El Centro de Estrategias de Atención Médica (CHCS) ha identificado colaboraciones prometedoras entre sistemas que apoyan la planificación y la implementación de la prevención integrada, y se centran cada vez más en enfoques preventivos. Tras revisar documentos y bibliografía, el CHCS entrevistó a 46 partes interesadas de cuatro estados (California, Kentucky, Nueva Jersey y Ohio) y una tribu (la comunidad indígena Salt River Pima-Maricopa en Arizona), entre las que se encontraban representantes de agencias de protección infantil, salud conductual, Medicaid, organizaciones comunitarias, jóvenes y familias con experiencia vivida, así como otros expertos en bienestar infantil y familiar. Estas jurisdicciones, geográficamente diversas, prestan servicios de prevención a través de una serie de estructuras de colaboración.

Este documento describe los esfuerzos de colaboración entre sistemas en Kentucky.¹ Para obtener información detallada sobre las demás jurisdicciones, consulte: California, Nueva Jersey, Ohio, y Comunidad indígena Salt River Pima-Maricopa. Para obtener una visión general de las lecciones aprendidas en estas cinco iniciativas de colaboración, véase: ¿Cómo pueden colaborar las agencias de protección infantil para prevenir el acogimiento familiar y apoyar el bienestar familiar?

Kentucky’s Cabinet for Health and Family Services oversees agencies and programs that administer child welfare, Medicaid, behavioral health, developmental disabilities, public health, and other services. The Department for Community Based Services administers services across nine regions, in coordination with partner organizations and communities. In addition to operating the state’s child welfare system, the department administers public assistance services provided to families including childcare, Medicaid, and economic supports such as the Supplemental Nutrition Assistance Program (SNAP).

Leaders have committed to strengthen prevention and community well-being in the Cabinet for Health and Family Services’ plan estratégico. Additionally, the agency created the new Division of Prevention and Community Well-being to strategically strengthen prevention services and supports over the long term. The goal is to move beyond tertiary prevention and create a mechanism to increase the agency’s focus on primary and secondary prevention strategies.

Kentucky has various cross-system collaborations designed to support a continuum of prevention planning and implementation. As a Thriving Families, Safer Children site, Kentucky implemented a statewide prevention collaborative and nine regional collaboratives that focus on primary and secondary prevention approaches. This effort includes representatives from state agencies, such as the Department for Behavioral Heath, Developmental and Intellectual Disabilities and the Department for Medicaid Services, as well as partners such as Prevent Child Abuse Kentucky, Kentucky Youth Advocates, community-based providers, and families with lived expertise in the child welfare system. To guide the work, a statewide prevention plan y regional action plans have been developed.

Complementary to this effort, Kentucky’s Family First Prevention Services Act (Family First) plan, which the state implemented in October 2019, primarily supports tertiary prevention strategies. This plan was developed with 1,150 stakeholders, including many state agencies — including those involved in behavioral health, juvenile justice, Medicaid services, and public health — and a wide array of community stakeholders including universities and the judiciary. While this planning process is complete, Kentucky is leading a continuous quality improvement effort to monitor implementation of its Family First Plan, gathering input from stakeholders and partners.

Kentucky has supported statewide adoption of the System of Care approach since 1990. The State Interagency Council — comprised of leaders from the primary child-serving agencies, a family-run organization, a transition age youth with lived experience, a parent who has a child with lived experience, and the chair of a committee on equity and justice for youth — has served as the governing body for the state’s six systems of care grants and other related initiatives. The position of chair of the State Interagency Council rotates every two years to support shared ownership of the group. There are also 18 Regional Interagency Councils. Historically, the chair of each regional council was a child welfare representative, but now the post is chosen through member vote. “It was a demonstration to members that they have equal voice and equal opportunity to share their concerns and discuss child- and family-serving systems from their perspective,” said an official with the Department of Behavioral Health, Developmental and Intellectual Disabilities.

Family Resource​ and Youth Services Centers which are designed to remove non-academic barriers to student success and wellbeing are available in 850 Kentucky schools statewide. Supported by the Cabinet for Health and Family Services, the centers offer a range of services related to kindergarten readiness, transitions to school and adult life, parent engagement, and student and family well-being.

The Department of Community Based Services partners with a range of community stakeholders with the goal of maintaining diverse representation and perspectives. Together with stakeholders, the department has hosted forums and work groups. Partnering with community stakeholders brings their critical perspectives to prevention planning and implementation, while also building buy-in and investment, and supporting accountability for meeting the shared vision and goals.

The department works closely with Kentucky Youth Advocates and other partners to elevate the voices of people with lived experience in the child welfare system. This is accomplished through building collaboratives, including a kinship family coalition and a birth parent advisory council, and supporting these groups in bringing their perspectives to state and local policymakers. Another advocacy group, Prevent Child Abuse Kentucky, leverages its 300 state and local partners within its network to help bring community stakeholders’ perspectives to Kentucky’s prevention efforts. The group leads Lean on Me Kentucky, an initiative to encourage the development of stronger communities that is a core component of the state’s primary prevention approach.

Stakeholders in Kentucky strive for alignment at the state and local levels on prevention-focused efforts. Having one cabinet-level agency overseeing a range of child- and family-serving agencies enables Kentucky to more easily share data related to Temporary Assistance to Needy Families (TANF), SNAP, Medicaid, and other family-serving programs, and use the data to inform prevention efforts. This structure also supports the state in braiding funding streams to support prevention efforts. For example, the state blends Title IV-B, TANF, and state general funds to support its family preservation program.

While the state’s Family First Plan was in development, the state tailored a systems of care grant application to match the definition of the Family First foster care candidate population. The state also changed services offered through a grant to ensure they did not overlap with those provided through Family First, in order to fill needed gaps instead of create duplication.