Santa Clara County Mental Health Board
System Planning and Fiscal Committee
January 5, 2012

Full service partnership addresses the needs of specific population disparities:





Adults with co-occurring mental health/substance abuse disorders
Individuals with co-occurring health/development disability
TAY aging out of the child service systems
Jail/Justice System-Involved, Homeless and/or Dual
Diagnosed
Un-served and Underserved ethnic and cultural groups
(specifically Latino, African American, Asian/Pacific
Islander, Native American and LGBTQ populations) with serious mental illness (SMI)






The FSP program serves both Youth / TAY meeting the program criteria; however it is specifically targeted to Native American,
Latino, Asian and African/African American Transition -Age Youth
(TAY) who are exiting child service systems.
Families of youth (under age 16) with SED or dual diagnosis who are at risk of, or returning from out-of-home placement (DFCS) and on formal Juvenile Probation.
Families of Youth (under age 16) with SED or dual diagnosis with multiple Emergency Psychiatric Services (EPS) episodes and/or frequent and extended hospitalizations.
TAY with SED or dual diagnosis who are at risk of, or returning from out-of-home placement and have been on formal Juvenile Probation.
TAY with SED or dual diagnosis with multiple psychiatric emergency services episodes and/or frequent and/or extended hospitalizations.

Youth with SED who fall into at least ONE of the following groups :
4.1.1. As a result of a mental health disorder, the Youth has substantial impairment in at least two of these areas:


Self-care
School functioning


Family relationships
Ability to function in the community
AND
Either of the following occurs:
A. The Youth is at risk of or has already been removed from the home
B. The impairment(s) have been present for more than six months or are likely to continue for more than a year without treatment.
4.1.2 Youth displays at least ONE of the following features:
Psychotic features
Risk of Suicide
Risk of violence due to a mental disorder

Transition-Age Youth (TAY) with SED who meet ALL of the following:
4.2.1: They fall into at least one of the groups in 4.1.1 or 4.1.2
4.2.2: They are un-served and underserved
AND
4.2.3. They are in one of the following situations:
1. Homeless or at risk of being homeless
2. Aging out of the child service systems (MH/DFCS/JPD)
3. Involved in the criminal justice system
4. At risk of involuntary hospitalization/institutionalization
5. Experience a first onset of mental illness

(con’t)


Medi-Cal

Unsponsored

Healthy Families-SED

Clients with SEMH can access/maintain FSP services as long as they are Medi-Cal eligible,
have no private insurance and meet program eligibility.
(FSP Governance: 2/13/08) (Revised F&C Division: 10/07/09)


35 Youth/18 TAY

40 Youth/35 TAY

17 TAY

Model:
Comprehensive program that combines critical core services within a
Wraparound Model that incorporates age-appropriate elements from the
Transition to Independence Model (TIP). This strength based approach incorporates family-centered service delivery that consists of comprehensive mental health and other services/supports in order to achieve individualized youth and family plan goals.
Target Population:

DFCS/Juvenile Justice Involved



SED African/African American, Native American and Latino youth.
Unserved/Underserved SED Youth
Youth with multiple episodes of emergency psychiatric services and/or hospitalizations.

Model:
The model reflects the core values of the Transitions to Independence Process
(TIP). Embedded in these core values is a strength based approach which incorporates the ideals of youth and family engagement and collaboration, cultural and developmental considerations for treatment, assessment, planning and intervention to assist TAY in making the transition to adulthood in each area of the basic life domains.
Target Population:

TAY who are exiting juvenile probation and dependency systems and are at

 risk of, or returning from intensive residential placement.
TAY with multiple psychiatric emergency services episodes and/or frequent/extended hospitalizations.
TAY experiencing a first psychotic episode


TAY with multiple episodes of emergency psychiatric services and/or hospitalizations.
SED African/African American, Native American, Asian and Latino TAY.










MHRC (Juvenile Probation Department)
DFCS (Differential Response Paths 2,3,4)
F&C County clinics and CBO’s
YATT
Adult County clinics
24-Hour Care
Adult Probation
Internal referrals from FSP contracted providers
Drug Treatment Court


MHD has discretion in consultation with the referring party to assess the developmental levels of TAY referrals and place them into a Youth slot if determined more appropriate for their needs.
(FSP Governance: 11/07/07)

MHD has final authority to triage referrals based on target population criteria (including ethnicity), acuity and date of referral.

FSP Contractor initiates contact with the candidate/family and begin engagement activities within
2 business days of assignment.

FSP Contractor contacts the referring parties (including the Probation Officer, Social Worker or Public
Guardian) or any current MH provider to arrange an initial joint meeting with the candidate/family for the purposes of introducing the candidate/family to the program and of establishing rapport.
(Engagement timeline 30 days).

If an existing FSP enrollee becomes incarcerated or is not in contact with the provider for more then a period of
60 days, then they are to be disenrolled from FSP services. (FSP Governance:11/07/07)

Reenrollment is when a previous enrollee desires to resume FSP services, after either a voluntary/involuntary discharge from the program. The priority of return will be based on original circumstances of the actual disengagement. MHD has the discretion to determine the final outcome of the returning enrollee referral. The determination will be based on the availability of providers and basis for original disenrollment. (FSP
Governance: 2/13/08)


