Appendix A1
Inter-Professional Education Saturday Seminar
April 2003
Case Study

Family Members:

Sarah and Jim, mother and father (foster parents)
Keisha (age 12), Sarah and Jim’s biological daughter
LaToya (age 7), niece/foster child of Sarah and Jim
Diego (age 15) and Jamal (age 3), foster children
Diane and Bill, LaToya’s biological parents, Diane is Sarah’s sister
Mable, Sarah and Diane’s mother

An African American couple, Sarah and Jim, have been successful foster parents for many years. They once received an award from the local foster family association. Jim works for the State Board of Corrections. Sarah is a stay at home mom. Both Sarah and Jim are active in their church. They are presently foster parents to three children: Diego, a 15 year old Hispanic male, LaToya, a 7 year old female, and Jamal, a 3 year old male whose parents are Native American-African American. The middle child, LaToya, is Sarah’s niece. Her biological parents are Diane and Bill. LaToya currently weighs 150 pounds. At a recent parent-teacher conference, the teacher noted that LaToya is only demonstrating pre-kindergarten reading behaviors. She also reported that the girl causes no classroom problems, but seems to be socially isolated. The teacher recommended diagnostic testing. The teacher also indicated concern over what she described as “periodic wheezing” displayed by LaToya after physical exertion. So far the suggested testing has not been accomplished as Diane has refused permission. LaToya came to live with Sarah and Jim, when Diane and Bill acknowledged meth addiction and sales. Diane is presently in a half way house in Yreka, and wants to plan for reunification with her daughter who has been cared for by her aunt and uncle since infancy. Sarah feels that her sister, Diane, will soon be clean and sober. Jim says “once a bum, always a bum”; he feels that clean and sober will only last until Bill is released from jail and returns the family to the streets. This difference in perspectives is generating marital tension between Sarah and Jim.

Sarah and Jim have one biological child, a 12 year old daughter named Keisha. She was a good student, until this year, when her grades started to fall. Keisha is spending more and more time outside of the home, “hanging” with her friends. Sarah has requested that she spend more time with the family and more time on her homework. Keisha has responded “Why shouldn’t I hang with my friends? Nobody needs me here.”

Sarah and Jim have just received a call from juvenile authorities. Diego was picked up by the county sheriff, hitchhiking on I-5 after leaving the campus of Hamilton Union High without permission. Other students in the school had been harassing him about his sexuality. He was trying to escape to San Francisco, where he believed he could explore his bisexuality. Diego has been fearful of discussing his sexuality with his foster parents because of their religious background.

The youngest child, Jamal, is on his third foster home placement due to failure to thrive. He has developmental delays in all areas and his facial configurations suggest possible fetal alcohol syndrome (FAS). For example, this child can only walk with assistance. He is not toilet trained. He has a vocabulary of only a few words, and tries to make most of his wishes known by pointing.

Mable, the 63 year old mother of Sarah and Diane, wants to move to California from Alabama when Diane, her younger daughter, is released from the halfway house. The two generations of this family have not had consistent contact, and Sarah and Jim are concerned. Other members of the extended family have provided information along the lines of, “We hadn’t wanted to mention it, but mom’s house is stacked floor to ceiling with newspaper. She eats Spaghetti O’s straight from the can. She has charged several thousand dollars to telemarketers for water purification units and crystals.” The family members also report that mom has maintained her life-long smoking habit of two packs a day. She is currently on Medicaid in Alabama for her chronic bronchitis and needs MediCal coverage when she arrives in California.

Appendix A2
Inter-Professional Education Saturday Seminar
February 16, 2002
CASE

Maria came to California from Mexico with Juan, her partner, and their one-year old son Juanito when she was sixteen.  They crossed the border in order for Juan to find work in the fields and to join Maria’s older sister, Angelica, and maternal grandmother, Abuelita Teresa. Angelica had been living in the United States for seven years with her husband, Pablo, and Abuelita Teresa was here even longer. Abuelita was widowed in Mexico, moved to California for work, and subsequently married an American citizen.  

Juanito was born at Maria’s home in rural Mexico. Even though he is almost three now, he doesn’t walk yet and his mother uses a stroller to get him around.  He is attempting to crawl by pulling himself with his arms and seems to be very stiff in his legs. Maria did not allow herself to be convinced that she was pregnant until she was nearly eight months when she went into early labor. Juanito was born weighing five pounds. He has had chronic ear infections. 

Juan left Maria shortly after arriving in California.  Maria didn't care when Juan left because he was rarely home and was frequently drunk. Their interactions were mostly screaming matches about finances and the burdens of Juanito’s care. Maria felt relieved yet anxious because she was left with no source of income. To support herself and Juanito, she began working as a housekeeper and cannery worker. Juanito's baby-sitters often changed as his mother's work hours changed.

 A few months after Juan’s departure, Maria began dating another Latino, Alberto, a mechanic for the local car rental agency. Alberto is bilingual as he has been in the United States for ten years. Maria and Juanito moved into Alberto's home in a trailer park.  To save money, they moved their trailer to the vacant lot adjacent to Maria's maternal grandmother, Abuelita Teresa’s house. The move enabled Maria to drop Juanito off at Abuelita’s for child care. Abuelita recently became a widow again at 68, and lives on a small income from Social Security.  She enjoys babysitting her grandson. Because her babysitting situation has become stable, Maria now attends ESL classes (English as a Second Language) to better her English. She loves to go to the classes, not only to learn English, but also to interact with other mothers and their small children. 

Juanito will be entering Head Start when he turns three. He recently had a test to screen for developmental problems prior to entering Head Start . After speaking with the health coordinator of the Head Start Program and watching her ESL friends’ children play together, Maria started to worry more about Juanito’s  physical development. Up until that time, she had focused mostly on trying to keep him healthy. While he did not talk very much, he communicated with her mostly with gestures and sounds. She remembered that about one year ago, a nurse at the clinic had mentioned that Juanito should have a hearing test. She began to wonder if there was any connection between Juanito’s ear infections and his limited speech. Maria felt that Juanito did need special attention and care, yet she was reluctant to have more tests, for fear that more problems would be identified. Further, she was preoccupied that she may be pregnant again. 

Maria's sister, Angelica, and her son, Mikey, appeared at Maria and Alberto’s trailer two months ago. Angelica just couldn’t stand life with her husband, Pablo. Pablo was disabled in a farm machine accident four years ago that resulted in brain injury associated with depression and mood swings. He has become physically abusive towards Mikey. He has not been regularly employed since the accident and they have been living on the edge of poverty. Angelica finds his mood swings and physical abuse towards Mikey intolerable. Although Angelica has tried a couple of jobs since Mikey started school, they didn’t work out well; it was hardly worth it because of the low pay and the greater complications in dealing with Mikey and Pablo. Angelica intends to leave Pablo and move into her own place when she can get organized and find a job.

Mikey is in his second year of kindergarten and is six years old.  He has difficulty in getting along with others and with motor and academic tasks. He has trouble sitting and listening to stories or instructions, and has difficulty completing tasks, remembering school routines, and keeping track of his belongings. He is disruptive both in the classroom and on the playground, interrupting others and interacting aggressively with other children. The school staff has repeatedly invited Angelica to a variety of parenting workshops. She attended none of them due to her work and family responsibilities and inability to comprehend the presentations. 

At home, Mikey also acts out.  Mikey smashed his new bike into Alberto and Maria’s CD player.  Alberto is becoming very frustrated with two families in such small quarters. He is also upset with Mikey’s disruptive behavior. Angelica "guesses" that Mikey's behavior might be a problem but she says she doesn't know what to do about it. Although Mikey likes to play with Juanito, they must be constantly supervised as Mikey tends to be too aggressive in his play. 

Lately, Maria and Angelica's grandmother has been experiencing health problems. She has also been having dizzy spells and has fallen several times. Maria contacted several of Abuelita Teresa’s friends from her church to look in on her and they have gladly done so. Also, Maria and Angelica check on her once a day to make sure she is okay. Maria is afraid to leave Juanito in her care any more and is again without child care.

Appendix A3
Inter-Professional Education Saturday Seminar
March 2000
Cast Study (American Indian)

Jessica, 17, and Marsha, 24, are sisters who are closely connected to the other members of the Maidu tribe. Their father who was not of Maidu decent, died in a logging accident about ten years ago, and their mother, who became their sole source of support, died two years ago after a lengthy bout with cancer. With assistance from other Maidu tribal members and a home health nurse, they learned to care for her at home.

At age 14, Jessica became pregnant by 17 year-old Hank, a caucasion member of a nearby small community. They have a three year-old boy, Johnny, who was diagnosed with cystic fibrosis shortly after he was born. Jessica did not allow herself to be convinced that she was pregnant until she was nearly eight months along. Johnny was born weighing six pounds. Jessica says Johnny has been a "difficult baby.” He has difficulty gaining and maintaining his weight, sleeps poorly when he is overly congested, and has frequent colds. To treat his lung congestion, which must be done three times every day without exception, she must perform chest physiotherapy. This requires her to hold him upside down and tap on his chest cavity to help relieve the congestion. Additional treatment requires that he drink a lot of water, eat a high protein diet and no junk food, and take pancreatic enzymes before eating so that his body can metabolize his food. The dietary regime is difficult to follow as the traditional Maidu diet does not include such large amounts of protein on a daily basis.

Hank left Jessica when Johnny was one year old.  Jessica didn't care when Hank left - he was rarely home and when he was, their interactions were mostly screaming matches about finances and the burdens of Johnny’s care. Jessica felt trapped and lonely. To support herself and baby Johnny, Jessica dropped out of school, and began a part-time job as a janitor. In addition to helping Marsha care for her ill mother, she had jobs as a delivery person, a newspaper agent, and a waitress. Johnny's baby-sitters often changed as his mother's work shifts changed.

Last year, Jessica began dating another Maidu, Lee, a mechanic for the car rental agency.  Jessica and Johnny moved into Lee's trailer.  To save money, they moved the trailer to the vacant lot adjacent to Jessica's maternal grandmother's house.  This way, Jessica could drop Johnny off at grandma's if other baby sitting arrangements fell through. 

Johnny had been on a waiting list for a day care center for low income families.  Jessica got a call saying that there was an opening; she was delighted!  The center's price was right, and the hours were compatible with her work schedule.  On the first two days that Johnny was at the center, the teachers gave him a variety of developmental tests.  Jessica was given a written report.  The findings were that his language was significantly delayed and that he was at the 30th percentile for height and 21st percentile for weight.
 
After reading the report, Jessica started to worry more about Johnny’s development. Up until that time, she had focused mostly on trying to keep him healthy. While he did not talk very much, he communicated with her mostly with gestures and sounds. She remembered that about one year ago, a nurse at the clinic had mentioned that Johnny should have a hearing test. She began to wonder if there was any connection between Johnny’s ear infections and his limited speech. Jessica felt that Johnny did need special attention and care, yet she was reluctant to have more tests, for fear that more problems would be identified. She considered visiting a tribal healer for advice.

Jessica's sister Marsha and her son Mikey showed up at Jessica and Lee’s trailer two months ago. Marsha just couldn’t stand life with her husband, Bert. Bert was disabled in a logging accident four years ago which resulted in an incomplete T-12 spinal cord injury.  He has been quite depressed for the past couple of years about being unemployed and living on the edge of poverty. Marsha finds his constant crabbiness and negativity hard to tolerate. Although Marsha has tried a couple of jobs since Mikey started school, they didn’t work out well; it was hardly worth it because of the low pay and the greater complications in taking care of Mikey and Bert’s needs. Marsha intends to move into her own place when she can get organized and find a job.

Mikey is in his second year of kindergarten and is six years old.  He has difficulty in getting along with others and with motor and academic tasks. He has trouble sitting and listening to stories or instructions, and has difficulty completing tasks, remembering school routines, and keeping track of his belongings. He is disruptive both in the classroom and on the playground, interrupting others and interacting aggressively with other children. The school staff has repeatedly invited Marsha to a variety of parenting workshops. She attended none of them, telling the school that other tribal members help her out.

At home, Mikey also acts out.  Mikey smashed his new bike into Lee and Jessica’s CD player.  Lee was furious and said the boy was a "little -- who just needed a "boot in the butt." Marsha "guesses" that Mikey's behavior might be a problem but she says she doesn't know what to do about it.

Lately, Jessica and Marsha's grandmother has been experiencing problems. She is forgetful and last Saturday, she nearly burned down the kitchen when she left the spaghetti unattended. She has also been having dizzy spells and has fallen several times. Jessica and Marsha try to check on her every few hours to make sure she is okay, and Jessica is afraid to leave Johnny in her care any more.

Appendix A3
Inter-Professional Education Saturday Seminar
March 1997
Cast Study (White)

Jessica W. became pregnant at age 13 in 1992.  Her periods had been irregular, and her build was chubby, so she did not allow herself to be convinced that she was pregnant until she was nearly eight months along.  Her son was born weighing 6lbs.; she named him Brad after her favorite movie star.  Jessica describes Brad as a “difficult baby”; he cried often and slept little.  Jessica had been advised in the hospital to breast feed, but she found the experience “gross” and so she soon stopped.  Jessica found that Brad was easier to deal with if she gave him a few sips of wine or beer.

For about the first six months of Brad’s life, Jessica Lived with Brad’s father, Hank.  Hank was 18.  His job at Burger King kept him out late many evenings, and other evenings he gradually fell into the habit of “hanging” with some of his buddies from high school.  Jessica felt trapped and isolated.  Her interactions with Hank centered around screaming matches.  Jessica didn’t even care when Hank announced that he’d joined the Navy and was leaving her.

Jessica returned to the house that she had previously shared with her mother.  She also returned to school, going to an alternative program for teenage moms.  Jessica’s mom lost her job as a clerk in a convenience store and wanted to move to Iowa to live with Jessica’s aunt.  When her mother left for Iowa, Jessica stayed behind, and moved in with a girlfriend.  In order to be able to meet her share of the rent payment, she dropped out of school, and began a job as a janitor.  Jessica subsequently had jobs as a flower delivery person, a newspaper agent, a waitress and an agent for a rental car company.  (Brad often changed babysitters, as Jessica’s work shifts changed.)  While in this job, Jessica met Mike, who was a mechanic for the rental agency.  Soon they were in love, and Jessica moved into Mike’s trailer.  To save money, they moved the trailer to the vacant lot adjacent to Jessica’s grandmother’s house.  This way, Jessica could drop off Brad at grandma’s if other baby sitting arrangements fell through.

In December, Jessica’s older sister, Marsha, showed up on morning at 3 a.m.   She brought her six year old son, Justice, with her.  The pair had been kicked out of the house that they had shared with Marsha’s husband, Bert.  Marsha said that Bert had gotten “drunk and mean,” and that she and Justice just needed a place to crash for “a few days” until Bert “slept it off.”  Marsha and Justice are still sleeping in the living room.  Marsha confided to Jessica that she may be several months pregnant.

Justice is in his second year of kindergarten and is six years old.  The school staff has repeatedly invited Marsha to a variety of parenting workshops.  She attended none of them.  Finally, the principal summoned Marsha to a parent-teacher conference.  She told her that the staff found Justice to be aggressive and disruptive.  He had been moved into a variety of classrooms, lunch tables and centers, and his behaviors had not changed.  At home, Justice also acted out.  Mike said that Justice was a “little ------” who simply needed a “a boot in the butt.”  Two weeks after his sixth birthday, Justice smashed his new bike into Mike’s CD player. Mike was furious!  Marsha “guesses” that Justice’s behavior might bea problem but she doesn’t know what to do about it.  

Brad had been on a waiting list for a day care center for low income families. Jessica got a call saying that there was an opening; she was delighted!  The center’s price was right, and the hours were compatible with her work schedule.  On the first two days that Brad was at the center, the teachers gave him a variety of developmental tests.  Jessica was given a written report on 4/6/97.  The findings were that his language was significantly delayed and that he was at the 50th percentile for height and the 34th percentile for weight.  Jessica was dubious about the assessments, and felt that the teachers might be picking on Brad.  Marsha advised her to “get the kid outta’ there, as those nosy parker teachers were goin’ call CPS on her.”  But what would she do for day care for Brad?  There’s always grandma.

However, Jessica’s grandmother has been experiencing increasing memory problems.  Last Saturday, she nearly burned down the kitchen when she left the spaghetti she was reheating untended.  The week before, Mike and Jessica had found Brad tied up in the garage when they returned from the movies one night.  They had left Marsha babysitting the two boys, but she had sent them to grandmother’s house when Bert invited her out for a drink.  Grandmother had gone to bed, leaving the two boys alone.  Brad could not tell them how he got into that position; Justice eventually returned to the trailer, but declined to respond to questions about the evening’s events. 

Appendix B
Inter-Professional Education Saturday Seminar
April 12, 2003
Agenda

9:00-9:15	Refreshments and Registration:  Shurmer Gym	
		
9:15-9:30	Welcome and Purpose of Inter-Professional Education:  Dr. Jane Rysberg	
		
9:30-10:00	Inter-Professional Small Group Meeting	
		•	Read case thoroughly
•	Develop Case Management Plan (Steps I and II)
•	Read about professionals and agencies
•	Plan team visits to professionals	
		
10:00-10:20	Introduction of Community Professionals and Family:  Dr. Judy Bordin	
		
10:20-11:15	Collaboration with Professionals and Family	
		
11:15-11:45	Inter-Professional Small Group: Case Plan Write-up	
		•	Review steps I and II, make necessary changes
•	Complete steps III and IV	
		
11:45-12:15	Family Feedback:  Dr. Denise Worth	
	Closing Remarks:  Dr. Jane Rysberg	
	Seminar Evaluation	

Sponsored by
Center for Excellence in Learning and Teaching (CELT)
Jeanne Thomas, Dean, College of Behavioral and Social Sciences,
CSU, Chico

Appendix C
Inter-Professional Education Saturday Seminar
April 12, 2003
Student Evaluation

Your Major_______________________Check One:   ___Grad Student  __Senior  __Junior

Please help us to evaluate the effectiveness of this seminar by answering the questions below (Circle).

1.  My group worked well together.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
2.  My contributions to the case management plan were significant.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
3.  By working as a team on the case management plan, I became more aware of other majors’ contributions to helping individuals and families.	
					
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
4.  I learned about many community agencies today.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
5. I increased my awareness of the importance of cultural influences upon individuals and families when developing a case plan.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
6.  I was satisfied with this seminar.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
7.  This seminar should continue to be offered to students in my major.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	

8.	What did you learn today by working in an interdisciplinary team? 

9.	What recommendations can you give us for the next seminar?

Thank you for your participation in this seminar!

Appendix D
Inter-Professional Education Saturday Seminar
April 12, 2003
Agency Representative Evaluation

Your Major____________________________Check One:   ___Grad Student  __Senior  __Junior

Please help us to evaluate the effectiveness of this seminar by answering the questions below (Circle).

1.  My group worked well together.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
2.  My contributions to the case management plan were significant.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
3.  By working as a team on the case management plan, I became more aware of other majors’ contributions to helping individuals and families.	
					
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
4.  I learned about many community agencies today.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
5. I increased my awareness of the importance of cultural influences upon individuals and families when developing a case plan.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
6.  I was satisfied with this seminar.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	
					
7.  This seminar should continue to be offered to students in my major.	
Strongly Disagree				Strongly Agree	
1	2	3	4	5	

8.	What did you learn today by working in an interdisciplinary team? 

9.	What recommendations can you give us for the next seminar?

Thank you for your participation in this seminar!