Minor s rights advocacy a primer
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Minor’s Rights Advocacy: A Primer. Presented By: Anne Lukito Sherri Rita Maggie Roberts Protection & Advocacy, Inc. PRAT 2003. Why Are Minors in Facilities?. Special Education Placements Foster Care Placements Court Ordered/Juvenile Probation Placements Parental Placements Emergencies.

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Minor s rights advocacy a primer

Minor’s Rights Advocacy: A Primer

Presented By:

Anne Lukito

Sherri Rita

Maggie Roberts

Protection & Advocacy, Inc.

PRAT 2003


Why are minors in facilities

Why Are Minors in Facilities?

  • Special Education Placements

  • Foster Care Placements

  • Court Ordered/Juvenile Probation Placements

  • Parental Placements

  • Emergencies


Advocacy arenas

Advocacy Arenas

Special Education

(IEP meetings, due process hearings, compliance complaints)

Juvenile Courts

(Placement and service advocacy for Wards & Dependents)

Medicaid Benefits

(Medi-Cal Fair Hearings, Mental Health Grievances)

Patients’ Rights


Minors bill of rights in foster care wic 16001 9

Minors’ Bill of Rights in Foster Care (WIC § 16001.9)

  • Right to live in safe, healthy, comfortable home and be treated with respect

  • Right to be free from physical, sexual, emotional or other abuse and corporal punishment

  • Right to adequate/healthy food, adequate clothing, allowance (if in group home)

  • Right to medical, dental, vision, and mental health services

  • Right to be free from medication or chemicals unless authorized by physician

  • Right to contact family unless prohibited by court order

  • Right to contact social workers, attorneys, foster youth advocates, CASAs, and probation officers

  • Right to visit/contact brothers and sisters unless prohibited by court order

  • Right to contact CCL or Foster Care Ombudsperson re: violations of rights, confidentially and free from retaliation

  • Right to make/receive confidential phone calls unless prohibited by court order

  • Right to send/receive unopened mail unless prohibited by court order


Minors bill of rights in foster care cont

Minors’ Bill of Rights in Foster Care (Cont’)

  • Right to attend religious services of choice

  • Right to emancipation bank account and manage own income unless prohibited by court order

  • Right to not be locked in any room, building, or facility unless in CTF

  • Right to attend school and participate in extracurricular activities

  • Right to work consistent with state law

  • Right to social contacts outside of foster care system

  • Right to attend Independent Living Program classes

  • Right to attend court hearings and speak with judge

  • Right to private storage

  • Right to review own case plan if over 12

  • Right to be free from unreasonable searches

  • Right to confidentiality of juvenile court records


Foster care ombudsperson

Foster Care Ombudsperson

  • Independent review of complaints made by or on behalf of children and youth in foster care

  • Information regarding rights

  • Contact: 1-877-846-1602 or [email protected]

  • See handouts for more information


Educational rights in facilities

Educational Rights in Facilities

ALL students with disabilities are entitled to FAPE that emphasizes education and related services designed to meet their unique needs and prepares them for employment and independent living.

20 USC § 1400(d)(1)(A), Cal. Educ. Code § 56000, SEHO Decision case #SN02-00778]


Consent rights

Consent Rights

  • Abortion

  • Treatment related to pregnancy (except sterilization)

  • Care for communicable reportable diseases/conditions (12 or older)

  • Care for rape (12 or older)

  • Care for sexual assault

  • Care for alcohol/drug abuse (12 or older)

  • Outpatient mental health treatment (12 or older)

  • Blood donation (17 or older)

  • Emergency care when parents not available

  • Everything if on active duty, married, previously married, emancipated, or self-sufficient (15 or older)

    See handouts for more information, citations to relevant laws


Seclusion restraint

Seclusion & Restraint

  • Unlike Group Homes, CTFs have the capacity for secure containment.

    Welf. and Inst. Code § 4094.5.

  • CTFs are governed by the same general licensing requirements as group homes, unless stated otherwise in the regulations.

    CCR, tit. 22m § 84110.


Minor s rights advocacy a primer

RESTRAINTS

CHILDREN IN GROUP HOMES HAVE A RIGHT TO BE FREE FROM RESTRAINT. RESTRAINT MAY BE JUSTIFIED IN CERTAIN SITUATIONS WHERE THE RISK OF IMMEDIATE HARM CAUSED BY THE CHILD’S CURRENT BEHAVIOR OUTWIEGHS THE RISK OF HARM BY THE RESTRAINT.

See, Cal. Code of Regs, tit. 22, § 84300.


When can restraints be used against minors

WHEN CAN RESTRAINTS BE USED AGAINST MINORS?

“Group homes staff may be justified/excused in using emergency interventions which include restraint if:

  • The restraint is reasonably applied to prevent the child engaging in assaultive behavior from exposure to immediate injury or danger to self or others; and

  • The force used does not exceed that reasonably necessary to avert the injury or danger, and

  • the danger of the force applied does not exceed that reasonably necessary to avert the injury or the danger, and

  • the duration of the restraint ceases as soon as the danger of harm has been averted.

    CCR,tit. 22, § 84300


Minor s rights advocacy a primer

POST INCIDENT REVIEW

  • Following an incident involving the use of manual restraints, the administrator or his/her designee must discuss the incident with the staff involved in the incident no later than the working day following the incident.

  • The administrator must determine whether the actions taken were consistent with the emergency intervention plan, and document the findings.


Restraint review

RESTRAINT REVIEW

The restraint review must evaluate:

  • what the staff did, if anything, to de-escalate the situation. What interventions were utilized and whether the staff attempted at least- two non-physical interventions.

  • If the use of de-escalation techniques escalated the child’s behavior, then the techniques must be re-evaluated for effectiveness. Ineffective or counter-productive de-escalation techniques must not be used.


Questions advocates should ask re restraints

QUESTIONS ADVOCATES SHOULD ASK RE: RESTRAINTS

  • Were manual restraints used only after less restrictive techniques were used and proven to be ineffective?

  • Was the restraint limited only to the period of time that the child was presenting as a danger to self or others?


Avoiding use of restraints in the future

AVOIDING USE OF RESTRAINTS IN THE FUTURE . . .

The administrator/designee, authorized representative or parent, and facility social work staff must assess whether it is necessary to amend the child’s needs and services plan.

CCR, title 22, § 84368.3.


Minor s rights advocacy a primer

An incident report pertaining to the use of physical restraint must include, among, many other things:

Date and time of other manual restraints within the past 24 hours;

Description of child’s behavior requiring restraint and precipitating factors;

Description of type and duration of manual restraints;

Description of what non-physical interventions were used prior to restraint and explanation of why more restrictive interventions were necessary.

Description of any injuries sustained by child or staff, and what type of medical attention sought and where taken.

Names of facility staff who: 1) provided restraint: and 2) witnessed the child’s behavior and the restraint.

Description of child’s verbal response and physical appearance at the completion of the restraint.

If post incident review shows that facility personnel did not attempt to prevent manual restraint, a description of what activity should have been taken by facility staff and what corrective action will be taken and why.

Cal. Code of Regs, tile 22, § 84061.

INCIDENT REPORTS


Minor s rights advocacy a primer

CHILD’s RIGHTS/ FACILITY RESPONSIBILITY

DURING RESTRAINT

A Child may only be restrained by facility staff who have received and maintained written certification by a certified training instructor that the staff member has successfully completed emergency intervention training in accordance with state regulations.

CCR, title 22, § 84365.5


Minimum standards

MINIMUM STANDARDS

  • IF the restraint requires two people, a minimum of two people must be used.

  • IF restraint continues after 15 minutes, a child must be visually checked by person(s) other than those who restrained the child to ensure that

  • The child is safe and the child’s personal needs, such as access to toileting facilities, are being met;

  • In order to continue restraints after fifteen minutes, written approval by the administrator or the administrator’s designee must be obtained after demonstration based on observation of the child that continued restraint is justified.

  • The child must be visually checked every 15 minutes after that to ensure that she is not being injured, that her personal needs are met, and that restraint is still justified.


Minimum standards cont

MINIMUM STANDARDS, CONT’

  • This process must be repeated again if the child is still being restrained after 30 minutes. Such a continuation must be approved, in writing, if possible, or verbally, by a member of the facility’s social work staff in addition to the administrator or her designee. There must be a specific finding by the administrator and the social work staff that the child is continuing to pose a danger to herself and that the facility has adequate resources to meet the child’s needs.

  • This process must be repeated every half hour, if the child remains in restraints.


Limits on restraint

LIMITS ON RESTRAINT

  • Manual restraint must not continue exceed more than 4 cumulative hours in a 24 hour period. If child is still presenting imminent danger to himself or others at that time, staff must:

  • Contact the child’s authorized representative; and

  • Community emergency services to determine whether or not the child should be removed from the facility.


Right to care while in restraints

RIGHT TO CARE WHILE IN RESTRAINTS

  • Staff must promptly and appropriately to a child’s request for services, assistance, and repositioning by someone other than staff doing restraining to determine whether the child is still presenting as a danger to himself or others, and whether the child is safe.

    C.C.R., section 84322.


Minor s rights advocacy a primer

CHILD’s RIGHTS/ FACILITY RESPONSIBILITY

BEFORE RESTRAINT

A continuum of interventions must be used, starting with the least restrictive intervention method must be used first. More restrictive methods such as use of separation room and restraints may be used only if less restrictive methods have been used and were ineffective and only if the child continues to be a present an imminent danger for injuring himself or others.


A child has an absolute right to be free from

A child has an absolute right to be free from:

  • Mechanical restraints (Note: Acute psych. Hospitals, PHFs, and CTFs can use mechanical restraint.)

  • Aversive behavior modification interventions, such as water spray, sensory deprivation;

  • Corporal punishment;

  • Verbal abuse or physical threats;

  • Manual restraints for more than 15 minutes in a 24 hour period unless specified 84322.2. (Different rules for Acute Psych. Hospitals (See CCR, tit. 22, §71545); PHF (CCR, tit. 22, 77103); CTF (CCR, title 9. § 1929)

  • Manual restraints for more than a cumulative 4 hours in 24 hour period. (no exception)

  • Manual restraints must not be used when the child’s current condition contraindicates the use of manual restraint. 843090.


Minor s rights advocacy a primer

Notification to their authorized representative no later than the next working day, and documentation of that notification in the incident report. Cal. Code of Regs, title 22, § 84061.

Post incident review of the restraint incident by the administrator or her\his designee no later than the next working day following the incident (Discussed below). Cal. Code of Rags, title 22, § 84369.3.

Report by telephone to the department no later than next working day following the incident.

The preparation and submission to the department within 7 days of a written incident report;

Documentation by staff involved of the incident immediately or no later than end of the shift on which the restraint occurred.

Immediate notice to the facility administrator or social work staff following any staff observation or client complaint of post emergency intervention injury or suspected injury;

A physical exam during or after an emergency interventions if, after talking to the child, the administrator or social work staff determine that there is an injury or suspected injury to the child. CCR, tit. 22, § 84369

Whenever an inappropriate restraint technique is used on a child, the licensee must develop a corrective action plan, and as part of that plan may require facility personnel to repeat the appropriate emergency training. CCR, tit. 22, § 84365

CHILD’s RIGHTS/FACILITIES OBLIGATIONS

FOLLOWING EACH EPSIODE OF RESTRAINT:


Minor s rights advocacy a primer

PROTECTIVE SEPARATION ROOM

While in separation room:

  • Staff must maintain eye contact with child at all times

  • Staff must remain in the room, if necessary, to prevent injury.

  • Staff must ensure that there are no objects in the room with which child can injure themselves.

  • Threats or physical abuse may not be used a method for placing a child in an isolation room.

  • A child may not be placed in separation room unless facility social work staff and child’s authorized representative indicate that in writing in the child’s needs and services plan.

  • A child placed in separation room may not be deprived of right of eating, toileting, sleeping or other basic daily living functions.

    CCR, tit. 22, § 84322.1


Minor s rights advocacy a primer

Avoiding or Transitioning From Institutional Placements


Minor s rights advocacy a primer

SPECIAL EDUCATION ADVOCACY


Special education advocacy

The Players:

The youth (up to age 22)

The Local Education Agency (School, District, Board, SELPA)

The adult with educational rights if youth is a minor

The Law:

Individuals with Disabilities Education Act (20 U.S.C. §1400 et seq.)

California Education Code §56000 et seq.

Special Education Advocacy


Applicable laws re education rights of children youth with psychiatric disabilities

APPLICABLE LAWS RE: EDUCATION RIGHTS OF CHILDREN & YOUTH WITH PSYCHIATRIC DISABILITIES

  • Federal and state laws provide that children with disabilities are entitled to a free, appropriate public education (FAPE) in the least restrictive environment (LRE).

    • Individuals with Disabilities Education Act (IDEA)

      • 20 United States Code § 1400 et seq

      • 34 Code of Federal Regulations § 300 et seq

    • California State Education Laws

      • Calif. Education Code § 56000 et seq

      • 5 Cal. Code Regs. § 3000 et seq


Right to a free appropriate public education fape

Right to a Free, Appropriate Public Education (FAPE)

  • Individually designed services

  • With all related services necessary for students to benefit from their education

  • At no cost to parents


Right to least restrictive environment lre

Right to Least Restrictive Environment (LRE)

  • Right to receive services in LRE with supports to the maximum extent appropriate with opportunities for children with disabilities to interact and be educated with children who do not have disabilities

    • Includes receiving their education in chronologically age appropriate environments with non-handicapped peers [CDE, Office of Special Education, Policy on Least Restrictive Environment (Oct. 10, 1986)]


Fape in institutions

FAPE IN INSTITUTIONS

  • A student’s right to FAPE is not abrogated or diminished because a student resides in a state hospital or other locked institution.

    Cal. Educ. Code § 56852

  • The state hospital in which student resides is responsible for ensuring that the student is provided with FAPE

    Welf. & Inst. Code § 4011.5


Fape in institutions cont

FAPE IN INSTITUTIONS (CONT’)

Although state hospital can contract with LEA, NPS, nonsectarian school or other agency to provide special education and related services on state hospital grounds for students whose IEPs don’t indicate that such education and services should be provided in a program other than on state hospital grounds.

Cal. Educ. Code § 56857


Fape in institutions cont1

Student, parents or legal guardian have a right to receive notice regarding a student’s right to receive education in the LRE, and specifically, “to be considered for education programs other than on state hospital grounds”

Cal. Educ. Code §56863

Students with disabilities, including those in state hospitals, are to be educated in the least restrictive environment and have available to them a full continuum of educational services

Cal. Educ. Code § 56850

Legislative intent is that to the maximum extent appropriate, students residing in state hospitals be provided services in the community near the state hospital and in the LRE

Cal. Educ. Code § 56850

Just because a young person is at a state hospital, doesn’t mean that they will not be able to attend school or programs with non-disabled peers. If an IEP team determines that because of the student’s current condition and disability, the student cannot tolerate a full day of regular school

FAPE IN INSTITUTIONS (CONT’)


Lre options for children youth in facilities

Options could include partial day participation in a local public school with supports, such as a behavior plan and a 1:1 aide.

Participation in an extracurricular activity in the community, such as joining a club, taking an art class, community center activity

It is PAI’s opinion that there should be no reason why a student is not considered or even attending a community program (at the least part time) if they have met discharge criteria.

LRE in a state hospital does NOT mean schooling in the on-grounds school, or having a tutor come in for a 1-2 hours per day, especially if they are nearing discharge from a facility.

LRE OPTIONS FOR CHILDREN & YOUTH IN FACILITIES


Behavior support plans

Behavior Support Plans

  • Individually designed to help distinguish, correct, replace or ameliorate unwanted behavior(s)

  • Attached as part of the IEP document

  • Strategies must bepositive [34 C.F.R. Sec. 300.346]

  • If the behavior plan is not working,

    then IEP team needs to reconvene to update or improve the plan

  • If behavior is more serious and pervasive and the above step has not been effective, may need Functional Assessment and Behavior Intervention Plan pursuant to the Hughes Bill


Hughes bill ab 2586 cal educ code 56520 56524

NEGATIVE INTERVENTIONS

Hughes Bill (AB 2586)[Cal. Educ. Code §§ 56520-56524]

  • Mandated the development and implementation of positive behavior intervention plans

    • Prohibited the use of aversive

      behavior interventions

  • Required that every special education student who demonstrates serious behavior problemsreceive a functional assessment of behavior


  • What does serious behavior problem mean hughes bill cont d

    What Does “Serious Behavior Problem” Mean? Hughes Bill (cont’d)

    Defined as one which

    • is self-injurious or assaultive;

    • or causes serious property damage;

    • or is severe, pervasive, and maladaptive, and for which instructional/behavioral approaches specified in the student’s IEP are found to be ineffective.

      5 C.C.R. Sec. 3001(aa)


    Functional analysis assessment should include hughes bill cont d

    Functional Analysis Assessment Should Include …Hughes Bill (cont’d)

    • Systematic observation & description of targeted behavior, antecedent events, consequences, alternative behaviors

    • Review of records, history of

      behavior

    • Analysis of communicative function of behavior and antecedents; ecological and data analysis

    • Recommendations to the IEP team, which may include a positive behavior intervention plan


    Components of a positive behavior intervention plan hughes bill cont d

    Components of a Positive Behavior Intervention Plan Hughes Bill (cont’d)

    • Summary of information from the functional assessment

    • Goals and objectives; Schedules for data collection

    • Objective and measurable description of targeted serious behaviors and positive replacement behaviors

    • Detailed descriptions of interventions to be used and the circumstances for use, such as settings, time periods.

    • Dates for IEP team to review plan’s effectiveness


    What is meant by positive interventions hughes bill cont d

    What Is Meant by “Positive” Interventions? Hughes Bill (cont’d)

    • Interventions that respect person’s dignity and personal privacy and assure physical freedom, social interaction, and individual choice

      • Do NOT include procedures which cause pain or trauma (ex.: pepper sprays, verbal abuse)

  • For more information on Hughes Bill and behavior interventions, see SERR*, Chapter 5

  • CDE has a great book, “Positive Interventions for Serious Behavior Problems: Best Practices in Implementing the Positive Behavioral Intervention Regulations”

    • Available at 916-323-0832, www.cde.ca.gov.cdepress

  • * Special Education Rights and Responsibilities (SERR)


    Before a child is placed out of home

    BEFORE A CHILD IS PLACED OUT OF HOME …

    • Prior to the determination that residential placement is necessary for the student to receive special education and mental health services, the IEP team

      “shall consider less restrictive alternatives, such as providing a behavioral specialist and full-time behavioral aide in the classroom, home and other community environments, and/or parent training in the home and community environments. The IEP team shall document the alternatives to residential placement that were considered and the reasons why they were rejected. Such alternatives may include any combination of cooperatively developed educational and mental health services.” (Emphasis Added)

      Tit. 2, Cal. Code of Regs., Section 60100(c)


    Minor s rights advocacy a primer

    MEDI-CAL ADVOCACY


    Medi cal advocacy

    Medi-Cal Advocacy

    • People eligible for full scope Medi-Cal services are entitled to receive all medically necessary services, including mental health services

    • Children, in addition, are entitled to Early, Periodic, Screening, Diagnosis, and Treatment Services (EPSDT)

      • The EPSDT program is not available for adults


    What can epsdt provide

    What can EPSDT Provide?

    • Screening and diagnosis for medical conditions and/or needs

    • Provide treatment services to address conditions revealed by the screening and diagnosis. EPSDT services can include:

    • Individual/ Group Therapy

    • Therapeutic Behavior Services

    • Family Therapy

    • Crisis Counseling

    • Case Management

    • Special Day Programs

    • Medication

    • Alcohol/ Drug Services


    What are therapeutic behavior services tbs

    What Are Therapeutic Behavior Services (TBS)?

    • 1:1 therapeutic contact to address target behaviors

      • The 1:1 aide/mentor is matched specifically for the child and the child’s strengths and needs.

      • Assists and provides behavior modeling, Increase social/ community competencies, Engage in appropriate activities

  • To prevent placement in a high level group home or locked mental health treatment facility;

  • Or to enable transition out of such placements into a lower level of care


  • What are therapeutic behavior services tbs cont d

    What Are Therapeutic Behavior Services (TBS)? (cont’d)

    • Can receive services up to 24 hours per day, 7 hours per week depending on child’s need

    • Can be provided in many

      settings: home, school,

      group home,

      recreation programs,

      community

    • Intended as a

    • short-term service


    Who is eligible for tbs

    Must meet all these requirements:

    Eligible for full-scope Medi-Cal benefits

    Receiving at least 1 other specialty mental health service

    Without additional support, may need acute care or higher level of residential care; or may not successfully transition to a lower level of care

    Must meet at least one of these requirements:

    Placed in group home Residential Classification Level (RCL) 12 or higher, or in locked mental heatlh treatment facility

    Is being considered for placement in group home RCL 12 or above

    At least one emergency psychiatric hospitalization within last 24 months due to current presenting disability

    Received TBS before and needs it again

    Who is Eligible for TBS?


    Limitations of tbs

    Limitations of TBS

    • Not a long-term service

    • Not to provide convenience for caregiver or supervision for compliance with probation

    • Cannot be just to ensure physical safety or to address conditions not part of the mental health condition

    • Child can be determined eligible in a PHF, IMD, State Hospital or Crisis Residential Facility, but can’t receive services while in such a facility or other facilities where outpatient specialty mental health services are not reimbursable through Medi-Cal


    Rehabilitation option services under medi cal

    Rehabilitation Option Servicesunder Medi-Cal

    • Assessment/Evalutation

    • Intensive Day Treatment

    • Rehab Day Treatment

    • In-Home Services

    • Collateral Services

    • Crisis Intervention

    • Medication prescription, administration, education, monitoring

    • Crisis Stabilization to avoid inpatient placement

      See DMH Letter 01-01: One to One Mental Health Services; Title 9, C.C.R. section 1810.243


    How to apply for medi cal mental health services

    How to Apply for Medi-Cal Mental Health Services

    • Call or write your county Mental Health Department’s access line (see handouts for numbers)

    • Call your service provider and/or Patient’s Rights Advocate.

    • If request or application denied,

      • can file a complaint or grievance

      • or file state fair hearing within 90 days of written denial

      • See handouts for numbers and addresses


    Minor s rights advocacy a primer

    REGIONAL CENTER ADVOCACY


    Regional center advocacy

    Regional Center Advocacy

    • Lanterman Act establishes the Regional Center system.

    • Intended to give people with developmental disabilities the right to services and supports that will allow them to live a more normal and independent life. § 4501

    • All citations are to the Welfare & Institutions Code.


    Regional center eligibility

    Regional Center Eligibility

    • Autism, Epilepsy, Cerebral Palsy, Mental Retardation, or a condition similar to or requiring similar treatment to Mental Retardation. §4512(a)

    • Originate prior to the age of 18.

    • Be substantially handicapping.

    • Expected to last indefinitely.

    • Not be solely physical.

      • Regional centers also state that it must not be solely psychiatric or solely learning disabilities but this is disputed. 17 Cal. Code Regs. §54000.


    Ipp process

    IPP Process

    Individual Program Plan (IPP)…

    • Must be done every three years or when requested. §4646.5

    • This is the contract between the client and the center that outlines what services will be provided. §4646.5(a)(4)


    Parts of the ipp

    Parts of the IPP

    • Goals and Objectives

    • Schedule of Types and Amounts of Services and Supports

    • Review of Health Status

    • Schedule for Review and Evaluation of the IPP. § 4646.5 (a) (2)-(5).


    Possible services

    Specialized medical and dental care

    Specialized training for parents

    Camping

    Infant Stimulation programs

    Respite

    Homemaker services

    Communication devices

    Advocacy

    Child care/Day care

    Short term out of home placement

    Diapers

    Counseling

    Mental Health services

    Behavior modification programs

    Adaptive equipment

    Possible Services


    Securing services

    The regional center must investigate and use creative and innovative ways to meet the family’s need and keep the child in the family home. § 4685( c)(2)

    There shall be no gaps in service.

    It is the regional center’s responsibility

    to ensure that all needed

    services

    are being provided.

    Securing Services


    Out of home placement

    Out of Home Placement

    • Numerous alternatives

      • Foster Family Agency (FFA) - specialized foster family.

      • Small Family Home or Community Care Facility (CCF) - up to six people who do not need more than incidental medical care.

      • Intermediate Care Facility (ICF) - 3 different kind with differing numbers of resident. These offer daily medical assistance.

      • Bates Homes - FFA and CCF’s with additional training for children with special health care needs that can quickly deteriorate.

      • Developmental Center - Institutional Care.


    Out of home placement continued

    Out of Home Placement continued

    • It must be reasonably close to the family home § 4685.1

    • If not, the IPP must contain a statement about efforts to do so.

    • The IPP must also include a written statement about developing the services and supports to return the child to the family home.

    • Some fees may be assessed for out of home placement.


    Coordination between regional center department of mental health

    Coordination between Regional Center & Department of Mental Health

    • Each regional center and county mental health agency must have a memorandum of understanding (MOU). § 4696.1

    • Regional Center must help you advocate for services from CMH. § 4648(b).

    • Regional Center must not allow any gaps in service.


    Emergency and crisis intervention services

    Emergency and Crisis Intervention Services

    • Include mental health services and behavior modification services in order to stay in your chosen living arrangement. § 4648(a)(10)

    • This could include extra staff or support in your home. § 4648(a)(9)

    • If needed, emergency housing must be made available in your home community.

    • Every effort must be made to return you to your home as soon as possible.


    At risk of entering the developmental center

    Regional Resource Developmental Project (RRDP) must conduct an assessment of

    the situation.

    § 4418.7

    Regional Center

    must provide any emergency services that the RRDP finds necessary.

    At Risk of Entering the Developmental Center


    Regional resource developmental project

    Regional Resource Developmental Project

    • Primary purpose is to provide support services to move clients out of the Developmental Centers (DC’s).

    • They provide assessment and evaluation to determine placement in a developmental center and how it can be prevented.


    Regional resource developmental project cont d

    Regional Resource Developmental Project (cont’d)

    • 7 RRDP’s in the state. Each serves a different area.

    • South Coast Regional Project: (714) 957-6518

      • Serves clients of Fariview DC in Orange County.

  • Lanterman Regional Project: (909) 444-7302

    • Serves clients of Lanterman DC in Pomona.

  • Porterville Regional Project: (559) 782-2120

    • Serves clients of Porterville DC in Porterville including those clients with criminal justice involvement.


  • Minor s rights advocacy a primer

    ADVOCACY FOR

    CHILDREN & YOUTH

    IN STATE CUSTODY


    What agency is responsible for delivering special education services

    Licensed Children’s Institution/Group Home = Special Education Local Plan Area, County Office of Education, or Local Education Agency

    Foster Home = Local Educational Agency

    Juvenile Hall = County Board of Education

    California Youth Authority = California Youth Authority

    What Agency is Responsible for Delivering Special Education Services?


    Special education and the juvenile justice system

    Children in juvenile justice system still entitled to special education and related services, including mental health services

    If court plans to order out of home placement and child is special education eligible, court should be informed of child’s eligibility for special education/mental health placement

    Identifying child’s special education and mental health entitlements in court order will also relieve parent and court from having to fund placement/services

    If child in juvenile justice system not already identified as special education eligible, court should be asked to await assessment for eligibility prior to disposition.

    If child already placed by juvenile court but not pursuant to special education eligibility, parent/educational surrogate may seek review of IEP and assessment for eligibility for mental health services and petition the court to modify its placement order in accord with the new IEP

    Court should also be informed of what services can be available to child through Medi-Cal and if child found eligible for services, these services can be made part of court’s order . . . .

    Special Education and the Juvenile Justice System


    Medi cal and juvenile justice

    Medi-Cal and Juvenile Justice

    “Public Institution” exclusion applies to individuals who are “inmates of public institutions,” including juvenile halls, unless

    • Minor placed in juvenile hall pre-dispositionif in facility for reasons other than alleged criminal activity and if stay is specifically temporary, or

    • Minor placed in secure treatment facility contracting with juvenile detention center but not part of criminal justice system, or

    • Minor on probation with home arrest restrictions, or

    • Minor placed as condition of probation in psych hospital, RTC, or in outpatient treatment

      22 C.C.R. § 50273


    Authority of juvenile court

    Authority of Juvenile Court

    • For Minors adjudged to be dependent or ward of court, court may make orders regarding care, supervision, custody, conduct, maintenance and support, including medical treatment for the dependent/ward

    • Court may join in proceedings any agency determined to have failed to meet legal obligation to provide services to ward

    • Services can only be ordered if ward already found eligible for services

      WIC §§ 362; 727(a); Appendix to Cal. Rules of Court 24(h)(4).

    • Courts expressly advised to take responsibility for ensuring child’s educational needs met regardless of placement, to require case plans, court reports, assessments, and permanency plan address children’s educational entitlements and how these are being satisfied, and exercise oversight of social service and probation agencies to ensure children’s educational rights are investigated, reported, and monitored.

      Cal. Rules of Court 24(h).


    Educational surrogates

    Welf. & Inst. Code §§ 361, 726:

    When court limits right of parent/guardian to make educational decisions, shall at same time appoint responsible adult to make educational decisions (note: applies to all children, whether special education eligible or not)

    34 C.F.R. § 300.515:

    Educational surrogate represents child in matters relating to eligibility for special education and delivery of FAPE

    Gov. Code 7579.5:

    LEA required to appoint educational surrogate for child if adjudicated ward or dependent upon referral for special education, if court limits parental rights and no surrogate appointed pursuant to WIC 361or 726.

    But see: Ed. Code 56055: Foster parents can exercise same rights as parents re: special education decisionmaking

    Educational Surrogates


    Guiding considerations

    Guiding Considerations

    • Children are entitled to special education and related services regardless of their placement

    • Children who are Medi-Cal eligible have an array of services available to them that can enable more effective placements

    • Special education programs, including related services such as mental health services, can offer an array of placement and support options

    • Court-ordered residential placements should be identified as educational, medically necessary, or the responsibility of a regional center or other agency as appropriate so that the wrong county agency or parents are not inappropriately stuck with the bill.


    Additional community based resources

    ADDITIONAL COMMUNITY -BASED RESOURCES


    Children s system of care csoc

    Children’s System of Care (CSOC)

    • Includes multi-agency programs, joint case planning, consumer and family input

      • Child-centered, family-focused, community-based services in the least restrictive environment

      • Agencies could include Probation, Social Services, Mental Health, Juvenile Justice, Education

      • Services can include Assessment/ Evaluation, Therapy, Medication Support, Day Treatment Intensive Services, Intensive Case Management, In-Home

        Support Services,

        Wraparound,

        Therapeutic Behavior

        Services


    Csoc goals

    CSOC Goals

    • Children Will Be Safe

    • Children Will Be In Home

    • Children Will Be In School

    • Children Will Be Out of Trouble


    Csoc targeted population

    CSOC Targeted Population

    • Target population: children age 18 and under who…

      • have a diagnosis of a mental disorder under DSM-IV, that is not a primary substance abuse or developmental disorder

      • have emotional disturbance, with 2 or more impairments in the following: self care, school performance, family relationships, ability to function in the community

      • have been or are at risk of being placed out of the home


    Program eligibility

    Program Eligibility

    • Kids who have serious emotionally disturbance, who belong in the target population

    • Kids who are referred by collaborating programs, including wraparound, family preservation, juvenile justice & probation, CalWorks, programs that serve kids with dual diagnosis

      Welf. & Inst. Code, Sec. 5856.2


    Wraparound services

    Wraparound Services

    • “[C]ommunity-based intervention services that emphasize the

      strengths of the child and family and includes the delivery of coordinated, highly individualized unconditional services to address needs and achieve positive outcomes”

      Welf. & Inst. Code § 18251


    Wraparound pilot project

    Wraparound Pilot Project

    • Available on a pilot basis in some counties and some geographic areas of some counties.

      • Participating counties: Alameda, Butte, El Dorado, Humboldt, Los Angeles, Mendocino, Monterey, Napa, Placer, Sacramento, San Diego, San Luis Obispo, San Mateo, Santa Clara, Siskiyou, Tehama

  • Check with your county regarding whether or not wraparound is available, or call DSS, Child and Family Services Division, Child Protection and Family Support Branch, Integrated Services Unit at 916/445-2890 (Cheryl Treadwell, Manager)


  • Eligibility for wraparound services

    Eligibility for Wraparound Services

    • Provided to children who are involved with child welfare service or probation and at risk of out-of-home placement; it is not limited to children on Medi-Cal.

    • May enter program as a ward or dependent of court, or through special education

      • Alternative to Group Home Placement


    Minor s rights advocacy a primer

    FAMILY ADVOCACY


    Minor s rights advocacy a primer

    ADVOCACY FOR TRANSITION-AGED YOUTH


    Minor s rights advocacy a primer

    DISCHARGE PLANNING FOR YOUTH AND ADULTS

    Presented by:

    Matthew Fishler

    Anne Lukito

    Stuart Seaborn

    Protection & Advocacy, Inc.

    PRAT 2003


    Minor s rights advocacy a primer

    HYPOTHETICALS


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