The Árborg children's prosperity team was established at the beginning of 2022 when the law on service integration for children's prosperity took effect. The members of the team came from school services, leisure services and welfare services, which form the family service sphere at Árborg along with the sub-institutions. The role of the team was to lead the implementation of multidisciplinary practices, to develop work processes, to press for their early adoption, and to develop a level-based system for providing service.

The children's prosperity team, a multidisciplinary group, started the journey towards development and implementation of service integration in Árborg by examining the depth of the procedures and practices within the family service areas, in order to identify challenges and opportunities.

There was an existing well-maintained procedure between preschool and primary schools and school services to address concerns about children’s development and well-being. In addition, there was already a strong tradition of multidisciplinary teamwork around children’s issues between specialists in school services, leisure services, counsellors in welfare services for disabled people and child protection. Furthermore, the leisure services have played a key role in the solution work by providing both timely input and more specialised resources.

The question was therefore, what was the children's prosperity law to add? Were services not already timely and integrated?

IMPLEMENTATION

To better understand the value and benefits of the children's prosperity law, it was necessary to examine how it interacts with other laws and regulations that have shaped the practice of family services.

This included examining conventional thinking within the professions and departments in order to understand how those ideas have shaped professional vision and work methods within the family services. The children's prosperity team used their consultations to reflect on procedures from different perspectives, and on the regulations that representatives followed into their departments. The project manager also led a thoughtful conversation with principals in preschools and primary schools, contacts and case managers, where the work methods of institutions and departments were examined.

Looking back, these conversations were professionally enlightening and laid the foundation for the steps that needed to be taken during the implementation period. On the surface, a pattern of ideas about the nature and benefits of integrated services without barriers emerged. These ideas had to be bridged into a common vision to ensure that all service providers were on the same path when implementing the law. Recognition that departments of the family services approached matters differently from different legal bases was the first step to a common vision. Trust between professional groups and humility towards the responsibility that comes with having the authority to communicate information between service providers was the next step.

Understanding the importance of supporting the development of professional practices was the final step. The joint vision of the Árborg team came to be that clear information and channels in administration were the key to creating secure connections between service providers, and an important prerequisite for being able to provide integrated service without barriers. In effect, this involved removing structural barriers by first integrating internal activities. Work processes that needed to be connected and well-documented were drawn up with efficient communication and using accessible tools.

The digital services of the municipality, the personal data protection officer and the municipality’s document manager were then involved in the development process, and worked with the children's prosperity team towards forward-looking solutions to simplify cooperation across service systems. In the development process, representatives from the National Agency for Children and Families with their specialized knowledge were also involved, along with colleagues in other municipalities that were on the same path.

THE ROUTE

Strong inter-disciplinary collaboration resulted in the development of digital solutions that support efficient and integrated service systems. The development process is now in its final stages and the implementation of these digital solutions is well under way. The framework is based on using the forms that have been published by the National Agency for Children and Families in the design of legal system templates.

• Request for a conversation with a contact person on the island.is website: The aim is to facilitate access for parents and children to contact persons through a request online for a conversation to assess the need for integration of services. The requests are directly transmitted into the primary service case system, which is intended to support effective responses to conversation requests.

• Primary service case system: The goal is for the contact point to have access to a web-based processing area that supports professional and efficient case handling. A template for the assessment interview and a plan for the next steps is available, along with a digital signature system for requests for service integration. The contact point can, following an assessment interview, in a simple and secure manner, share the results and signed request for integration through the case system to the child welfare services team, who then assign a case manager for the issue. Information on processing status is stored directly in the child's case record, which ensures that there is no interruption in its handling.

• Family services case system: The goal is to connect the primary service case system and the family service case system so that the processing can become compatible across systems. The case manager has access to an electronic template for a support plan that ensures service providers access to the document at the processing stage and in its final version. Templates for meeting minutes and approved projects will also be available in the case system and linked into a child's case in the primary service.

The lessons learned by the Árborg team in this implementation process are that the prerequisite for integration is to ensure effective internal processes, in line with the administration in each municipality. Digital solutions will in the future support professional and integrated processing of cases, so that service providers' time is effectively used to support the well-being of children and families through cooperation between service providers.

June 2024

The municipality of Vestmannaeyjar is now in its third year of working according to the law on service integration for children's prosperity; requests for service integration from parents and children began in early 2022.

Implementation

Before the law was passed we were well prepared, as there was already effective cooperation between the welfare and school services. The family and education departments were merged into one department in 2006. Since then the cooperation has been solid and the communication channels short, but thanks to the service integration work the cooperation became even stronger and better.

In the implementation process we started to map out the situation we had, i.e. what we were already doing, what resources and cooperation projects we had, and then if and how that would fit into the service integration work. We also evaluated what was needed in order to meet all the requirements. We started by inviting all service providers to a meeting where the law and the role of service providers were well presented, and we discussed various approaches and configurations for the work and cooperation. Presentations were also held for all service providers’ staff, as well as for elected representatives of the municipality. Next, decisions were made in cooperation with service providers’ managers on who would take on the role of contact persons and case managers. After that work began on preparing forms and procedures for both contacts and case managers.

When all this was done, the service was advertised on all media in the municipality, and presented at parents' meetings in the schools. The interest was clear, because as soon as we opened an application system for service integration, we received numerous requests. At the end of 2022, the number of service integration cases had reached 105, out of just over 900 children who were then living in the municipality.

This started off quickly and well for us, but we can feel today, in the program's third year, a certain balance has been reached on the requests. The number of requests for integration has slowed down, which we consider normal given how quickly they came in at the beginning, and how some of those cases are still active. We can sense positive changes and satisfaction among both those who both provide the service and those who use it. We are also always learning something new and developing and refining our work and methods, according to what is best for both service recipients and service providers.

Adaptation and changes

Examples of changes that have taken place are changes in application forms and work procedures, they have been updated as appropriate in each case.

Changes have also been made in the contact persons, who were first department heads in preschools and elementary schools. In preschools the change was that the special education director of each preschool is now a contact person instead of department heads, which was a successful change in our opinion. In elementary schools the change was that an employee of the school service was defined as the project manager for the contact persons, that person is employed by the school service, but has a workplace within the schools themselves. The project manager therefore both serves as a contact person and manages the contact persons of the school. The manager is also responsible for introducing service integration to children and parents of the school, and since taking on the role has visited all the classrooms of the school, introducing the project and the manager's role. We also think this is a successful change for us. The project manager for contact persons works together with the implementation managers as well as the case managers of the second and third level of services.

Some changes were made to who was defined as case managers, but first it was decided that all counselors for social and school services would become case managers. Shortly afterwards the implementing managers decided that a school psychologist would not be case manager but would be used as a resource in the support program. Children in integration could therefore receive three interviews with a psychologist in their program. The psychologist then assesses whether there is a need to continue. This was also a good change and we have added behavioral counselors as a resource in the support program.

There have been a number of changes in how requests were distributed. First it went through the student services, where requests were distributed to department heads who were then contacts. That didn't last long, the student services were removed from the request process. Today no meetings are being held, and therefore there is no waiting for the case to be assigned to the right place. Children and parents have free access to contacts and work can therefore begin in an interview with a contact person, who fills out an evaluation sheet and request for service integration if the evaluation indicates that it would be in the interest of the child to integrate the case. Also, if parents send a request for service integration electronically through the portal, then it reaches the contacts or case manager, as appropriate, the same day.

We have always kept track of all registrations but added our registration document following the registrations that were requested to come monthly from the National Agency for Children and Families.

The future

Even though we now have a stable work flow concerning the children's prosperity law, we are always learning and always looking at what we could do better and differently in our work, to make the service the best possible for those who request it and deliver it.

Finally, I would like to add a text from a mother whose child is receiving services in stage 2 of integration:

Written: September 2024