Placer County Children's System of Care Collaborative Services

EMERGENCY SERVICES

Family & Children's Services - Child and Community Emergency Services System

• Information and Referral: Within Family & Children's Services, the intake staffs are trained to provide information and referral to all of our clients upon request. Each intake unit has a resource binder that is constantly updated with all known Placer County resources and many resources and services that are available in our surrounding counties.
• Intake: Within the Family & Children's Services team, intake staff provides 24-hour phone coverage, ensuring that all calls requesting service, emergency or routine services issues, as well are triaged in a timely and appropriate manner.
• Crisis Intervention: The Family & Children's Services Response team provides telephone and one-on-one mental health crisis intervention services.
• 5150 Mental Health Assessments: Family & Children's Services Response team has been certified to assess persons for involuntary hospitalizations as a danger to self, danger to others, or gravely disabled due to a mental disorder (California Welfare and Institutions Code 5150). These staff then consults with designated psychiatrists who have the authority to admit patients to certified or licensed psychiatric facilities.
• Mental Health Assessments: Assessments for ongoing Mental Health Services are provided by Masters level professional staff in Auburn, Roseville and King’s Beach (Tahoe area) for all of Placer County. In the Tahoe area these services are provided through Sierra Family Services, a contract provider. Self-referred individuals or families will either have an appointment scheduled with Family & Children's Services or Sierra Family Services or they will be linked to an appropriate provider depending on needs and insurance coverage. (Note: Public Agency referrals for mental health services are not triaged for CSOC Team Assignment through Family & Children's Services, but are assigned through the CSOC Case Assignment Meeting and/or a SMT Family Conference.) After each assessment is completed, persons requiring additional mental health services will be referred to the Children’s System of Care (CSOC), the Adult System of Care (ASOC) or to one of the 80 certified network providers. A supervisor, who screens the referral for level of intensity, makes this determination.
• Private Psychiatric Inpatient Services: Placer currently has multiple contracts with Children and Adolescent facilities with easy driving distance for families. Placer ensures indigent, under insured, as well as Medi-Cal children and adolescents have access to inpatient care. Placer provides immediate case management services.
• CWS – Child Welfare Services: The Family & Children's Services Response team has been designated to provide emergency response investigations and services to children and families who are at risk or have suffered from abuse or neglect. CSOC staff partner with key community agencies to provide prevention and early intervention services to families who may not be experiencing abuse or neglect of children, but who are experiencing related high risk.
• Family Team/Family Conferencing Pilot: The Family & Children's Services Response team has begun to use Family Conferencing with at risk families to develop, whenever possible, an agreed upon family based alternative to court intervention to assure children are kept safe and not at risk to abuse or neglect. A specially trained mediator joins the Family Team to develop a plan. All staff receives trainings and supervision in the family conferencing model. The Court Officers including Judges, County Counsel, and Minor’s Attorney’s, the District Attorney and the Public Defender are in support of this approach.
• MDIC: Multi-Disciplinary Interview Center: The Multi-Disciplinary Interview Center is a child friendly office where a specially trained social worker and a supporting team of specially trained law enforcement and legal professionals are able to interview and videotape a child regarding suspected child abuse, usually sexual abuse. This interview is used in the criminal prosecution of the perpetrator and/or in the dependency hearing process. The many benefits of this interview include reducing the number of times the victim must be interviewed and avoiding the interrogation of cross-examination in court.
• Court Unit: A specialized unit to assure that in all situations where children must be legally detained, or the Department files a petition to request that the juvenile Court intervene in the family, the child abuse and neglect investigation and submission of court reports occur in a timely fashion. The staff completes a detailed and thorough investigation of the issues which brought the family to the attention of the Department, the results of their investigation, along with a presentation of the family strengths and issues which may have led to the abuse or neglect.
• Family Support Counselor Team: Short Term: Support Counselors assure those families entering the court process receive the services needed and required from the outset. Services may include transportation, supervised visits, scheduling specialized intervention services and placement of the children with relatives or in foster care.
• Behavioral Health Service: Case Management Less Intensive: Placer County has organized a network of 80 private sector practitioners (i.e. Licensed Marriage Family Therapists, Licensed Clinical Social Workers, Psychologists and Psychiatrist) who are available to provide behavioral health/mental health services to children, families and adults. Under direction from CSOC/Family & Children's Services teams Placer County Services Authorization Unit staff is able to match the need of each individual with a practitioner in this network and authorize services for up to six (6) months. The needs of individuals served by these network providers fall in the “less intensive” end of the continuum. In other words, these individuals appear to be able to benefit from a single categorical service (e.g. behavioral health intervention). The Service Authorization Unit may also link a child or adult with medication evaluation and management services (as a stand-alone service) with either a County or a community-based provider.
  
  Should any individual in this “less intensive” track need a referral to additional therapeutic and support services the Less Intensive Case Manager, who is a member of the Services Authorization Unit, merely completes the appropriate paperwork and the referral is placed into the case assignment process for either the Adult System of Care or the Children’s System of Care. SMART Management Team is available for a Family Conference if the complexity of needs require. Only individuals who appear to be making progress toward their outcomes remain in the “less intensive” track for services. All other individuals are reassessed for additional services and supports and whenever appropriate opened in the ongoing multi service intensive track in the System of Care.

ONGOING SERVICES

Mental Health Services (MHS)

• Members of Family Centered Service teams provide a full range of treatment and intervention services in the office, home, community and schools which are made available to all children and adolescents, no matter which agency door they entered through, who suffer from moderate to severe emotional or behavioral problems.
• Family Centered Support Teams may enhance these services or CSOC may purchase mental health services through a network or organizational or private provider.
• Medication evaluation, monitoring and support services are also available, as needed.
• Services may include assessment, individual, group, family, crisis, and therapeutic behavioral and case management services.
• Mental health services are generally provided in collaboration or integrated with other child and family services.
• Some of these collaborative services include.
  • Special Education/Mental Health Services: Treatment and placement services are provided through an Individual Educational Plans (IEP), pursuant to California Education Code, Section 26.5. Treatment Services may include individual, family or group therapy, medication support and monitoring, Intensive Day Treatment, Day Rehabilitation Services or Residential Placement. If Residential Placement is approved by the IEP team case management Services will be provided.
  • School Based Intervention Programs for Special Education Students who are Emotionally Disturbed: collaboration between CSOC, Placer Union High School District, Placer County Office of Education, Rocklin Unified School District and Equinox Residential Treatment Center. Treatment and placement services are provided through an Individual Educational Plans (IEP), pursuant to California Education Code, Section 26.5.
    • Sierra Vista School – Intensive Day Treatment for Junior High and High School
    • Secret Ravine School – Day Treatment Rehabilitative Services for Grades K-8
    • Del Oro High School – Intensive Outpatient Counseling Grades 9-12
    • Rocklin High School – Intensive Outpatient Counseling Grades 9-12
    • Rocklin Elementary – Outpatient Services for Grades 4-6
  • TBS - Therapeutic Behavioral Services: Specially trained family support counselors and other professional staff will provide one-on-one assessment and intervention services to children whose behaviors put them at risk for school or placement failure. These intensive services are individualized to meet the unique needs of each child.
  • Wraparound Services: Wraparound is a program for providing intensive in-home support services families in Placer County where children are at risk of out-of–home placement or they have been put in placement and cannot return home successfully without extra support. The Wraparound program uses the “whatever it takes” approach as it focuses on building upon family and individual strengths to reach successful outcomes. Success lessons learned from Wraparound will be applied to all other CSOC services.

Child Welfare Services (CWS):

Juvenile Probation Services

• The Juvenile Division of the Placer County Probation Department is bifurcated with some services provided within the Probation Department and some services provided within the Children’s System of Care. All services and programs operate under the oversight of the Chief Probation Officer who is also a member of the SMART governing board. Within the Probation Department, probation officers provide field supervision to youth on formal probation, operate a 70-bed Juvenile Detention Facility, and operate a Court Unit and a Placement Unit.
• Below is a comprehensive list of the services and programs provided through the Children’s System of Care.
  • Youth and Family Diversion Services: Information, referral, and short-term intervention services for children and youth that have runaway and/or are beyond parental control. The program has a group component consisting of 16 weeks of skill building, team building, and community service activities.
  • Youthful Offender Program: This is an early intervention education program (ages 11 and under), administered by the Probation Department and open to all CSOC staff for referrals.
  • Citation Hearing: The report prepared by law enforcement in connection with a crime comes first to the Probation Department for review. The Probation Officer assigned the citation hearing must make an initial determination of where the case will go next. Common dispositions include closing the case at intake with a warning, First Offender Program, Diversion Peer Court, informal probation or referring the case to the District Attorney’s Office for possible prosecution.
  • Informal Probation: Under this approach, the minor signs a contract to observe good behavior for six months. Drug testing, curfew, school attendance, and searchable probation are common terms and conditions of probation. Violation of the contract could result in the original citation being forwarded to the District Attorney’s Office.
  • Crisis Resolution Center (CRC): The CRC provides services to pre-delinquent youth and their families through collaborative, integrated, multidisciplinary approach, and a contract with a private group home provider to provide county wide services. The intent is to provide services to youth who are runaways, truant, or beyond control and at-risk of committing a law violation to prevent the escalation of behavior and decrease the likelihood of entrance into the Juvenile Justice System. The CRC provides short-term shelter care, crisis intervention counseling and follow-up outreach services to assure successful outcomes.
  • Intensive Services Caseload: All youth being referred to the Juvenile Division receive a risk/needs assessment to determine which youth need a high level of services and intense supervision. The youth with high level needs are transferred to the Probation staff within CSOC. Youth on the Intensive Services Caseload (ISC) will attend a Family Team Meeting within 30 days in order to develop a comprehensive unified services plan. The Probation Officer will be responsible for one face-to-face contact with the minor weekly, two (2) home visits monthly, two (2) contacts with the parent monthly and one (1) contact with school authorities monthly, in addition to ensuring the youth receives appropriate treatment and services.
  • Youth Resource Center (YRC):The YRC consists of a community school program provided in collaboration with PCOE and an after school program. The after school program is provided by community based programs through contract. Youth are referred to the program by Probation Officers after the completion of a risk and needs assessment. The after school includes mediation and conflict resolution, anger management, drug education, life skills, employment skills, health and HIV education, mentor ship, teem parenting and violence prevention.
  • Juvenile Drug Court: This is a specialized supervision and drug treatment program. Youth are on formal probation and attend intensive weekly counseling and supervision. There is a strong family component to the program. The Juvenile Court Commissioner meets with these youth, families, and service staff at least monthly to review progress and address consequences as needed.
  • Formal Juvenile Probation (Section 602 California W & I Code): Any person who is under the age of 18 and violates any law of the state, other than curfew, is within the jurisdiction of the Juvenile Court, which may adjudge such person to be a ward of the court. Field supervision requires two face-to-face contacts a month. Supervision usually lasts a minimum of six months.
  • Enhanced Services to the Juvenile Detention Facility: Through JJCPA (Juvenile Justice Crime Prevention Act) funding a full-time social work practitioner was transferred to the juvenile detention facility to provide mental health screenings, crisis intervention, and group treatment to youth housed in the detention facility. Other services are provided through contract with public and private agencies. These services include anger management, health education, substance abuse education, and conflict resolution and violence prevention.

Other

• Services Parent Involvement Family Advocacy Program: A major guiding principle of Placer County Children’s System of Care is the concept of family involvement and participation at every level of our organization, from active participation in advisory and decision-making committees and boards. Currently, CSOC employs a Parent Involvement Coordinator through a contract with United Advocates for Children of California. This Coordinator provides consultation, training and policy guidance on involvement of consumers and families in our mental health, child welfare, and probation and Special Education programs. The Parent Involvement Coordinator also offers direct advocacy services for families and serves on the SMART Management team and Quality Improvement Committee. Currently other parents volunteer their time to guide and mentor families receiving services in the system. A stipend helps to defray their expenses. A goal is to continue to increase family involvement at the direct services and policy levels. Another goal is add youth involvement in direct services and advisory and decision making committees.
• SMART Management Team (SMT): SMART Policy Board appoints the SMART Management Team. It is composed of managers from across the Systems of Care, the Department of Health and Human Services, and the SMART Governance Board. Managers represent the Adult System of Care, Children’s System of Care, Placer County Office of Education, Community Health, Cal Works, Juvenile Probation, and the Parent Involvement Coordinator. Referrals are made to SMT members from the parents, youth, community, schools, private providers, courts, SMART Policy, and County staff. SMT Managers review each request for SMT Presentation and have the authority to solve the reason for referral or set for SMT Conference. SMT Managers have complete authority to offer necessary services without further approval of administration. All parents, siblings, extended family members, teachers or mentors, counselors, pastors, or anyone who is significant to the child and family’s life may be invited to contribute to the SMT review process. The SMART Management Team meets weekly for up five (5) hours to:
  • Review intensive casework issues; resolve conflicts that exceed the capacity of the Family Team to address, and to assist in securing needed services and resources.
  • Review and authorize system access for otherwise “unfunded” children - assigning Lead Case management and authorize comprehensive services plan as necessary.
  • Authorize and review requests for out-of-state placements for children.
  • Authorize services as necessary.
  • Identify areas for system improvement.
  • Develop system change/improvement plans for implementation.
• Placement Review Team (PRT): SMART Policy requires review of all placement recommendations for Group Home, Residential Treatment Center, Camps, Ranches, State Hospital, and Youth Authority placements or all changes in placement levels through the SMART Placement Review Team, which is a subcommittee of the SMART Management Team. PRT meets weekly for up to three (3) hours to:
  • Assist the family in remaining together by reviewing alternative service possibilities and thereby avoiding high level out-of-home placement.  Review staff requests for out-of-home placement.
  • Provide authorization for Placement Prevention Services.
  • RAFT –SB 163.
  • Intensive in-home behavioral and family support.
  • Therapeutic Behavioral Services.
  • Provide authorization for Foster Family and Group Home Placements.
  • Provide authorization for additional services to ensure placement is successful.
  • Make recommendations to SMART Management Team for system improvements.
  • PRT representatives are appointed by SMART Policy. Team membership includes Children’s System of Care supervisors, a probation supervisor, a representative from Placer County Office of Education and a parent representative. The CSOC Probation Manager facilitates this team. All parents, siblings, extended family members, teachers or mentors, pastors, or anyone who is significant to the child and family’s life may be invited to contribute to the review process. SMART Management Members may serve as alternates to the Placement Review Team. SMT Managers have complete authority to offer necessary services without further approval of administration.
• Quality Improvement Committee (QIC): The purpose of the Quality Improvement Committee is to support integration of Placer Counties Adult and Children’s Systems of Care and Family-Centered Practice; including a strengths-based approach to working with clients and families to provide full-scope services in order to attain comprehensive desired outcomes. The QIC also oversees activities required for compliance with regulatory authorities and control agencies and reviews administrative and other organizational processes to promote their effectiveness and efficiency. The Quality Improvement Committee serves as the hub or our QI program and Links with the System of Care (SOC) Management Team, the Department of Health and Human Services (HHS) Policy Team, the Systems Management and Resource Team (SMART) Policy Board and committees, subcommittees and teams, which comprise the QIC. QIC functions as the overseeing body of all QI activities; review and evaluates the results of QI activities; ensures follow-up of QI processes; institutes needed QI actions; and recommends policy decisions. The membership of the QIC is a combination of community and consumer representatives and designated management staff. SOC Directors and Medical Director are standing members of the committee. The Quality Assurance Coordinator is executive staff to the committee. Some of the membership is derived from the leaders of the QIC sub-committees, which are as follows:
  • The Client-Family Relations Committee: This committee focuses on client concerns, including access to services, cultural competency, client outcomes, client satisfaction and other related activities to support client-family partnership with SOC. This committee reviews aggregate statistical data and information on access to services; monitors request for ethnic specific services, monitors the development and implementation of the SOC Cultural Competency Plan; reviews documentation submitted to it on client-related problem resolution activities.
  • The Behavior Health Network Committee: The purpose of this committee is to strengthen and support the collaborative partnerships between the County SOC and the larger Mental Health and Alcohol and Drug provider community; to ensure that positive and active communication takes place between the SOC and all interested providers; and to participate in the County’s continuous process for quality improvement. This committee serves as a continuous link between SOC and the provider community. It contributes to development of community resources by focusing on reviewing, training, credentialing and supporting private providers. This includes mental health and alcohol and other substance abuse providers.
  • The Cultural Competency Committee: The purpose of this committee is to ensure SOC continues to advance in its efforts to be culturally competent, with agencies, programs, and services that are responsive to the cultural, racial, and ethic differences of the clients/communities they serve. The committee focuses on developing and monitoring the implementation of the SOC Cultural Competency Plan. Specific functions include ensuring compliance with State Departments of Social Service and Mental Health regulations and best practices pertaining to cross-cultural service delivery; prioritization of unmet needs, submit recommendations to QIC for SOC implementation; develop, implement and support cross-cultural trainings on a regular basis; develop strategies for outreach to underserved groups with the larger community to enable those individuals to access SOC programs and services.
    
    Each of these committees meets at least monthly and prepares recommendations to the QIC for actions. In addition, the committee makes reports to the full QIC semi-annually. The QIC reviews and approves recommendations made by the Committees regarding system improvements and plans of correction. The Parent Involvement Coordinator and Consumer representatives are key members of the QIC.
• Unity Care Group - A non-profit community-based agency, providing educational and social programs to enrich the lives of at-risk-youth.
• United Advocates for Children and Families -  A non-profit organization with a mission to improve the quality of life for all children and youth with mental, emotional, and behavioral challenges and to eliminate institutional discrimination and social stigma.