Screening and Placement of Children, Youth and Nonminor Dependents (NMDs) in a Short-Term Residential Therapeutic Program (STRTP)
0100-510.55 | Issue Date: 01/07/19
Overview
This policy was developed to align with Continuum of Care Reform (CCR) mandates for placement of children/youth/NMDs in STRTPs and addresses the roles and responsibilities of placing a child/youth/NMD in an STRTP, including utilizing the Interagency Placement Committee (IPC) screening process.
TABLE OF CONTENTS
Short-Term Therapeutic Residential Program
STRTP Placement Criteria for Children/Youth/NMDs
Interagency Placement Committee
Referring A Child/Youth/NMD For An IPC Screening
ARA or Designee Responsibilities
RA or Designee Responsibilities
Residential Care Liaison (RCL Responsibilities
ARA or Designee Responsibilities
RA or Designee Responsibilities
Residential Care Liaison (RCL) Responsibilities
Presenting and Placing a Child/Youth/NMD’s Case to the IPC
Residential Care Liaison (RCL) Responsibilities
Version Summary
This is a new policy developed to align with CCR.
Pursuant to Assembly Bill (AB) 403, the Continuum of Care Reform (CCR) was established to ensure that, when children/youth are removed from their families, they are supported by a broad continuum of programs and services tailored for their individual needs and their family’s needs. Under CCR, reliance on residential care is limited to circumstances in which the child/youth/nonminor dependent (NMD) requires residentially-based, short-term interventions designed to successfully transition the child/youth/NMD into a permanent, home-based family setting.
Case planning and placement decisions are required to be informed by Child and Family Teams (CFTs), who identify the core services and supports for the child/youth/NMD and their family.
Under CCR, the community care facility category “Short-Term Residential Therapeutic Program” (STRTP) was established in place of group home care. STRTPs provide more intensive care and supervision, services and supports, treatment, and short-term 24-hour care and supervision of children/youth/NMDs than previously required in group home settings. STRTPs are intended to serve children/youth/NMDs who are in need of a level of care and supervision that cannot be met in a family-like setting and who are not in need of inpatient services, such as a psychiatric hospital or Community Treatment Facility. STRTPs provide specialized intensive treatment and oversight of children/youth/NMDs whose needs cannot be served in a less restrictive environment. Any child/youth/NMD placed in an STRTP is to have a case plan indicating the necessity for placement in an STRTP. Specifically, the case plan is to reflect that the STRTP placement is for the purposes of providing short-term, specialized, and intensive treatment and include the anticipated duration of the treatment as well as the transition plan to a less restrictive environment (WIC 361.2(e)(9)).
Exploration of family-like settings should be given priority, particularly for children twelve (12) years of age and under.
The transition process from group home licensure to STRTP and the establishment of new STRTPs began January 1, 2017. All existing group homes that transition to STRTPs are expected to complete the process by December 31, 2018. Extensions for group homes may be granted on a case-by-case basis beyond December 31, 2018.
STRTPs are required to provide trauma-informed and culturally relevant core services to children/youth/NMDs directly in their facility or through formal agreements with other agencies. The goal of STRTP therapeutic interventions is to address a child/youth/NMD’s needs in order to assist the child/youth/NMD in transitioning to a permanent home-based family setting.
To qualify for placement in an STRTP, the child/youth/NMD must meet all of Criteria One (1) and at least one (1) of Criteria Two (2), and be authorized by the IPC screening, as follows:
Pursuant to WIC Section 361.2(e)(g), the case plan for a child/youth/NMD placed in an STRTP or group home is to contain the following information:
The Interagency Placement Committee (IPC) is a multi-agency, multi-disciplinary team which serves to support children/youth/NMDs with significant behavioral, emotional, medical and/or developmental needs through a screening process whereby a child/youth/NMD’s treatment and placement needs are determined. The IPC screening process includes a review of available assessments/evaluations, treatment information and other relevant information regarding the child/youth/NMD’s history and current services and needs.
The CFT process is an integral part of family engagement and service planning and is designed to empower the family. Placement decisions are a key part of this process, thus CFTMs are to be utilized to keep the CFT members fully informed and involved in decision-making. While a formal Child and Family Team Meeting (CFTM) is not required, available members of the CFT must confer regarding placement of a child/youth/NMD in a STRTP. A consensus amongst the CFT members is not required in order to proceed with an IPC screening.
An IPC screening will be held within forty eight (48) hours of submission of the completed IPC screening referral packet. If an IPC screening is needed in less than forty-eight hours, the Residential Care Liaison (RCL) can assist in that process.
The IPC consists of permanent representatives from the following agencies:
In addition to the permanent IPC members, other participants may include, but are not limited to, the following:
The Residential Care Liaison (RCL) assists in ensuring the IPC screening referral packet is completed accurately and assists in coordinating the screening of cases.
The case of a DCFS-supervised child/youth/NMD is to be presented via telephone by the:
The IPC discusses a child/youth/NMD’s current status and needs, asks questions of the presenter, and determines whether or not the child/youth/NMD meets criteria for placement in an STRTP. DMH documents the discussion, including the outcome of the IPC screening, and provides the presenter with a written copy of the recommendation. For those children/youth/NMD’s determined to meet the criteria for a STRTP, prospective STRTP placement options will be provided by DMH.
The emergency placement process differs from the non-emergency and expedited screenings processes in that placement occurs prior to an IPC screening. Although the IPC screening is not required prior to an emergency placement, an IPC screening referral is to be completed in order to initiate the IPC screening process.
On rare occasions, it may be necessary to place a child/youth in an STRTP on an emergency basis upon consultation and approval by your SCSW, ARA, and RA or their respective designees prior to an IPC screening.
For children twelve (12) years of age and under, an IPC screening must be held prior to placement in an STRTP. Children twelve (12) years of age and under are not eligible for emergency placement in an STRTP.
An IPC screening referral is to be completed in order to initiate the IPC screening process.
All of the following conditions must occur for an emergency placement in a STRTP:
Children/youth/NMDs placed in an STRTP on an emergency basis will be presented to the IPC within thirty (30) days for a determination on continued placement in an STRTP. In some instances, the IPC may determine that continued placement in a STRTP is not warranted. As such, a transition plan should be considered at the time of placement.
Following the emergency placement, the following must occur:
Residential care (i.e., placement in a STRTP) is best used when necessary as a short-term, therapeutic intervention until such time as a child/youth/NMD can transition to a home-based family-like setting. Under CCR, case plan documentation and age-based second level review processes are applicable once a child/youth/NMD is placed in an STRTP and it is determined that placement in a STRTP continues to be necessary. The case plan documentation requirements and age-based placement timeframes for second level review are available via Second Level Review for Children, Youth, and Nonminor Dependents in a Short-Term Residential Therapeutic Program (STRTP) and Group Home.
Upon determining that a child/youth/NMD meets the criteria for a referral to an STRTP, a referral may be completed for an IPC screening. An IPC screening will be held within forty eight (48) hours of submission of the completed IPC screening referral packet. If an IPC screening is needed in less than forty-eight hours, the Residential Care Liaison (RCL) can assist in that process.
The IPC screening protocol applies to all children/youth/NMDs when placing in an STRTP either as an initial placement or as a replacement, including moving the child/youth/NMD from one STRTP into another STRTP.
For children twelve (12) years of age and under, additional information may be needed to ensure the needs of these younger children would be best served through the intensive services and supports of an STRTP, which are primarily utilized for older youth and NMDs.
Confer with the available CFT members when there is consideration being given to placement in an STRTP. Utilize the “Questions to Ask When Considering GH/STRTP Placement.”
If a decision is made by the CFT members that the child/youth/NMD’s needs warrant consideration for placement in an STRTP, consult with the SCSW, ARA and RA or their designees, and the Deputy Director (DD) or designee as applicable, regarding referring the child/youth/NMD for an IPC screening and document each consultation in the CWS/CMS Case Notes (i.e., Title XX’s).
If approval is not given for placement in an STRTP, discuss alternative placement options. Placement in a STRTP should not occur.
If approval is given, submit the IPC referral packet to the ARA for approval.
Approval must be obtained from the SCSW, ARA and RA or designees, and, for children under twelve (12) the DD or designee prior to proceeding with the IPC referral
Refer the child/youth/NMD for an IPC screening by completing the IPC screening referral packet and email the packet to the RCL via the DCFS IPC central inbox at DCFSIPC_referrals@dcfs.lacounty.gov
DCFS IPC Referral Form
Mental health assessment and diagnosis completed by a licensed mental health professional within the last year
Clinical documents from recent psychiatric hospitalization(s), if applicable and available
Psychotropic Medication Authorization form (JV-220), if applicable
Health and Education Passport, including but not limited to, current physical examination results, immunization and school records, and, if applicable, the child/youth/NMD’s Individualized Education Plan (IEP)
Developmental records, including Regional Center assessments/evaluation, if applicable
Recent Status Review Court Report and Detention Report or Jurisdiction Report
The most recent minute order that contains language that a mental health assessment and/or services have been ordered
Discuss the reasons for the IPC referral for consideration of an STRTP placement with the CSW.
Consult with the ARA and RA or their designees regarding the IPC referral or ensure the CSW consults with the ARA and RA or their designees prior to the CSW referring the child/youth/NMD for an IPC screening and ensure the consultations are documented in the CWS/CMS Case Notes (i.e., Title XX’s)
ARA or Designee Responsibilities
RA or Designee Responsibilities
Discuss the reasons for the IPC referral for consideration of an STRTP placement with the CSW and/or SCSW.
Residential Care Liaison (RCL) Responsibilities
Review the IPC Referral Form and contact the CSW to discuss the appropriateness of an STRTP placement.
Assist the CSW in obtaining relevant mental health information such as that outlined in the list of “Questions to Ask When Considering GH/STRTP Placement” when not acquired through the CFT members or as a result of a CFTM.
Assist the CSW in gathering the required documents for completion of the IPC screening referral packet, as needed.
For children twelve (12) and under, email the CSW upon receipt of the referral and documents to confirm ARA and RA approval.
Submit completed referral packet to DMH via email at IPC@dmh.lacounty.gov in order to schedule an IPC screening and preparing for the presentation. In addition, submit referral packet to all STRTPs that are eligible to take youth based on demographics
The IPC will be held within forty-eight (48) hours of submission of the referral packet to DMH.
Coordinate the teleconference date, time, location, and call-in information for the IPC screening from DMH.
CSWs should make every effort to place a child/youth/NMD in an STRTP via the routine/non-emergent process. However, in those instances when an urgent placement is needed and an IPC screening is needed prior to the forty-eight (48)-hour process, CSWs should consult with the RCL to discuss alternatives, such as an expedited IPC screening or an emergency placement which occurs prior to an IPC screening.
Emergency placement in an STRTP may be utilized in those circumstances when the conditions for such a request have been met.
Emergency placements occur prior to an IPC screening.
Children twelve (12) years of age and under are ineligible for an emergency placement in a STRTP as an IPC screening must occur prior to placement.
Efforts should be made to place a child/youth/NMD through the IPC screening process. For those children/youth/NMDs that require placement in a STRTP on an emergency basis, a set of guidelines has been established, as follows:
The following documentation should be uploaded as part of the referral packet:
The following documentation is not required for submission of the referral packet; however, the CSW should be able to address historical and current information related to the following:
Health and Education Passport, including but not limited to, current physical examination results, immunization and school records, and, if applicable, the child/youth/NMD’s Individualized Education Program (IEP) or any other related assessments, if available
Developmental records, including Regional Center assessments/evaluations, if applicable
Recent Status Review Court Report and Detention Report or Jurisdiction Report
The most recent minute order that contains language that a mental health assessment and/or services have been ordered
An IPC screening will be held within thirty (30) days of the emergency placement. Prior to the IPC screening, convene a CFTM regarding placement, including continued placement in the STRTP.
ARA or Designee Responsibilities
RA or Designee Responsibilities
Residential Care Liaison (RCL) Responsibilities
A set of guidelines has been established for presenting cases to the IPC for placement of all children/youth/NMDs in STRTPs. The process for presenting non-emergency and emergency placements and replacements (including from one STRTP to another) of children/youth/NMDs in a STRTP follow the same set of guidelines.
To assist the CSW in preparing for the IPC screening, DMH has developed a presentation guide that the CSW may find useful towards preparing for the IPC screening presentation.
Present the child/youth/NMD’s case on the appointed day/time via teleconference.
If the IPC recommends a placement in an STRTP, the CSW will be provided with the IPC Authorization and prospective STRTP placements from DMH at the close of the meeting.
DMH will forward the IPC Authorization and three (3) prospective STRTP placements to the CSW, SCSW, and RCL via email.
Placement of the child/youth/NMD is not limited to the three (3) prospective STRTPs provided by DMH
If the IPC authorizes placement in an STRTP, complete the DCFS 280, Technical Assistance Action Request form to acquire a placement packet and proceed with placement. An IPC authorization is not a guarantee of acceptance of placement.
If the STRTP interviews the child/youth/NMD and declines placement, notify the IPC and continue to next prospective STRTP
The IPC placement authorization is valid for a limited timeframe as indicated on the IPC Authorization form.
If the placement authorization could not be met within the IPC Authorization form’s indicated timeframe, the child/youth/MD must be re-presented to the IPC
If the child/youth/NMD is already placed in a STRTP as a result of the emergency placement process, the child/youth/NMD may remain in a STRTP
If the IPC does not recommend placement in an STRTP, obtain referral and linkage assistance to appropriate supports and services.
If the child/youth/NMD is already placed in an STRTP as a result of the emergency placement process, the child/youth/NMD may remain in his/her current STRTP placement until such time as an appropriate placement is identified
If the IPC determines that the STRTP is not appropriate due to a health or safety concern, the child/youth/NMD must be immediately transitioned to an appropriate placement
Document how the specific needs of the child/youth/NMD cannot be met in a less restrictive placement.
Describe the treatment that will be provided to the child/youth/NMD.
Residential Care Liaison (RCL) Responsibilities
Assist the CSW in gathering any additional documentation, if necessary, in preparing for the IPC screening presentation.
Participate in the IPC screening.
Upload the IPC Authorization in the CWS/CMS Case Management section and document the outcome of the IPC screening in the CWS/CMS Contact Notebook.
Enter the IPC screening date on the “Special Projects” page of the CWS/CMS.
Maintain a log of all children/youth/NMDs who received an IPC screening.
If the placement authorization could not be met within the IPC Authorization form’s indicated timeframe, assist the CSW in re-initiating the IPC screening process.
Automated DCFS 280, Technical Assistance Action Request
Questions to Ask When Considering GH/STRTP Placement
0070-516.15, Screening and Assessing Children for Mental Health Services and Referring to the Coordinated Services Action Team (CSAT)
0070-548.01, Child and Family Teams
0080-502.10, Case Plans
0080-505.20, Health and Education Passport (HEP)
0100-505.52, Placement Preservation Strategy, 14-Day Notice of Placement Changes, and the Grievance Review Process
0100-510.60, Placement Considerations for Children
0100-510.56, Second Level Review for Children, Youth, and Nonminor Dependents in a Short-Term Residential Therapeutic Program (STRTP) and Group Home
0600-501.05, Psychological Testing of DCFS Supervised Children
0600-505.20, Hospitalization of and Discharge Planning for DCFS-Supervised Children
0600-505.21, Presumptive Transfer of the Responsibility for Specialty Mental Health Services (SMHS) When a Dependent Child/Youth Resides Out of County
0600-514.10, Psychotropic Medication: Authorization, Review, and Monitoring for DCFS Supervised Children
0700-504.20, Referring Children for Special Education or Early Intervention Services
All County Letter (ACL) 16-84 - Provides the requirements and guidelines for creating and maintaining a child and family team.
ACL 17-11 – Indicates, in part, the payment rate for STRTPs and rate structure for group homes; the latter to remain in effect until December 31, 2018 when all group homes will have either transitioned to an STRTP or discontinued services to children under the jurisdiction of child welfare agencies and/or the juvenile justice system.
ACL 17-122 – States, in part, the case plan documentation requirements for initial placements and maintaining placements in a STRTP, including but not limited to the placement purpose and plan for transitioning to a less restrictive environment. Age-based placement timeframes in a STRTP and second level review requirements for continued placement are also indicated.
Health and Safety Code (HSC) Section 1502 – Defines, in part, a community care facility as well as a residential facility and a community treatment facility.
Katie A., et.al vs. the State of California – Obligates the Los Angeles County DCFS, in part, to improve and better ensure services to children with mental health needs.
Welfare and Institutions Code (WIC) Section 361.2(e)(9) – States, in part, that a child of any age who is placed in residential care shall have a case plan that indicates that the placement is for the purposes of providing short-term, specialized, and intensive treatment and is to reflect a projected timeline by which the child will be transitioned to a less restrictive environment.
WIC Section 361.2(e)(9)(A) – States, in part, that a child under the age of six (6) may be placed in residential care for short-term, specialized, and intensive treatment up to 120 days and that an extension may be given when progress has been made, or active efforts toward implementing the case plan, to transition the child to a less restrictive environment have been documented, including barriers towards meeting the case plan goals with Director or Deputy Director approval for continued placement in residential care every sixty (60) days.
WIC Section 361.2(e)(9)(B) – States, in part, that a child age six (6) to twelve (12) years of age, inclusive, may be placed in residential care up to six (6) months when progress has been made, or active efforts toward implementing the case plan, to transition the child to a less restrictive environment have been documented, including barriers towards meeting the case plan goals with Director or Deputy Director approval for continued placement in residential care every sixty (60) days.
WIC Section 361.2(e)(10)(B) – States, in part, that a child under the age of six (6) may be placed in an STRTP with his or her minor parent for the purpose of reunification.
WIC Section 11462.01(b)(2) – States that a child may be placed in an STRTP upon an assessment determining as such. Further, the assessment shall ensure that the child has needs in common with other children or youth in the residential care facility.
WIC Section 11462.01(b) – States the conditions required for placement of a child in an STRTP.
WIC Section 11462.01(3)(A) – Permits a child to be placed in an STRTP on an emergency basis, prior to an interagency placement committee screening with specific requirements if licensed mental health professional has made a written statement within 72 hours of placement that placement in an STRTP is necessary to meet the child or youth’s behavioral or therapeutic needs.
WIC Section 11462.01(3)(B) – States that following an emergency placement, an interagency placement committee meeting shall convene and, if it is determined the STRTP placement is no longer appropriate, the child may remain in the STRTP until such time as an alternative, suitable placement is located. The child may remain for an unspecified timeframe unless health and safety concerns are identified at which time immediate arrangements for transition is to occur.