Second Level Review for Children, Youth, and Nonminor Dependents (NMDs) in a Short-Term Residential Therapeutic Program (STRTP) and Group Home
0100-510.56 | Issue Date: 01/07/19
Overview
This policy guide outlines the State requirements under the Continuum of Care Reform (CCR) for case plan documentation and age-based placement time frames for the continued placement of children/youth/nonminor dependents (NMDs) in a Short Term Residential Therapeutic Program (STRTP) or group home.
TABLE OF CONTENTS
Placement Extension Conditions
Age-Based Placement Time Frames for Second Level Review
Children Under Six (6) Years of Age
Children Six (6) to Twelve (12) Years of Age
Children Thirteen (13) Years of Age and Older
Children Under Six (6) Years of Age
Children Six (6) to Twelve (12) Years of Age
Children Thirteen (13) Years of Age and Older
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.
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.
Reliance on residential care should be limited to circumstances when a child/youth/NMD requires residentially-based, short term therapeutic interventions designed to enable a successful transition into a family-like setting. Placement in residential care facilities, such as a STRTP or Group Home, is best used when necessary under such circumstances.
Under CCR’s design, the State implemented case plan documentation requirements and age-based second level review processes for those children/youth/NMDs placed in STRTPs or Group Homes to ensure that ongoing efforts are made towards meeting the case plan goals, which includes transitioning to a less-restrictive setting.
For children/youth/NMDs placed in an STRTP or Group Home who continue to require the services and supports provided by a STRTP or Group Home, an extension may be given to remain as placed if the following placement extension conditions have been met:
The second level review time frame requirements are based on a continuous time period, and is not reset or altered when a placement change occurs between STRTPs.
Under CCR, a child of any age may be placed in residential care, such as a Group Home or STRTP, for the purposes or providing short-term, specialized, and intensive treatment; however, exploration of family-like settings should be given priority, particularly to those children twelve (12) years of age and under.
Placement of children under six (6) years of age in an STRTP or Group Home should be extremely rare (e.g., facilitation of family reunification of a minor parent placed in an STRTP or Group Home). Placement in an STRTP or Group Home should not exceed 120 days unless the above placement extension conditions have been met.
Placement of children ages six (6) to twelve (12) years of age, inclusive, should not exceed six (6) months unless the placement extension conditions have been met.
Placement of children thirteen (13) years of age and older should not exceed six (6) months unless the placement extension conditions have been met.
For children/youth/NMDs placed in an STRTP or Group Home who continue to require the services and supports provided by a STRTP or Group Home, an extension for continued placement in an STRTP or Group Home may be obtained through the second level review process, which includes obtaining the appropriate approval levels as outlined by the State under CCR. The age-based timeframes for second level approvals are, as follows:
When it is determined through an assessment of the child’s needs for services and supports to continue placement of a child under the age of six (6) in an STRTP or Group Home beyond 120 days, Director or Deputy Director is be obtained no less than every sixty (60) days.
When it is determined through an assessment of the child’s needs for services and supports to continue placement the placement of a child between the ages of six (6) and twelve (12), inclusive, in an STRTP or Group Home beyond six (6) months, Director or Deputy Director approval is to be obtained no less than every sixty (60) days.
When it is determined through an assessment of the youth’s needs for services and supports to continue placement of a youth thirteen (13) years of age and older in an STRTP or Group Home beyond six (6) months, Director or Deputy Director approval is to be obtained every six (6) months, thereafter.
Pursuant to WIC Section 361.2(e)(9), the case plan for a child/youth/NMD placed in an STRTP or Group Home is to contain the following information:
At the time it is determined there is a need for continued placement in an STRTP or Group Home, second level review extension criteria is to be documented, as follows:
In order to ensure timely assessments and review and approvals of STRTP and group home placement extension requests, all re-assessments should begin forty-five (45) days prior to the expiration of the placement timeframe as required by the State.
Documentation for continued placement in an STRTP or group home should be submitted to the Deputy Director (DD) within fifteen (15) days of the expiration of the placement timeframe as required by the State. The documentation needed for approval include the following:
Utilize a teaming process, such as conferring with available Child and Family Team members to discuss the child/youth/NMD’s need for continued placement in an STRTP or group home.
Obtain the child/youth/NMD’s current Needs and Services Plan (NSP) from the STRTP or group home.
Update the Case Plan to include the child/youth/NMD’s placement needs consistent with the NSP.
Provide clear and specific reason(s) as to the need for continued placement in an STRTP or group home
Provide the anticipated date that the child/youth/NMD will be replaced from the STRTP or group home
Provide detailed efforts towards meeting the case plan goals, including transitioning to a less restrictive setting
Include completed goals in the updated Case Plan
Complete the DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
Updated Case Plan
Needs and Services Plan
Child and Family Team Meeting notes
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
Upon approval, notify the STRTP or group home of the placement extension by providing copies of the updated Case Plan and the DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form.
If approval is not given, discuss alternatives to continued placement in an STRTP or group home with the SCSW and/or ARA
Updated Case Plan
Needs and Services Plan
Child and Family Team Meeting notes
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
If approval is given, sign the DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form form and updated case plan and forward to the ARA for review and approval or return to the CSW to submit to the ARA.
ARA or Designee Responsibilities
Review the following to determine if an STRTP or group home placement extension is warranted:
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
If approval is given, sign the DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form and updated case plan and forward to the RA for review and approval or return to the CSW to submit to the ARA.
RA or Designee Responsibilities
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
Deputy Director (DD) Responsibilities
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension form
DCFS 2235, Request for Short Term Residential Therapeutic Program/Group Home Extension
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
0100-510.60, Placement Considerations for Children
0600-501.05, Psychological Testing of DCFS Supervised Children
0600-505.20, Hospitalization of and Discharge Planning for DCFS-Supervised Children
0100-510.55, Screening and Placement of Children, Youth, and Nonminor Dependents (NMDs) in a Short-Term Residential Therapeutic Program (STRTP)
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 a 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 a 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 a 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 a STRTP.
WIC Section 11462.01(3)(A) – Permits a child to be placed in a 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 a 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.