Early Intervention in Pennsylvania - PowerPoint Presentation

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Early Intervention in Pennsylvania

Birth to Five Years OldSlide2

What is Early Intervention?

Early Intervention (EI) helps develop a child’s

potential when there is a developmental delay.EI builds upon the natural learning opportunities that occur within the daily routines of the child: - at home - at child care - in the community

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Why Early Intervention?

While all children grow and learn at their own rate, some children experience delays in their development.

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Who should be referred to EI?

Any birth to 5 year old if:

There is a concern about any area of developmentAges & Stagesresults in a red flagFamily is concerned about development

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A parent or care giver may notice a child who is not…

Talking or able to focus P

laying with other children Interested in toys, books or pretend play Crawling, walking or running like his/her peers Participating because of a behavior

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Referral to Infant/Toddler

Program:

Evaluations occur within 45 days of initial callEligibility is determined at the evaluation The Individualized Family Service Plan (IFSP) is usually developed the same dayServices start within 14 days

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Referral to the Preschool Program:

Most children are screened first to determine if an evaluation is neededThe evaluation process can take up to 60 days

The Individual Education Plan meeting (IEP) is held within 30 daysServices begin within 14 calendar days

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Evaluation Timeline

The time from the first parent contact to when the child is determined eligible is: ~Infants and Toddlers

up to 45 days ~Preschoolers up to 120 daysCaryn Kadel,  Interagency CoordinatorBucks County Intermediate Unit1-800-770-4822 x 1102ckadel@bucksiu.org

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Infant Toddler -Who may be eligible?

Children from birth to three years of age who demonstrate a 25% delay or 1.5 Standard Deviation below the mean in any area of development Children who have a diagnosis which would indicate a high probability of a delay(i.e. Cerebral Palsy, Down Syndrome, Hydrocephaly, PDD/Autism)Slide10

Preschool Eligibility

Eligibility is a two-pronged decision.Developmental DelayOrDiagnosisAndIn need for special education and related services.Slide11

Multidisciplinary Evaluation

Establishes eligibilityLooking at all five areas of developmentThe participants may include Slide12

Evaluations look at the Five Domains of Child Development

Cognition – thinking and learningCommunication – talking, understanding, expressing needs

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T

he Five Domains…Physical –moving, seeing and hearing

Social/Emotional – self regulation and relating to othersSelf Help –eating, dressing, and self care

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If the child is not eligible for Early Intervention

Resources will be given to the family:Behavioral Health

Child Care SubsidyKeystone STARS sitesPre-K Counts, Head Start andIdeas for home and community settings

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Strategies may also be shared with the family or primary care giver.

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Eligibility for EI

Once eligibility is determined, recommendations are made to the family.

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Next the child

’s team develops a planThe team includes:

Family membersEarly Childhood Teacher or DirectorEI Service CoordinatorEI RepresentativePsychologist/TherapistsAnyone else the family would like involved

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The Plan includes Goal Statements to address the

child’s needs:

Goals are:Unique to each childBased on the evaluation and information from the family and teamInclude teaching strategies to help the child be successful (SDI or Specially Designed Instruction)

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Goals are Measurable:

This enables the EI team determine if the child is making progress. YOU have a critical role!

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The

“I” in IFSP and IEP

What does the “I” stand for?The plan and services provided to children and their families differ based upon the individual needs of each child and family.

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How are services funded

In Pennsylvania there is no direct cost to the family or child care program for Early Intervention. Publicly Funded, entitlement program

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Where does EI occur?

Early interventionists support children any place children are found:

Child careCommunityHomePreschool

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What routines does Early Intervention help with at home?

MorningMeal time Play time with siblings or

neighborsGetting in and out of the carNap time Bath time Bed time

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Early Intervention helps with transitions & unstructured routines

ArrivalFree time

Open playPlaygroundLunch or snackSelf help activities

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Early Intervention helps with the structured activities in child care

GreetingCircle TimeCentersArt MovementMusicNap timeField Trips

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Consultative Model

EI is most effective for a child when it is incorporated into the routines alongside typical childrenEI is most effective when working in collaboration with others.

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What are the benefits of working together?

New and practical strategies to help with the identified concern. Positive changes with the child. Education regarding child development. (i.e. is this an age appropriate expectation?).

Unique perspective of the child’s day.Many opportunities for child to practice everyday life skills.Allows us to create and utilize coordinated/ comprehensive plan. Slide28

How can families, care givers and other systems help early intervention staff?

Build relationships with the EI

team Share how information with the EI teamLet the Early Interventionist know how its going day to dayTry the recommended strategies.

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Transition from the Infant/Toddler EI Program to Preschool EI:

Bucks County’s MH/DP service coordination and Infant Toddler EI services end at the child

’s 3rd birthdayBefore that, a new evaluation is developed by BCIU evaluatorsthis usually includes observations in the home or at child care A new IEP is developed

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The transition from Preschool EI to

School Age Special Education:BCIU staff support the family as they begin transition planning for a special education program in their school district or private school

The IU begins this process each fall, a year before children starts school The first step is a meeting with the school district, the family, and an EI representative.

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What can you do right away?

Help the parent call the EI program!

For Infants and Toddlersbirth up to age 3 215-444-2828For Preschoolers ages 3 to 5 years 800-770-4822 x1716Slide32

Thoughts

QuestionsFeedbackSlide33

Overview of Mental Health Services

Bucks County Department of MH/DPPresentation by Lisa A. HaraburdaSlide34

Bucks County Department of Mental Developmental ProgramsSlide35

Our roles:

The Interagency Team Planning Process and CASSPInteragency planning is utilized to provide an opportunity for individuals and families to coordinate existing services and supports, as well as identifying additional resources. We work as a team with all involved child-serving systems.The team works to develop comprehensive recommendations and activities to support successful outcomes and well-being for the child and family (home, school and community).

Provides an opportunity to brainstorm and bring people together across systems, agencies and natural supports.Looks at the individuals strengths, needs, hopes and opportunities for positive change.CASSP seeks to understand how the children’s behavioral health system works in our County and can serve as a resource to family members, providers and others who need assistance with services. This includes providing information on resources and technical assistance.Slide36

Child & Adolescent Service System Program (CASSP) Principles

Child-centeredFamily-focusedCommunity-based

Multi-systemCulturally-competentLeast-restrictive/least-intrusiveSlide37

Accessing the Behavioral Health System through Medical Assistance (MA) and County Funding

A child/adolescent must meet eligibility requirements for MA through documentation of a disability. Typically, individuals come to the system by referral from schools, child-care providers, health care providers and family members.

Magellan Behavioral Health is the identified MCO for Bucks County.If MA eligible, the member/family should contact Magellan to request an assessment for services. Depending on the service requested, the member may be referred to their primary insurance.County Funding is available for specific services and needs to be authorized by County Staff ( FSS ).Slide38

Administrative Case Management

Service Description: General case management that provide referral, monitoring and service coordination. Funding Source: County

Population Served: Children/Adolescents/Transition AgeSlide39

Asperger’s

Awareness, Community Education and Support (AACES)Includes the Coffeehouse Center of Bucks County. This program is designed to support successful transition for individuals ages 16-26 years-old with a diagnosis of Asperger’s Syndrome or PDD/NOS. Provides social skills training and informal peer support. Currently serves 30 individuals.

Funding Source: ReinvestmentPopulation served: Transition age youthSlide40

Behavioral Health Rehabilitation Services for Children & Adolescents

Service Description: Individualized strength-based behavioral health services delivered in the home, community, school, or in combination as medically necessary. Services are designed to keep a child in the community( least restrictive environment ). These services include but are not limited to mobile therapy, behavioral specialist and therapeutic staff support.

Funding Source: HealthChoices; MA Fee-for-ServicePopulation Served: Children/AdolescentsSlide41

Blended Case Management

(formerly Intensive Case Management & Resource Coordination)Service Description: Eligibility-based case management service with 24/7 capacity to provide individualized, face-to-face contact with person on an ongoing basis to assist the person in gaining access to needed supports, services and to assist in the coordination of care.

Funding Source: County; HealthChoices; MA Fee-for-ServicePopulation Served: Adults; Children/AdolescentsSlide42

Bucks County Children’s Crisis Support (ACCESS Services, Inc.)

Service Description: Available telephonically and through mobile engagement ( 8:00 AM- 8 PM) 24/7

-Bucks County Children’s Crisis Support offers telephone and mobile crisis support to individuals (up to 21) and their family members. Includes follow-up if needed and referral to appropriate services and supports.Funding Source HealthChoices and County Base Dollars (Children’s)Population Served: Birth-21.Slide43

Family Based Mental Health Services

Service Description: Intensive, team delivered family therapy and case management delivered in the child’s home, school and community with crisis response and prevention available 24 hours a day/7 days a week for a maximum of 32 weeks.Funding Source: County (NHS only); HealthChoices; MA Fee-for-Service

Population Served: Children/AdolescentsSlide44

Outpatient Services

Service Description: Mental Health treatment services provided by qualified mental health professionals that include individual, group and family therapy, medication management, diagnostic evaluation and assessment. Funding Source: Commercial insurance, County; HealthChoices; MA Fee-for-Service; Other

Population Served: Children/AdolescentsSlide45

Hi-Fidelity Family Teams

What is HiFi? Bucks County High Fidelity Family Teams utilizes a national model to bring change to the lives of families who have children with complex needs through the following ways: Partnering with families to use their voice and strengths as well as professional and community supports to build teams that keep children in their own homes and communitiesOffering a family-driven planning process that puts families and youth in charge of their own plan

Supporting families to function with more community supports and fewer professional supports in their livesBringing people together from different parts of the family’s life to help families realize their hopes and dreamsNot available to children diagnosed on the autism spectrum Funding: Reinvestment Population Served: Children and adolescentsSlide46

Respite Care

Service Description: Provides a short-term, temporary care to families who need support in caring for a child with behavioral needs. The goal is increased well-being of the entire family through a structured break, either in the home or in a host-home.Funding Source: County funds and BHS reinvestment

Population Served: Children and AdolescentsSlide47

ID Intake

Referral made by family memberContact our Intake Office – 215=444-2800Submit reports and evaluations that document an IQ of 70 or below prior to age 22Assigned to a BSU and Supports CoordinatorSC helps family/individual to access community supports and services, as well as MA funded services (Waiver – when need is assessed and funds are available)Slide48

Overview of Mental Health Services for Adults and Suicide Prevention in Bucks County

Wendy Flanigan- Bucks County Department of Mental Health/Developmental ProgramsSlide49

Accessing the Behavioral Health System through Medical Assistance (MA) and County Funding

An Adult must meet eligibility requirements for MA through documentation of a disability. Typically, individuals come to the system by self referral, family members, or transition to the Adult services from children services. Magellan Behavioral Health is the identified MCO for Bucks County.

If MA eligible, the member should receive an intake at with a Bucks County provider that accepts MA- Penndel Mental Health, Lenape Valley Foundation, Penn Foundation, and Family Services.County Funding is available for specific services.Slide50

Administrative Case Management

Service Description: General case management that provide referral, monitoring and service coordination. Funding Source: CountyPopulation Served: AdultsProviders that provide ACM- Penndel Mental Health, Lenape Valley Foundation,

and Penn FoundationSlide51

Blended Case Management

(formerly Intensive Case Management & Resource Coordination)Service Description: Eligibility-based case management service with 24/7 capacity to provide individualized, face-to-face contact with person on an ongoing basis to assist the person in gaining access to needed supports, services and to assist in the coordination of care.Funding Source: County;

HealthChoices; MA Fee-for-ServicePopulation Served: Adults; Children/AdolescentsSlide52

Assertive Treatment Team (ACT)

Service Description: ACT is a service-delivery model that provides comprehensive, locally based treatment to people with serious and persistent mental illnesses. ACT recipients receive the multidisciplinary, round-the-clock staffing of a psychiatric unit, but within the comfort

of their own home and community. ACT team members are trained in the areas of psychiatry, social work, nursing, substance abuse, and vocational rehabilitation.Funding Source: County; HealthChoices; MA Fee-for-ServicePopulation Served: AdultsSlide53

Bucks County Crisis Support

Service Description- Provides 24/7 crisis intervention services throughout Bucks CountyGrandview Hospital- Crisis services are provided by Penn FoundationDoylestown Hospital- Crisis services are provided by Lenape Valley Foundation

Lower Bucks Hospital- Crisis services are provided by Lenape Valley FoundationMobile Crisis Services- (Monday-Friday)- Crisis services are provided by Lenape Valley FoundationFunding Source HealthChoices and County Base Dollars (Adult)Population ServedSlide54

Outpatient Services

Service Description: Mental Health treatment services provided by qualified mental health professionals that include individual, group and family therapy, PHP, TOP, medication management, diagnostic evaluation and assessment. Funding Source: Commercial insurance, County; HealthChoices; MA Fee-for-Service; Other

Population Served: AdultsSlide55

Housing- Community Rehabilitation Residences (CRR) and Supported Living

Program Description- Housing options for eligible people with serious and persistent mental illnesses. Supervision varies from programs to meet individuals’ needs. Housing is transitional and helps individuals move on to independent living.Funding Source- CountyPopulation Served- AdultsSlide56

Suicide Prevention

Bucks County Suicide Prevention Task ForceWendy Flanigan- Chair- wflanigan@buckscounty.org- 215-444-2882Sharon Curran- Chair- scurran@Lenapevf.org - 267-893-5500Maria Picciotti- Chair- mpicciotti@fsabc.org-

215-355-6611SubcommitteesTAY First ResponderAdultProfessionalOlder AdultsSlide57

Suicide Prevention Con’t

Initiatives#HoldOnYouMatter Walk- April 30th at Bucks County Technical SchoolQPR trainingConcertSlide58

Questions? Comments?

THANK YOU!Wendy Flaniganwflanigan@buckscounty.org

215-444-2882Slide59

Intellectual Disability(ID) Intake & Supports

Bucks County Department of Mental Health/Developmental ProgramsSlide60

How to Connect with ID Intake

Main Number215-444-2800Intake Referral Line215-444-2847

Individual/legal guardian must call to start processSlide61

Intake Process

Initial letterFollow-up letterRecord Request(s)Complete packet or closureRecord reviewEligibility determinationIntake meetingTransfer to Supports Coordination OrganizationSlide62

Documentation Required

Standardized assessment(s) of intellectual functioningStandardized assessment(s) of adaptive functioning (ABS)Educational records

Medical recordsRelease of Records request forms Signed Health Insurance Portability and Accountability Act (HIPPA) Notice of Privacy PracticesBirth CertificateSocial Security CardMedical Assistance CardsThird Party Insurance Cards,Legal Guardian or Custodial DocumentsProof of Citizenship Slide63

Intake/Registration Eligibility Criteria

Licensed psychologist, certified school psychologist, psychiatrist, or licensed physicianPerformance that is at least two standard deviations below the mean of a standardized general intelligence test (IQ of 70 or below)Manifested during the developmental period (birth to age 22)

Psychological and ABS consist of the following:The clinical data and an overall score.A statement by the certifying practitioner that the results are considered valid and consistent with the person’s degree of functional restriction.A statement by the certifying practitioner as to whether the results indicate that the individual has intellectual disabilitySlide64

Supports Coordination

Individuals who are registered receive Supports Coordination servicesLocate, Coordinate, and Monitor an individual’s services and supportsSlide65

Home & Community Based Waiver Services (HCBS)

Service PreferenceHome and Community-Based ServicesICF/ID ServicesComplete Prioritization of Urgency of Need for Services (PUNS)Prioritizes the needs of registered individuals to determine who are in most need of waiver services, at a given timeUnfortunately, resources are limited Slide66

Home & Community Based Waiver Services (HCBS)

There are two HCBS Waiver programs for individuals with intellectual disabilityConsolidated Waiver (no cap)Person/Family Directed Supports Waiver (has an annual spending cap)The ID Waivers primarily support adultsIndividuals who are school aged are entitled to receive medically necessary supports through EPSDT servicesSlide67

Home & Community Based Waiver Services (HCBS)

The receipt of waiver services is:Based on assessed needsThat are required for the participantSlide68

Home & Community Based Waiver Services (HCBS)

Waiver services include:Assistive Technology Behavioral SupportCompanion ServicesEmployment ServicesHome and Community Habilitation (Unlicensed)Home Accessibility Adaptations

Licensed Day HabilitationNursing ServicesResidential Habilitation Services (Consolidated Waiver)Slide69

Home & Community Based Waiver Services (HCBS)

Waiver services (continued):RespiteTherapy ServicesTransportationVehicle Accessibility AdaptationsSlide70

Upcoming Changes

The state has proposed the addition of autism as a qualifying diagnosis for the Consolidated and P/FDS waivers, as of 7/1/17.This needs to be approved by the Centers for Medicare/Medicaid servicesThe state has proposed that prevocational & day habilitation services be replaced by Community Participation supports, as of 7/1/17.This needs to be approved by the Centers for Medicare/Medicaid services Slide71

Navigating Behavioral Health Services for Youth and Young Adults

Emily Ferris Transition-Age Youth Support CoordinatorMagellan Behavioral Health of Pennsylvania April 27th, 2017 Slide72

About Magellan Behavioral Health of Pennsylvania…

Magellan manages the behavioral health benefits for members of Pennsylvania’s HealthChoices program in Bucks, Delaware, Montgomery, Lehigh, and Northampton Counties. Pennsylvania HealthChoices Program

To become a member of the Pennsylvania HealthChoices (Medicaid/Medical Assistance) program, you can apply through: COMPASS (Pennsylvania’s online application for health and human services program) www.compass.state.pa.us/Compass.Web/public/cmphome Bucks County Assistance Office 1214 New Rodgers Road, Bristol, PA 19007-2593 (215) 781- 3300 How does Magellan help? Learn about and get the services you need. Find a provider. Get answers to your questions. Get a referral for care. April 27, 2017Youth & Young Adult Services

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Mission Statement

Magellan Behavioral Health of Pennsylvania is committed to ensuring the delivery of high-quality behavioral health care to help individuals and families achieve their goals. We partner with local counties, providers, members, families and other stakeholders to ensure a system of care based on innovation,

clinical excellence and a philosophy of wellness that focuses on discovering personal strengths, building hope and offering choices. Together, we facilitate and accelerate transformation of the behavioral health system, supporting individuals and families on their journey toward recovery, building resiliencein their lives and securing a healthier future.73Youth & Young Adult ServicesApril 27, 2017Slide74

How do I get services?

You can go directly to an in-network provider to ask for care. Finding an in-network provider: Visit http://magellanofpa.com/

to find a provider near you. Call 1-877-769-9784 to speak to a customer service representative.Getting the appropriate type of care: Your provider will work with you to see what level of care will best fit your needs. Your in-network provider will know how to get your services approved through Magellan. Some services will require an evaluation or preauthorization. If you have any questions during this process, you may call Magellan at 877-769-9784. If you feel that you need to see an out-of-network provider, please call our customer service department. All out-of-network providers must have prior authorization. Out of Pocket Costs & Benefit Limitations: As a recipient of Pennsylvania Medical Assistance, there are currently no benefit limitations or out-of-pocket costs for medically necessary covered services. You have the right to request a second opinion from a network provider at no cost to you. April 27, 2017Youth and Young Adult Services

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http

://www.magellanofpa.com/benefits-services-pa/pa-member-handbook.aspx Pennsylvania Member Handbook Pick up a hard copy today or view online at

: Slide76

Getting Help for Youth and Young Adults…

My Role… The role of the Transition-Age Youth Support Coordinator is to support efforts to enhance supports and resources for youth and young adults so that their wellness and recovery goals become more attainable. Challenges and Opportunities 1 in 5 young adults live with a mental health condition. Half of those youth develop the condition by age 14 and three-quarters by the age of

24 (National Alliance on Mental Illness) Supports and Services specifically Transition Age Youth in Bucks County: Transition to Independence Process (Access Services) Now is the Time Healthy Transitions Grant funded services: Bucks County LIFE (Access Services) TAY RISE (Child and Family Focus) TAY HiFi (Child and Family Focus)April 27, 2017 Youth and Young Adult Services76Slide77

Getting Connected….

April 27, 2017 Youth and Young Adult Services

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April 27. 2017

Youth and Young Adult Services78

Magellan Youth Leaders Inspiring Future Empowerment Magellan’s MY LIFE Program is leading the way nationally for youth in behavioral health and foster care systems. MY LIFE Consists of youth ages 13 – 23 who have experience with mental health, juvenile justice, substance use, and foster care related issues. Regular meetings are the foundation of the MY LIFE model, providing youth the opportunity to come together to create a community of support, plan activities and initiatives, practice social skills, learn from presenters and provide peer mentoring. MY LIFE…Slide79

Confidentiality Statement

April 27, 2017 Youth and Young Adult Services79

By receipt of this presentation, each recipient agrees that the information contained herein will be kept confidential and that the information will not be photocopied, reproduced, or distributed to or disclosed to others at any time without the prior written consent of Magellan Health, Inc. The information contained in this presentation is intended for educational purposes only and is not intended to define a standard of care or exclusive course of treatment, nor be a substitute for treatment.Slide80

Bucks County Intermediate Unit

Multi-Systems Training

April 2017Caryn Kadel,Interagency CoordinatorBucks County Intermediate Unit

ckadel@bucksiu.org

215-348-2940 x1102Slide81

How Many Schools?

131 Public Schools in Bucks County

(104,000+ students)Over 60 Non-Public, Catholic, Academies and Charter Schools(19,000+)Slide82

Funding

Local school district contracts and shared contributions

State allocations and grantsFederal grants and projectsSlide83

Non-Public School Services

Remedial Rea ding and Math Programs

Counseling/Psychological ServicesProfessional developmentSpecial education servicesSlide84

Safe and Drug Free Schools

Prevention programs to all public and non-public schools in the areas of:

AlcoholTobaccoDrugsViolenceSuicide preventionBullyingPeer mediation/conflict resolutionSlide85

Special Education Services

Classroom Programs

Itinerant ServicesRelated ServicesSlide86

Eligibility for Services

Services for K-12 students are requested through individual school districts with parent agreement and are usually reflected in the IEP

Services for Early Childhood (ages 3-5) are requested by parent

Parent must be in agreement with all services providedSlide87

Head Start and Early Head Start

Head Start and Early Head Start are federally funded programs designed to meet the social, educational, emotional, health, and nutritional needs of income eligible children and families.Slide88

Head Start

open to residents of Bucks County, PA this program is FREE to qualified low income children ages 3-5.  Head Start programs support children’s growth and development in a positive learning environment through a variety of services including early learning, health and nutrition, and family well-being. 

Head Start Features:Full-time, full-day classroomsClass size is approximately 15-20 studentsActive learning environmentsNutritional snacks and mealsFamily involvementServices for children with special needs Slide89

Early Head Start

Early Head Start

FREE to qualified low income pregnant women and children ages birth to 3.  Early Head Start programs support children’s growth and development in a positive learning environment through a variety of services including early learning, health and nutrition, and family well-being. Early Head Start Features:Weekly home visits Monthly socialization groups

Promotes parents and children learning together

Health and wellness services

Mental and behavioral health services

Opportunities to engage in community activities Slide90

Classroom Programs

Preschool Early Intervention ServicesAutistic/Pervasive Developmental Disorder

Severe Language SupportDeaf and Hard of Hearing SupportMultihandicapped SuppportPhysical SupportLife Skills SupportEmotional SupportLearning SupportSlide91

Early Childhood Services

Responsible for all 3-5 year olds with special needs

Conducts screenings, evaluations and direct servicesOver 80 programs with 5000 children servedSlide92

Autistic Support

527% increase in past 10 years

Over 60 classesUses varying instructional trainingSlide93

Multiple Disabilities Support

Trend from institutionalization to community support in least restrictive environment

Complex medical conditionsAssistive technologySlide94

Related / Itinerant Services

School PsychologyAudiological Evaluations

Occupational TherapyPhysical TherapySocial Work ServicesJob Development/Placement CoachingTransition ServicesInterpreter ServiceAssistive TechnologyStaff DevelopmentTransportationSpeech and LanguageGiftedVision SupportHearing SupportSlide95

Bucks County Intensive Interagency Program

Students who are at risk of not receiving an appropriate educational program for 30 days or more due to barriers in locating or implementing such a program are referred/reported to the BCIU Interagency Coordinator or to the Regional Interagency Consultant at PaTTAN by school districts, families or community agency professionals.Slide96

Intensive Interagency Team

Identify strengths and needs of student

Determine barriers to placementInsure involvement of all relevant child-serving systemsDraft action plan with timeline, outlining steps to secure appropriate services for studentIdentify primary case manager to facilitate team communication Slide97

Intensive Interagency Team

Bucks County CASSP Director

Barb Miller215-444-2800bjmiller@co.bucks.pa.usChildren’s Services Coordinators Lisa Haraburda Joyce Lucas

215-444-2800 215-444-2800

laharaburda@co.bucks.pa.us

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CHILD WELFARE

Bucks County Children & Youth Social Services Agenc

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Our Mission

The Bucks County Children and Youth Social Services Agency is responsible under Pennsylvania Public Law to receive and investigate reports of child abuse and neglect, provide for the temporary care of children not able to remain with their own families and develop community-wide social service programs that promote family stability. The Agency endeavors to be responsive to the changing health and welfare needs of all families by encouraging the development of programs that reduce dependency and strengthen family life. Slide100

FEDERAL AND

Pennsylvania Public Law THAT GUIDES CHILD WELFARE PRACTICEJUVENILE ACT (42 Pa. C.S.A. Section 6300) The Pennsylvania Juvenile Act42 (“The Act”), was first enacted in 1972 as part of the general legal trend granting children a variety of constitutional protections. The Act enables the Commonwealth to intervene when a child is alleged to be “dependent.” The Juvenile Act recognizes ten categories of dependent child, i.e. - “is without proper parental care or control, subsistence, education as required by law, or other care or control necessary for his physical, mental, or emotional health, or morals.”

Child Protective Services Law (23 Pa. C.S.A. Section 6300) Enacted to protect children from abuse – physical, sexual, and mental abuse .23 pieces of legislation went into effect in December 31, 2014 which expanded the definitions and responsibilities of mandated reporters.Slide101

FEDERAL AND

Pennsylvania Public Law THAT GUIDES CHILD WELFARE PRACTICEASFA-ADOPTIONS AND SAFE FAMILIES ACT of 1997

ASFA imposed substantive and procedural requirements on states, courts and welfare system to better promote the safety and stability of abused and neglected children. Concurrent Planning-- working on reunification while developing an alternative placement plan. FOSTERING CONNECTIONS TO SUCCESS AND INCREASING ADOPTIONS ACT OF 2008 The Fostering Connections to Success and Increasing Adoptions Act (H.R. 6893) (the FCA or FosteringConnections Act) was signed into law on October 7, 2008, as Public Law 110-351. FCA amended parts Band E of title IV of the Social Security Act to connect and support relative caregivers, improve outcomesfor children in foster care, provide for Tribal foster care and adoption access, improve incentives foradoption, and for other purposes.Slide102

Children & Youth

Safety Assessment ProcessSAFETY ASSESSMENT AND MANAGEMENT PROCESS: Informs and guides all decisions made from intake through case closure, including removal and reunification decisions.

Information is used to conduct a thorough analysis to decide if a safety plan is needed and what specific interventions are available and accessible to control identified threats. Safety Interventions are used to supplement the caregiver’s protective capacities. The interventions may be in-home, out-of-home or a combination of the two. Slide103

WHAT HAPPENS WHEN A REPORT IS MADE ?

Screening Unit receives calls from the communityAssess every situation presented for immediacy of safety, risk and need. Screeners check previous history with the agency, do appropriate research (i.e. criminal checks, if necessary, DPW or DRO) checks for addresses and other data, and makes collateral contacts). Screeners gather as much information as possible to assist Intake in doing a thorough assessment.If it is an emergency, the Screening Unit passes the referral immediately on to Intake.Intake Supervisor reviews the case and assigns a response time depending of the age of the children and the allegations being reported. Intake further assesses the children and their families in a variety of ways, i.e. school, hospital, or home visits. Intake works with expediency to stabilize the situation. If further services are needed, the referral is transferred to one of the In-Home Divisions. Slide104

C&Y CHILD PROTECTIVE SERVICES

The Child Protective Services (CPS) Unit receives physical, sexual, emotional, and imminent risk reports from the community and Childline.Reports are numbered when the Alleged Perpetrator (AP) is a parent, person responsible for the welfare of a child, an individual residing in the same home as a child or a paramour of a child’s parent.

Numbered reports require that the child victim is seen within 24 hours.Serious physical and sexual reports are reported to the local police and the District Attorney’s office.When the worker does the 24-hour contact, he/she assesses the seriousness of the injury/report and reacts accordingly in order to address the safety and well-being of the child. Cases can involve placements and/or court involvement, if necessary. Slide105

C&Y GENERAL PROTECTIVE SERVICES

AGES 0-8Assess caretaker protective capacities in accordance with PA State Safety Assessment Create Caretaker Safety Plan if necessary

Assess household in accordance with PA State Risk Assessment. Identify factors which present safety or risk to the child(ren).Open case for service on sixtieth (60) day. Parent has appeal rights.Create Family Service Plan with the family specifying goals to reduce or negate safety and risk to children. Parent has appeal rights.If the risk or safety concerns rise, or there is lack of FSP goal completion, court action could be necessary for compliance or temporary placement.Issues of child neglect, medical neglect, Drug and Alcohol or Mental Health issues by the parent/caregivers, homelessness.CAPTA Children.Develop a Family Service Plan to outline objectives needed to address allegations/concerns.Slide106

C&Y GENERAL PROTECTIVE SERVICES—AGES 6-18

General issues of Neglect for school age youth

Assess safety of youth experiencing: Severe parent-child conflict Youth drug & alcohol issues Youth mental health issues Truancy Running away Defiance/acting out behaviors Curfew violationsCaseworker strives to assist family in problem-solving without resorting to foster placementCaseworker provides community service connections and collaboration (includes 13 school districts, Juvenile Probation, Mental Health/Mental Retardation systems, drug & alcohol resources)Slide107

C&Y PLACEMENT SERVICES DIVISION

Placement Services

How is a child matched with a placement? Child’s needs Siblings Location of home/school district Other children placed at foster home/facilityWhat type of placement is needed?  Foster care Kinship Agency Provider Group HomeWhat is Emergency Caretaker and when is that done?

Clearances

Home visit

What if child has mental health needs? How is the right placement found?

A. Evaluation of client needs:

Inpatient hospital-acute, RTF –chronic,

Therapeutic foster

care,Partial

hospital 

  Maintain Agency foster homes, provide foster parent training, meet state regulations.

  Slide108

C&Y PLACEMENT SERVICES DIVISION

Foster Care

Foster Care—Goal becomes ReunificationCase ManagementEnsure visits occur between children and parents (Supervised or unsupervised)Frequency—Regulation = One hour every two weeksPlacement Permanency Plan (PPP)—Develop with family; review every six monthsDetermine services needed to address issues that brought child into careAssist family in accessing servicesMental Health treatment Housing Counseling Substance Abuse TreatmentEnsure court paperwork

is completed and review hearings are scheduled

Evaluate Progress

Meet with parents and children

Maintain contact with service providers

Attend Concurrent Planning Review (CPR)

Permanency Review

Visit with child at placement setting

Once per month—insure medical, dental, educational, developmental, psychological needs

SPLC—Subsidized Permanent Legal Custodianship

Independent Living

—Personalized Transition Plans developed at age 16

Tabor Services—Life-skills--Take Ansell-Case Life Skills Assessment Life Skills Group (15 Weeks)

Self esteem/interpersonal relationships

Goal and career planning

Resume and interview skills

Banking and money management

Higher education

Eligible to stay in care up to 21

st

birthday—Board Extensions

Slide109

QUESTIONS?Slide110

Bucks County

Drug & Alcohol Commission, Inc. Renee M. Calhoun, LMFT, CAADC, CCDPD, CTTSApproval of Care Supervisor600 Louis DriveSuite 102AWarminster, PA 18974

215-773-9643267-885-1336 (fax)Slide111

Accessing Services

AssessmentOpen access and appointmentsFace to Face InterviewReviews client history including drug use, medical issues, and mental health as well as a variety of other questions to help determine the most appropriate placementTreatment RecommendationsLevels of care as well as specific programming (trauma, MAT, etc.)Non treatment related needs are assessed and referred for as appropriate

Healthcare coverage, basic needs, physical health, emotional/ mental health, family, childcare, legal status, education/ vocation, life skills, social, and employmentSlide112

Eligibility Criteria

Must be a Bucks County ResidentResidential- 90 days prior to the assessmentAmbulatory- 30 days from the date of the assessmentExceptions may be given for priority populationsPregnant women & adolescents are always exempt from any restrictionsMust be the payer of last resortCannot be covered through other insurance such as private insurance, Medicare,

HealthChoices, etc.Priority populationsPregnant IDU, pregnant substance abusers, IDU, Veterans, overdose survivorsSlide113

Ambulatory Services Offered

All ambulatory services include a combination of individual, family, and group therapy as well as psychiatric servicesPartial Hospitalization- minimum of 3 days per week with a minimum of 10 hours per weekIntensive outpatient- 5-9 hours per weekGeneral outpatient- up to 3 hours per weekSlide114

Residential Services Offered

All residential services include a combination of individual, family, and group therapy as well as psychiatric servicesDetoxificationHospital Non HospitalRehabilitationHospital Non Hospital Short Term- up to 28 days

Long Term- up to 90 daysDualHalfway HouseCommunity based, state licensed, regulated and professionally staffed; live in/ work out environmentSlide115

Medication Assisted Treatment

MethadoneSuboxoneVivitrolSlide116

Ancillary Services

Mobile Engagement ServicesSpecialty program with C&YIntensive Case ManagementCenters of ExcellenceBCARESBPAIRRecovery CentersRecovery Houses

NarCan DistributionSlide117

Transition Aged Youth Population

Young People in Recovery AmiCareSlide118

Family Participation

Family participation is encouraged throughout all levels of care and through all programs. Each provider handles family involvement differently. Some providers have monthly groups open to the public, most inpatient providers family have to attend a psychoeducation lecture before visitingVoice and Vision Survey with TAY population indicated client’s requested more family engagement during treatment and next steps involve obtaining feedback from providers about what the barriers are to doing soSlide119

Collaboration

Elise Case StudySlide120

Bucks County

Drug & Alcohol Commission, Inc. Renee M. Calhoun, LMFT, CAADC, CCDPD, CTTSApproval of Care Supervisor600 Louis DriveSuite 102AWarminster, PA 18974

215-773-9643267-885-1336 (fax)Slide121

Bucks County Juvenile Court

55 East Court Street 6

th FloorDoylestown, PA 18901Slide122

WHAT IS JUVENILE COURT?

The court that hears cases involving juveniles between the ages of 10 and up to age 18 who have been charged with specific types of crimes.Juveniles can remain under Juvenile Court supervision until they are 21 years old Slide123

HOW DOES A JUVENILE COME TO THE ATTENTION OF JUVENILE COURT?

Juveniles are referred to Juvenile Court by the police or any law enforcement agency who have filed criminal charges.Slide124

WHAT HAPPENS WHEN A JUVENILE IS REFERRED TO JUVENILE COURT? One Of Two Paths Can Occur

A decision needs to be made whether the juvenile should be detained or not.If the decision is to detain, the juvenile is taken to the juvenile detention centerSlide125

WHAT HAPPENS WHEN A JUVENILE IS REFERRED TO JUVENILE COURT?

A detention hearing is held within 72 hours to determine whether the juvenile should remain in detention or be released.

If the juvenile remains in detention a court hearing has to take place within 10 days.If the juvenile is not detained an intake interview will be scheduled by the Juvenile Probation Department.Slide126

WHAT HAPPENS DURING AN INTAKE INTERVIEW?

A probation officer will ask lots of questions to find out as much as possible about the juvenile and the family.

A decision is made to schedule the case for court or divert the case from court.Slide127

WHAT IS DIVERSION?

For less serious charges, juveniles are given an opportunity to be placed on a probation contract without going to court. It is less formal than going to court and the probation period is not as long as for those going to court.Slide128

WHAT HAPPENS IN JUVENILE COURT?

The District Attorney reads the charges to the Judge.The Judge asks the attorney representing the juvenile if the juvenile admits to or denies the charges.

If the juvenile admits, the Judge will make a finding and ask the probation officer for a recommendation of placement or probation based on BARJ and EBP.If the juvenile denies, then the Judge hears evidence before making a finding.Slide129

WHAT HAPPENS IN JUVENILE COURT?

If the Judge makes a finding for the juvenile, the charges are dismissed and the juvenile is free to go.If the Judge makes a finding against the juvenile, the Judge asks the probation officer for a recommendation of placement or probation based on BARJ and EBP.

The Judge imposes the court orderSlide130

WHAT IS BARJ?

Balanced and Restorative Justice, which is equal attention to:Community Protection – protecting the community from the criminal acts of juvenile offenders

Accountability – Holding juveniles accountable to the victim and the communityCompetency Development – developing skills in the juvenile offender to make the juvenile a more productive citizenSlide131

WHAT IS JJSES?

JJSES

was rolled out in Pennsylvania in 2012 implementing strategies that are grounded in evidence-based practices (EBP) seeking to prevent delinquency and out-of-home placement by working with juveniles to reduce their risk of recidivism and to enhance those protective factors that result in a law-abiding life.

Evidence-based practice simply means using research that has shown “what works” and applying what has been scientifically shown to be effective to what we do in our work with youth, their families, and the communities in which we live.Slide132

WHAT DOES EBP INCLUDE?

Using a statistically valid assessment to guide case decisions that describe who will most likely need interventions,

what specific needs must be addressed to reduce reoffending behavior, and how to match interventions with an individual’s traitsGetting juveniles treatment ready and engaged by using motivational interviewing, strength based approaches, and rewards and sanctionsTarget interventions by using behavioral and cognitive behavioral techniques (interventions designed to restructure problematic thinking patterns and attitudes) on medium and high risk juvenilesSlide133

ASSESSING CRIMINOGENIC RISK/NEEDS

Using the Youth Level of Service (YLS) assessment tool 8 domains are measured to identify risk to reoffend.

Main Four Dynamic Risk Factors:Antisocial Thinking Antisocial Personality/Attitude Antisocial Peers Family CircumstancesLesser Four Risk Factors:Substance Abuse Education Employment LeisureSlide134

WHAT IS PLACEMENT?

The juvenile is removed from home and placed into foster care or a residential facility for a period of time.Slide135

WHAT IS PROBATION?

The juvenile remains at home and fulfills the court ordered obligations, which can include:Community Service

RestitutionFinesCounselingOther in home servicesSlide136

Types of Probation Officers

IntakeLine/Community Based InstitutionSlide137

WHAT DOES A PROBATION OFFICER DO?

Prepares a case for courtCompletes YLS assessment

Collaborates with juvenile and family to create a case planCollaborates with private providers and other agencies to connect needed servicesMakes the recommendation to the judge, including the conditions of probationSlide138

WHAT DOES A PROBATION OFFICER DO?

Supervises the order of the court

Works as an “Agent of Change” with the juvenileUsing tools like Motivational Interviewing, risk assessment, and the case plan to track and update goals and activities Slide139

WHAT DOES A PROBATION OFFICER DO?

Case Closing Process:Ensures that all court ordered conditions were completedFacilitates the connection of the juvenile/family to other community based services if neededCommunicates with other involved juvenile or adult agencies Slide140

Questions?