Our Work
The Build Up Team provides support to the Child Behavioral Health (CBH) Team at NC DHHS and its partners (e.g., the Behavioral Health Springboard via UNC’s School of Social Work). Through CBH funding Build Up’s scope of work is multidimensional and complex. Examples of our activities include: (a) facilitating annual strategic thinking and planning for the CBH Team as it considers ongoing funding obligations and new resource acquisition; (b) providing broad (universal) and tailored implementation support to LME/MCO agencies as they work alongside their provider networks, consumers, and cross-system partners – this includes enhancing workforce development systems in provider and Medicaid management organizations so that those working with complex needs consumers achieve improved clinical and system level outcomes; (c) helping local Systems of Care Collaboratives build and activate capacities to advocate for behavioral health/substance use/developmental disabilities resources; (d) co-facilitating design thinking and whole systems change in support of a new vision regarding local community resilience capacity building fully informed by trauma-informed, trauma-centered, trauma-healing services/programs; (e) supporting the alignment and growth of infant and early child mental health resources within DCFW and DHHS; and (f) developing a resourceful, helpful, and practical web hub designed to offer implementation science practice tools, resources, lessons learned from the former Building Bridges/Six Core Strategies pilot project, and other guidance.
Learn about our project work below.
- Children with Complex Needs
- System of Care
- Infant Early Childhood Mental Health
- Trauma & Resiliency Co-Design Group
Children with Complex Needs (CWCN)
North Carolina’s LME/MCOs recognize persons with mental / behavioral health and intellectual / developmental disabilities diagnoses (e.g., Children with Complex Needs) within their catchment area eligible to receive Medicaid or other state plan funds. Once identified, members receive various plan and care management services to assist in connecting them to community-based mental health treatment, respite care, residential treatment services, applied behavioral analysis (ABA) therapy, and other available resources. Members within this population may also qualify for additional Medicaid 1915(c) Innovations Waiver services, allowing persons with I/DD diagnoses to receive home and community-based long-term care relying on LME/MCO network partners.
As part of North Carolina’s state-level support system, DHHS’ Division of Child and Family Wellbeing works with each LME/MCO to improve workforce development outcomes for agencies and providers working with CWCN. The LME/MCOs are focusing their use of implementation best practices primarily in their workforce development planning efforts. Strategies can include identifying root causes of observed system symptoms, structuring well informed teams for effective implementation, building a learning culture that is supporting of evidence driven change, and conducting small tests of change to further understand the needs of the population. Teams are also improving their use of workforce-related data in service to improving external clinical and system outcomes, and internal LME/MCO activities.
System of Care
Build Up partners with the North Carolina DHHS System of Care (SOC) state team to provide implementation support to local SOC coordinators/collaboratives. Implementation support focuses on building capacity and infrastructure to support collaborative functions and outcomes.
What is System of Care?
System of Care is a framework that places the family at the center of their child’s care, supported by a coordinated network of care that offers high-quality, integrated services to help families achieve their goals. SOC is not a service, rather it is a way of working together with children, youth, and families to achieve desired outcomes. The System of Care framework is comprised of 7 values and 4 key components1:
Learn more about System of Care.
- North Carolina Department of Health and Human Services (2024, October 24). System of care. https://www.ncdhhs.gov/divisions/child-and-family-well-being/whole-child-health-section/child-behavioral-health/system-care
Infant Early Childhood Mental health
The Infant Early Childhood Mental Health (IECMH) Planning Group was first convened with the aim of identifying the presenting needs relative to those serving this portion of NC’s children. Following the completion of a landscape survey which was completed by completed by approximately 40 people across five or more program areas, multiple challenges were noted including workforce shortages, resource limitations, and data needs. This feedback was paired with a number of potential professional development topics identified by the group. A concept paper, which named the importance of IECMH work, further refined the purpose of the convening, set a focus of alignment, and expressed a desire for strategic planning relative to the Division of Child and Family Wellbeing (DCFW)’s IECMH programming.
Grounded in applied implementation science best practices, the Build Up team facilitated a group process (co-designed as “early wins”) to set two internal (to DCFW) goals and one external (including other Divisions in DHHS) goal. Guided by adaptive leadership principles, the group defined their problem statement and created a narrative theory of change. The goals center on increasing collaboration and networking across DCFW, increasing training opportunities, and increasing opportunities to align with Division of Child Development and Early Education (DCDEE). With facilitative support from the Build Up team, the group produced an action plan, which will move into the next phase of the work. Role of implementation science best practices through Build Up’s facilitation includes strengthening teaming structures, embedding an equity lens into group processes, and supporting readiness building to execute the strategies outlined in the plan.
Trauma & Resiliency co-Design Group
Beginning in early 2023, a group of cross-sector system and community partners convened for a series of exploratory co-design conversations focused on strengthening trauma-informed systems and community resiliency-building efforts across North Carolina. These conversations were initialized by Division of Child and Family Well-being (DCFW) leaders at NC’s Department of Health and Human Services (DHHS) and the HopeStar Foundation, aiming to create an initial forum for partners currently engaged in trauma-informed, resiliency-building efforts around the state. The Build Up team, part of the Impact Center at UNC’s Frank Porter Graham Child Development Institute, was invited to facilitate the group’s co-design process, using implementation science and human-centered design best practices to inform the early phases of the work.
Labeled the “Design Group” for the exploration phase, members represented a snapshot of the continuum of work across NC. Their expertise and experiences spanned a broad array of services and programs supporting the health and resiliency of our citizens and communities, with key functional focus areas including attending to trauma-informed/trauma healing systems of care, improving access to services, ensuring representation of different perspectives and lived experiences, and emphasizing local voice within resiliency-building groups.
Funders (DCFW, HopeStar Foundation) initiating Design Group efforts acknowledged that while momentum has been building across the state toward strengthening trauma-informed systems and accelerated community resiliency building, there are substantial gaps in the prevention system itself and these current efforts lack a systemic, coordinated approach and state-level cross-sector strategic leadership. North Carolina’s partners in these work streams voice a desire to better align partnerships, policies, and programming across state, intermediary, and local service delivery levels.
Guided by these insights and prior significant contributions from well-delivered studies that outlined key recommendations to improve things, the Design Group set out to consider:
- “How might we design a statewide support infrastructure to build and strengthen capacity for trauma-informed systems and community resiliency?”
- “What steps would be necessary to create a state-level entity (i.e., building a new or different organization; creating an infrastructure of collaborating organizations; or expanding/adapting an existing agency to take on the key leadership and backbone functions) required for the task?”
- “And, what plan might come from cross-system, cross-sector collaborative design activities that would overcome historically challenging barriers to the creation of a statewide, public-private infrastructure focused expressly on building and sustaining local capacities for community and whole-person resilience, and infusing NC’s prevention and service delivery systems with trauma-informed, trauma-responsive best practices?”
A set of recommendations was co-designed and shared with interested parties and partners as a cumulative product of Phase I exploratory conversations. The recommendations outline suggested strategies and key tasks to be addressed during Phase II to continue to visualize and operationalize the North Carolina statewide prevention and support infrastructure for trauma-informed, resiliency-building systems.
View the full summary report and recommendations to advance this work.