• Maintaining a values orientation which is adaptable and relevant as the needs of families and participating systems change
• Creating a collaborative management culture which is meaningful in the face of fiscal challenges
• Adapting the management structure to have maximum impact on the direct services actually delivered to children and families
• Expanding the inclusive agenda while holding onto the values base
• Expanding the field of operations to affect all levels of care rather than a narrowly defined target group

When Stark County began its efforts, the needs of children and families shaped thinking about what type of system to create. In early meetings, one would notice that despite this focus, parents and family members were not at the table. After initial efforts at collaboration, it became clear to system stakeholders that they needed to facilitate meaningful interaction between system representatives and family members. This began with the invitation of one parent from the community to a creative planning retreat which consisted of System Executives. From this initial meeting, the role of parents has continually expanded with six parent representatives on the Stark County Family Council Board as well as paid parents who are employed as Family Council staff. In addition, a not-for-profit coalition of parents was seeded through Family Council activities and is functioning as an independent entity within the community today (FACES). With the inclusion of parents and other family members in Family Council activities, activities have continued to evolve. At this point, parents serve a central role in all Council activities including:

Parents as Service Providers: Parents in Stark County are functioning as service providers. In this role, in which they formally function as advocates and conveners of CCOs, the gap between provider and recipient is narrowing. It is one thing to publish a set of Beliefs or Principles which state that parents are full partners. It is quite another to allow them to join the discussion as a valued service provider. This step has moved the Council to an arena in which token or marginal participation of parents on any level is not acceptable. In order to get to true integration, parents must be included at all levels, even when redefining how help or service is delivered. (Appendix Z)

Parents as Policy Makers: Parents serve on the Board of Trustees of the Family Council and are expected to be involved in all levels of policy making. With the presence of six voting members of the Council, parents can represent a bloc of votes on any policy issue which is considered. As members of the Board of Trustees they focus on administrative issues such as salary schedules, budgeting and personnel matters as well as setting programmatic direction for the county. Recently, the Board of Trustees hired the parent who initially attended the Board retreat as the Executive Director of the Family Council.

Parents as Service Recipients: At the direct service level, guiding principles inform the conversation which occurs between families and direct service providers. Parents are expected and supported to be responsible for their children while direct service providers are expected to be responsive to child and family needs. This can be a challenge for both parents and direct service staff who are struggling with new ways to hold a conversation. Policy makers set the stage for a new type of conversation by role modeling collaboration which extends beyond government and service providers to include families of children with special needs as the ultimate stakeholder. This is all done in the context of accountability and efficiency. In Stark County, best practice means principled practice.

System stakeholders in Stark County are very clear about the fact that the inclusion of parents and family members has changed their thinking and their way of doing business. In this case it would seem that the process of inclusion has become the central emphasis which allows the Stark County Family Council to continue to grow and change. In many respects the process of inclusion of parents and other family members has had more impact than any other single activity the Council can point to. Given this fact, there remains an important lesson for other communities embarking on this journey. That is, all activities will be meaningless without the anchors to families. Initial Stark County leaders were aware enough to adjust their processes to include other stakeholders, namely families themselves. Communities just beginning these activities would do well to build parents/family members into a central role with clear voice from the beginning of activities. The relationships and conversations with parents at the table has pointed the Council in a direction for system change which would not have occurred without their clear participation. Putting this value in at this point in the document replicates what occurred in Stark County. It is not a pull-out lesson but a foundation upon which the next series of lessons build.

The next lessons focus on what Stark County has encountered in developing an ongoing structure. They are more about ongoing management than initial implementation. At this point, Stark County reality is about developing and nurturing a sense of mission, process and protocols which will make this type of initiative relevant in the next century. It is important to note that communities who are just embarking on this journey may not need to take the same amount of time that Stark County has taken in getting to the next lessons. As a community involved in early innovation, what we know in the nineties is different than what we knew in the eighties. Many communities will find that they can go through the process of creating an infrastructure far quicker than Stark County because of the lessons learned in other communities.