Heath, Children’s Bureau  

        Catherine.Heath@acf.hhs.gov

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