Interagency Collaboration and Mental Health General Description 12-1 District 622 Interagency Collaboration Initiatives 12-1 Interagency Early Intervention Committee (IEIC) 12-1 Therapeutic Support Program (TSP) 12-1 Community Interagency Transition Committee (CTIC) 12-1 ISD 622’s CTIC Representatives 12-2 Project Enhance 12-2 Suburban Ramsey Family Services Collaborative (SRFC) 12-3 Ramsey County Children’s Mental Health Collaborative 12-4 Washington County Mental Health Collaborative 12-4 District Mental Health Initiatives 12-5 District Mental Health Screenings 12-5 Mental Health Evaluations 12-6 Building Mental Health Crisis Teams 12-6 County Mobile Crisis Response Teams 12-6 Child Protection Guidelines 12-7 Lack of Supervision 12-8 Mandated Reporting 12-9 Mental Health and Community Resources 12-9 Forms Mental Health Screening Instrument Matrix Procedures for Responding to a Student in Crisis Building Mental Health Crisis Team Template Mental Health Crisis Team Interview Form Tips for Avoiding Conflict Child Protection Report Form Risk Inquiry for Secondary School Chapter 12 Interagency Collaboration and Mental Health The purpose of this chapter is to outline the collaborated efforts of District 622 to work with county and other local agencies to plan and coordinate services for students with disabilities. This chapter also provides information on mental health resources. District 622 Interagency Collaboration Initiatives Interagency Early Intervention Committee (IEIC) District 622 is part of the local interagency early intervention committee and service providers with Ramsey County and the Washington counties. It provides service coordination for the families of children ages birth-5 with disabilities. A central directory, created by the Minnesota Department of Health, provides information on resources that may help families, providers and others working with young children with special health needs or disabilities. It is arranged with general resource descriptions up front, specific local resources listed by the county or reservation the child lives in and by the school district the child would attend. Therapeutic Support Program (TSP) The Therapeutic Support Program is a collaborative project between Human Services, Inc. and five Washington County school districts: Mahtomedi, South Washington County, North St. Paul-Maplewood-Oakdale, Stillwater and Forest Lake. Services are targeted to children receiving special education who have an emotional or behavioral difficulty that adversely affects their ability to function at home, in school or in the community. Services are provided to those children at greatest risk for alternative school or out-of-home placement. Referrals can only be made by school social workers in ISD 622. Community Interagency Transition Committee (CTIC) CTICs identify, coordinate, and plan needed services to help young people with disabilities reach their potential at home, work and in the community. District 622 serves on the Suburban Ramsey County and the Washington County CTICs. Members of CTICs are individuals who represent the key players in developing transition services from school to adult Page 12-1 10/31/08 life. They are students, family members, county service providers, rehabilitation service counselors, other employment and training agencies, as well as other individuals from health care, business, recreation and post secondary education. To become a member of the Suburban Ramsey County and the Washington County CTICs, contact the Director of Special Services for District 622. District 622’s CTIC Representatives are listed below. The teacher and work based learner coordinator will attend both CTICs together & are expected to arrange for a replacement from their building if they cannot attend (1/2 day sub is provided). ISD 622’s CTIC Representatives School Rep Name County ALC Special Education Teacher Suburban Ramsey Next Step Special Education Teacher Work Based Learning Teacher Special Education Teacher Work Based Learning Teacher Special Education Teacher Work Based Learning Teacher Suburban Ramsey Next Step North HS Tartan HS Special Education Teacher Work Based Learning Teacher Washington Suburban Ramsey & Washington Suburban Ramsey & Washington Project Enhance Project Enhance combines the strengths of intensive Ramsey County case management and family community support. Enhance staff work with small caseloads of Severe Emotionally Disorders (SED) children from Suburban Ramsey County School Districts. They assess, plan, arrange and monitor mental health services and supports for children and their families. They provide individual, group and family interventions in school, home and community. Enhance provides the following services: Assessment: Initial functional assessment will include review of current diagnostic assessment, school status, family and peer issues and previous mental health treatment plans. Planning: The mental health portion of the IIIP will be completed with family and school Page 12-2 10/31/08 participation - to determine needed mental health services and supports. The plan will include a crisis response plan. In order to qualify for Enhance services a student must: Have a current SED diagnosis. (Children who likely meet SED criteria but do not have a current diagnostic assessment must be assessed by either Enhance intake or a community mental health provider within 30 days of the beginning of services.) Have the voluntary consent of their parent or legal guardian to participate in the progra Be referred through a school liaison and/or the Ramsey County CMH Intake Unit and be accepted by Enhance intake, in consultation with the child's school district. Children must be a resident of Ramsey County and reside in one of the four suburban school districts. For K-5 students, students must have an EBD and SED diagnosis. For secondary students, they only have to have a SED diagnosis. For more information, please contact Jennie Kula at 651-702-8506 Suburban Ramsey Family Services Collaborative (SRFC) District 622 is part of the Suburban Ramsey Family Services Collaborative (SRFC). SRFC is a comprehensive system of care approach designed to support children, youth and families in Suburban Ramsey County. This collaborative model incorporates formal and informal resources, is integrated and coordinated, and meets and flexibly responds to the emergent, multiple and changing needs of children and their families in our communities. Stakeholders include parents and youth, schools, social service and mental health agencies, county services, businesses, faith communities and local, state and federal funding organizations. The Suburban Ramsey Family Collaborative mission is: Connecting individuals, families and community resources to create relationships which enhance the well-being of our kids. Our primary objective is to serve children, youth and families experiencing at-risk circumstances in Suburban Ramsey County by improving and enhancing the formal and informal support systems they rely on for the following outcomes: their health, learning, safety Page 12-3 10/31/08 and security. For more information, please contact Lisa Hoogheem at 651-748-7453 Ramsey County Children’s Mental Health Collaborative District 622 is part of the Ramsey County Children’s Mental Health Collaborative. It provides advice to member agencies and to coordinate and develop mental health services for children, adolescents and their families, including working toward the development of a local system of care in Ramsey County. Below are the goals for the collaborative: Successfully sustain/support a child with complex mental health needs in achieving his/her maximum level of functioning. Create an integrated service system for the target population. Provide cost effectiveness/cost containment through implementation of an integrated service system. Strengthen community-based services and nonresidential alternatives. Increase system capacity for prevention and early identification / intervention. Increase access and provide culturally appropriate programs and services. For more information, please contact Lisa Hoogheem at 651-748-7453 Washington County Mental Health Collaborative District 622 is part of the Ramsey County Children’s Mental Health Collaborative. The collaborative mission is to improve and support the maximum level of functioning for children with a severe emotional disorder and their families within their home and community through the promotion of agency collaboration, coordination, integrated funding and service system change that provides culturally competent, flexible, non-traditional, wraparound services and funding to children and their families. The target population is youth 0-17 years old, with a severe emotional disorder (as defined by statute), that is receiving services from more than one collaborative member agency. For more information, please contact Jennie Kula at 651702-8506 District Mental Health Initiatives The federal Individuals with Disabilities Education Act (IDEA) require educational agencies to provide special education and related services to eligible children and youth. Page 12-4 10/31/08 Mental health services are not clearly defined in IDEA although it does define a number of related services (e.g. counseling, psychology, social work, etc.), which may be included in a child’s Individualized Education Plan (IEP). These related services are to be made available to a child with disabilities to ensure that child receives a benefit from their specialized instruction and receives a free and appropriate public education (FAPE). District Mental Health Screenings Mental Health Screenings are a required part of any special education evaluation to determine eligibility for emotional/behavioral disorders or as a result of the student having more ten dismissals from school. A mental health screening is a brief, culturally sensitive process designed to identify students who may be at risk of having impaired mental health that warrants immediate attention. The primary purpose for screening is to identify the need for further evaluation using valid, reliable instruments. Mental Health Screening activities must adhere to the following standards: Screening must be voluntary and parental consent must be obtained Screening instruments used must be both valid and reliable in identifying the need for further assessment Any person conducting the assessment must be qualified and trained Screening must consider the cultural background of the family Screening must never diagnose or label a child as having a mental health disorder Confidentiality must always be insured District 622 will use the tools to screen for any mental health concerns that meet the above standards. A sample list of screening tools is located at the end of this chapter. School social workers will conduct the screening. Contact the social worker at the building that your child attends for more information. Mental Health Evaluations If result of a mental screening indicates the need for further mental health evaluation, the family may choose to seek out a mental health evaluation. A mental health evaluation is conducted by the family’s physician and/or mental health professional. Results of the Page 12-5 10/31/08 evaluation can be shared with the educational agency at the discretion of the parent. Parents must sign a release of information with the educational agency to release the results of the evaluation. Building Mental Health Crisis Teams In District 622, every building will have a mental health crisis team in place to assist with mental health emergencies. Team members may include the social worker, psychologist, school counselors, and nurses. Annually by October 15th, school socials will facilitate the implementation of the mental health crisis team and educate all teachers and support staff on the mental health crisis procedures. Social workers will outline procedures that staff should follow in a mental health crisis. These procedures can be accessed at the end of this chapter. County Mobile Crisis Response Teams Parents or school staff may contact their respective counties mobile crisis response team when crisis has escalated where family, student, or staff safety are a grave risk to self or others. When a crisis occurs at school, staff must obtain parent permission prior to enlisting the help of mobile crisis. Mobile crisis will need insurance information to access this service. The parent may choose to transport the student and not use mobile crisis. If parent permission can not be obtained, the building administration may consider calling 911. Washington County Crisis Response: 651-777-5222 Ramsey County Crisis Response: 651-774-7000 Mobile Crisis Response teams are composed of one Licensed Mental Health Professional and one Mental Health Practitioner (Crisis Intervention Specialist). Below is a list of services provided: Crisis Response Services: Face-to-face short-term intensive mental health services provided in-home. Crisis Assessment: An on site crisis, functional, and diagnostic assessment by a mental health professional following a screening which suggests that the individual may be experiencing a mental health crisis or emergency. Page 12-6 10/31/08 Crisis Intervention: de-escalation, safety assessment, crisis intervention, assessment for level of care, mental status exam, treatment plan, provisional diagnosis, psychotherapy, collaboration with providers, appropriate referral. Crisis Stabilization Services: Face-to-face individualized mental health services following crisis intervention services or as a preventative measure, designed to restore the individual to his or her prior level of functioning. A diagnosis is necessary for stabilization services. Stabilization Assessment: face-to-face multi-systemic functional assessment and stabilization. Stabilization Intervention: crisis stabilization, psychotherapy, diagnostic assessment, functional assessment, community resource linkage, skills training, service planning behavior management, collaboration, referrals. Planning/supported Transition: assist in the transition of services. Child Protection Guidelines Response to Reports of Unsupervised Children Washington County Community Services will assess the following reports: for children ages 7 or younger, all reports of a child being left alone for any period of time. For children ages 8 or 9, all reports of a child(ren) who is alone for more than one or two hours. It is acceptable, in most situations, for a child to be at home alone while a parent runs an errand or to be home alone before and/or after school until a parent returns from work. For children ages 10 through 13, all reports where a child(ren) is alone for more than 8 to 12 hours. It is acceptable for a child to be alone all day until parent(s) returns from work but it is assumed a parent, guardian or caretaker will be there in the evening. And for children ages 14 and older, all reports where a parent has been gone for 24 hours or more if the child(ren) does not know the whereabouts of a parent or when the parent(s) will return. It is acceptable for a child to be home alone for 24 hours or more provided they have knowledge of where a parent is and how to contact a parent or designated caretaker if needed. For children ages 11 to 14, it is acceptable to babysit younger children all day with the expectation that a parent or guardian will be returning to supervise the child(ren) later the same day. And for children ages 15 and older, it is acceptable to babysit children for more than 24 hours. Page 12-7 10/31/08 Lack of Supervision Lack of Supervision is defined as failure to provide supervision, care, guidance and/or protection, which results in the child being in situations beyond his ability to cope, at risk of physical harm, at risk of sexual and/or other exploitation. The child is left alone or is held responsible for siblings or other children for extended periods of time and in circumstances beyond the child’s chronological age, social maturity, or judgment to handle safely. This includes the child’s exposure to, or expectations to manage environmental hazards. Assessments will be conducted on the following: a. Children age 5 and younger left alone for any period of time. b. Children ages 6-9 alone over three hours. c. Children ages 10-13 alone for over 12 hours. d. Children alone over 24 hours if parent’s whereabouts are unknown to children. In all of above, Child Protection Services (CPS) will involve police for immediate safety check of children where appropriate. e. Children ages 11 to 14 may baby-sit with the expectation that an adult will return later in the day. f. Children age 15 and older may baby-sit for more than 24 hours. The caretaker displays erratic or impaired behavior, engages in substance abuse, suffers from severe emotional disturbances or is documented by a professional as so developmentally delayed, and whose behaviors, alone or in combination, are of such duration and intensity that the bare minimum of child-caring tasks and human responses necessary for physical and emotional nurturance cannot be performed. Reports of women in third trimester of pregnancy who are diagnosed as seriously mentally ill, significantly developmentally delayed, and whose parental rights to another child have been involuntarily terminated. Lack of supervision includes, but is not limited to, such behavior as: Selecting unreliable persons to provide child care, leaving a young child alone for an extended period of time without access to a responsible adult or without knowledge of how to reach help, caretaker is arrested for driving under the influence with children in the car, drug raids where children are present and drugs are found, or Page 12-8 10/31/08 child is present/involved in parent committing a criminal act. Mandated Reporting Under Minnesota Statute 626.556, persons in designated professional occupations are mandated to report suspected child abuse or neglect. Persons who work with children and families are in a position to help protect children from harm. These persons are required by law to report to child protection if they know or have a reason to believe that a child is being abused or neglected or that a child has been neglected or abused within the prior three (3) years. The individual with direct knowledge of possible child abuse or neglect is individually responsible to report to the police or child protection. Reporting the concern to a supervisor, administrator, or other co-workers does not mitigate your responsibility to report. If a mandated reporter does not report suspected abuse or neglect, they could be prosecuted for committing a misdemeanor. If a child suffers substantial or great bodily harm as a result of not receiving needed treatment for the abuse or neglect because of a failure to report, it is a gross misdemeanor. If the child dies as a result, it is a felony. The reporter's name is confidential, accessible only if the reporter consents or by a court order. Child Protection Reporting Phone Numbers Ramsey County 651-266-4500 Washington County 651-430-6457 Mental Health and Community Resources Links to mental health and community resources will be posted to the district website at http://isd622specialservices.webaloo.com/interagency_collaboration.aspx Page 12-9 10/31/08