San Bernardino County
Children’s START:
Screening, Triage, Assessment, Referral, &
Treatment
Amy Cousineau, Children’s Network
Jenae Tucker, Desert Mountain SELPA
Children’s Center
January 2005: Children’s START
Planning Retreat
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Facilitated by Drs. Chasnoff and McGourty from the
Children’s Research Triangle, the following partners
attended:
Children’s Network
IEHP
CSUSB
First 5
Head Start
Public Health
Desert/Mtn SELPA
DCS
Children’s Fund
DBH
LLU Children’s Hospital IRC
Children’s START Vision Statement
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Children and their families, especially young children
ages 0-6, will be screened, assessed and referred for
treatment through a universal collaborative and
standardized process that strengthens and builds on
existing programs in the community. Our goal is to
improve the mental and social functioning of children
as measured by school readiness and the
achievement of appropriate developmental
milestones.
Initial Goals
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The group decided that San Bernardino
would need 3 START Centers due to
the geographic size of the County.
The 1st Center opened in October,
2005 at the Desert Mountain SELPA.
The 2nd Center opened in December,
2006 at CSUSB.
The 3rd Center opened in October,
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2007 at West End Family Counseling.
Children’s START
Lessons Learned
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EPSDT funding will not allow intensive
assessment up front. All psychological
assessments funded by EPSDT must
be linked to the DSM IV diagnosis and
treatment plans.
CAPTA
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New requirement that “child protective
services refer children under the age of
3 who are involved in a substantiated
case of child abuse or neglect to early
intervention service funded under Part
C of the Individuals with Disabilities
Education Act...”
The amendment does not change
eligibility, as children referred must 6still
CAPTA & START
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Suggested Strategies from ACL No: 0654
Develop MOU between child serving
agencies outlining procedures, roles,
and responsibilities for screening,
evaluation, and referral for early
intervention services for children under
the age of 3.
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CAPTA & START
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Identify multiple pathways, in addition to
Early Start, for child serving agencies
and providers to collaborate and assure
that children receiving child welfare
services and under the age of 3 are:
Screened for developmental status,
Referred for developmental evaluation
and assessment if screening indicates
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the need for referral.
CAPTA & START
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Identify developmental screening tools
that are practical and effective for use
by caregivers and social workers.
Provide cross-training opportunities and
educational materials that will increase
the caregivers and social worker
knowledge about the developmental
needs of young children receiving child
welfare services.
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Screening DCS Children
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DCS developed policy that all children
with open cases ages 0-5 will be
referred to their regional START
provider. Screening then occurs as part
of the initial intake assessment.
Results of the ASQ/SE are sent to DCS
and input into CMS for tracking and
follow-up.
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Children’s START
Braided Funding/ Desert
Training & Capacity
Building
First 5
Public Health Nurse
Funded with matching $$
1st START
from First 5
Center
Desert/MTN
IRC
SELPA
Mental Health Treatment
EPSDT funding & match Counseling
Pediatrician funded
Center
from First 5
through CHDP & IEHP
& Education
Speech/Language &
O/T
funded by Education
$$$
Mental Health
Treatment
CAPIT funding
Children’s START
Braided Funding/Central Valley
Training & Capacity
Building
First 5
IRC
Mental Health
Treatment
EPSDT & match
from First 5
2nd Center
CSUSB
Speech/Language &
O/T
funded by First 5
Public Health Nurse
funded with match
from First 5
PediatricianIn development
Funding from IEHP
No Education
Dollars
(Yet)
Children’s START
Braided Funding/ West Valley
Mental Health Treatment
EPSDT & match from
First 5
West End SELPA
Speech/Language &
O/T
Public Health Nurse
Funded with match
from First 5
West End
Family Counseling
Training and Capacity
Building
First 5
IRC
Children’s START
MOU Between County Agencies
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A Memorandum of Understanding for Children’s
START was approved by the San Bernardino County
Board of Supervisors on June 27, 2006.
Participating departments include:
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Children and Families Commission for San Bernardino County
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Children’s Fund
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Children’s Network
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Department of Behavioral Health (DBH)
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Department of Children’s Services (DCS)
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Department of Public Health (DPH)
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Preschool Services Department (PSD)
Children’s START Collaborative Process
Lessons Learned
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Identify key stakeholders who have program
expertise and/or resources.
Create a common vision in which everyone can
invest.
Identify or create a neutral convener/infrastructure for
leadership.
Use First 5 dollars to leverage State and Federal
funds.
Partner with County Mental Health for EPSDT
utilization.
Children’s START: SUSTAINABILITY
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This effort will not succeed with First 5
investments alone. It is imperative that a
County develop partnerships with the
following entities:
Local Mental Health Agency
Public Health Agency
Child Welfare Agency
Grant-making organizations
Regional Centers
Children’s START: SUSTAINABILITY
EPSDT
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First 5 San Bernardino invests critical
matching dollars in order to draw down
the federal EPSDT dollars. For every
nickel invested, there is approximately a
95% return from the State and Federal
government for children who meet the
“medical necessity” criteria and are fullscope medi-cal beneficiaries.
CAPTA & START
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While our initial goals for the START
program did not set out to meet the
CAPTA requirements, we have created
a system that will do so.
Future plans include partnering with
MHSA/PEI to assist in meeting the
screening goals for our child welfare
population.
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In Closing...
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Thank you for the opportunity to share
our experience with the development of
the San Bernardino County START
program.
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Contact information:
acousineau@hss.sbcounty.gov
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