Cross Systems Training. December 10, 2014

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1 Cross Systems Training December 10, 2014

2 Meet Sara and Her Family Sara is 17 years old History of sexual abuse History of drug use and hospitalization Experience in the Juvenile Justice system Experience in the Child Protective System Potential transitional/housing issues School challenges

3 The System of Care An organized network of formal and natural support providers who come together to move to an integrated system

4 The System of Care How a community takes care of it s own Recognizes that child and family needs may not fit our categorical services Respects each agency s societal mandates Is comprised of formal and natural community stakeholders

5 Systems in Broward Family and Youth School Board- Learning Child Welfare- Safety and Permanency Planning for Children Department of Juvenile Justice- Community Protection Behavioral Health- Emotional Health Department Of Health- Disease Prevention Entitlements- Medicaid Adult Resources Local Funding- (CSC, BBHC, SAMH, CSAD, United Way)

6 School Board of Broward County Kimberly DiLuzio-FDLRS (Florida Diagnostic &Learning ResourcesSystem) Child Find Faye Kravitz-District Coordinator Student Services Rosemary Russo- Family Counseling Coordinator Charlene Grecsek-SedNet Coordinator

7 Florida Diagnostic & Learning Resources System (FDLRS) Discretionary project of the Florida Department of Education (FLDOE) Bureau of Exceptional Education and Student Services (BEESS) Provides diagnostic, instructional, and technology support services to district exceptional education programs and families of students with disabilities 19 Associate Centers throughout the state

8 Child Find Function Awareness of Programs & Services Outreach Assessment Placement Training and Support CHILD FIND SPECIALISTS: Dr. Ellen Breslow Kimberly DiLuzio Phone: Fax:

9 STUDENT SERVICES BROWARD COUNTY PUBLIC SCHOOLS

10 STUDENT SERVICES ADMINISTRATORS Dr. Laurel Thompson Director Faye Kravitz Rosemary Russo Debbie Winters District Coordinator, Student Services Family Counseling Coordinator Dependency Program Manager

11 Administrators, continued Angela Ryan-Lublin, Delinquency Manager Latrell Carr, Mentoring Tomorrow s Leaders Manager Carole Mitchell, HEART Manager Yva Dieudonne, Child Abuse Services Manager

12 SEDNET Charlene M. Grecsek, EdD, LMHC Mission Statement: The division of Exceptional Student Education and Support Services is committed to preparing students for success in a global society.

13 SEDNET SERVICES Trauma Informed Care ESE Family Counseling Baker Act Information SEDNET Case Management SEDNET Suicide Prevention & Intervention Behavioral Health Community Partners Community Contracts Community Collaboration

14 Name of Supervisor ESE Supervisors Area 1. Theresa Spurlock 2. Debra Harrington 3. Tara Rodger 4. Gwen Lipscomb 5. Donna McCain 6. Deneen Gorasini 7. Lou Ruccolo 8. Felicia Starke 9. Diana Cruz 10. Mary Claire Mucenic 11. Rhonda Said 12. Charlene Grecsek 1. Deaf and Hard of Hearing 2. Speech/Language (OT/PT) 3. McKay and EASY IEP 4. FDLRS/FIN 5. PreK- ESE 6. Medicaid/ Transition 8. Resolution Office 9. Resolution Office 10. Psychology Coordinator 11. Psychology Coordinator 12. SEDNET/ ESE Family Counselors

15 Child Protective Investigations Broward County Overview Broward County Sheriff s Office Child Protective Investigations Section

16 Florida s Child Welfare Components Florida Abuse Hotline. The hotline serves as the central point for receiving and assessing information about suspected abuse or neglect of children and other vulnerable citizens, including disabled or elderly adults. Protective investigations. Investigators from DCF and six sheriffs offices conduct investigations of abuse reports received from the hotline to determine harm and address safety. In-home services. When needed, services from case management, counseling & parenting training, etc. may be used to protect children who remain in their home. In-home services can be voluntary, but may be court-ordered in cases that are more serious. Out-of-home services. When a child must be removed from the home, they may be placed in the care of a relative, nonrelative, or a foster care home. Adoption services. The program arranges adoptive homes for those children who cannot be returned to their families. This includes finding adoptive families, paying court costs & monthly cash subsidies for some children.

17 Florida s Legislative View Recognize that most families desire to be competent caregivers and providers for their children and that children achieve their greatest potential when families are able to support and nurture the growth and development of their children. Provide a child protection system that reflects a partnership between the department, other agencies, and local communities. To provide a child protection system that is sensitive to the social and cultural diversity of the state. Provide procedures which allows to respond to reports of child abuse, abandonment, or neglect in the most efficient and effective manner that ensures the health and safety of children and the integrity of families. Preserve and strengthen the child's family ties whenever possible, removing the child from parental custody only when his or her welfare cannot be adequately safeguarded without such removal. The health and safety of the children served shall be of paramount concern. The prevention and intervention should engage families in constructive, supportive, and non-adversarial relationships. The prevention and intervention should intrude as little as possible into the life of the family, be focused on clearly defined objectives, and take the most parsimonious path to remedy a family's problems. The prevention and intervention should be based upon outcome evaluation results that demonstrate success in protecting children and supporting families.

18 Florida s Abuse Hotline Accepts reports of known or suspected abuse, neglect, or exploitation of a vulnerable adults. Accepts reports of known or suspected abuse, abandonment, sexual abuse or neglect of a child. Broward County averages more 40 reports daily. In 2013 Broward handled over 14,500 unduplicated intake reports requiring a response.

19 Mandatory Reporting of Suspected Abuse Mandatory reports of child abuse, abandonment, or neglect; mandatory reports of death; central abuse hotline. (1)(a) Any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or other person responsible for the child s welfare, as defined in this chapter, or that a child is in need of supervision and care and has no parent, legal custodian, or responsible adult relative immediately known and available to provide supervision and care shall report such knowledge or suspicion to the department in the manner prescribed in subsection (2). Law change effective October (b) (c) Any person who knows, or who has reasonable cause to suspect, that a child is abused by an adult other than a parent, legal custodian, caregiver, or other person responsible for the child s welfare, as defined in this chapter, shall report such knowledge or suspicion to the department in the manner prescribed in subsection (2). Any person who knows, or has reasonable cause to suspect, that a child is the victim of childhood sexual abuse or the victim of a known or suspected juvenile sexual offender, as defined in this chapter, shall report such knowledge or suspicion to the department in the manner prescribed in subsection (2).

20 Mandatory Reporters Mandatory reports of child abuse, abandonment, or neglect; mandatory reports of death; central abuse hotline. (d) Reporters in the following occupation categories are required to provide their names to the hotline staff: 1. Physician, osteopathic physician, medical examiner, chiropractic physician, nurse, or hospital personnel engaged in the admission, examination, care, or treatment of persons; 2. Health or mental health professional other than one listed in subparagraph 1.; 3. Practitioner who relies solely on spiritual means for healing; 4. School teacher or other school official or personnel; 5. Social worker, day care center worker, or other professional child care, foster care, residential, or institutional worker; 6. Law enforcement officer; or 7. Judge. The names of reporters shall be entered into the record of the report, but shall be held confidential and exempt as provided in s

21 Florida Abuse Hotline Statewide toll free number: ABUSE Website reporting: Fax Reports: If web-based reporting is used user may set up profiles with DCF for ease in reporting.

22 Hotline Interview Process: Hello Thank You Listen Demographics Caller s Allegations Decision Sources Jurisdiction Means to locate Directions Who,What, When, Where, Why, How? Alleged Harm by Caregiver? Accept for DCF Screen Out Parent & child Functioning, parent practices, discipline? Alleged Harm by adult other than caregiver? Accept for LEO Screen Out Risks

23 Maltreatment Types: There are 20 possible maltreatments that can be assigned to an intake; each intake of abuse or neglect must contain at least one of the following maltreatments. There is no limit as to how many maltreatments may be included on an intake, as long as each one is justified by allegation narrative. Abandonment Asphyxiation Bizarre Punishment Bone Fracture Burns Death Environmental Hazards Failure to Protect Failure to Thrive Family Violence Threatens Child Human Trafficking Inadequate Supervision Internal Injuries Malnutrition/Dehydration Medical Neglect Mental Injury Physical Injury Sexual Abuse Substance Misuse Threatened Harm

24 DCF intake report types handled by CPIS: Fla. statute requires four types of intakes be accepted. Each type requires different requirements for the commencement, handling, and disposition. 1. In-Home Reports 2. Institutional Reports 3. Child-On-Child Sexual Abuse Reports 4. Special Conditions Referrals 5. Human Trafficking

25 In-Home Reports: Reports involving children with their lawful custodian, caregiver, or parent. Institutional Reports: Reports involving children alleged to be harmed by foster parent; employee of schools, public or private child day care center, institution, facility, or agency; or any other person legally responsible for the child's welfare in a residential setting; and also includes an adult sitter or relative entrusted with a child's care. For the purpose of departmental investigative jurisdiction, this definition does not include law enforcement officers, or employees of municipal or county detention facilities or the Department of Corrections, while acting in an official capacity unless LEO is under contract with DJJ for the service.

26 Child-On-Child Sexual Abuse Reports: Reports involving child 12 years of age or younger who is alleged to have committed a violation of chapter 794, chapter 796, chapter 800, s , or s ; or a child who is alleged to have committed any violation of law or delinquent act involving juvenile sexual abuse. Special Conditions: Caregiver Unavailable parent or caregiver incarcerated, hospitalized, or died and immediate plans must be made for the children s care. Parent Needs Assistance Situations in which a parent or caregiver is having difficulty caring for a child, is afraid of abusing the child, or is looking for help to the degree that it appears likely that, without intervention, abuse, neglect, or abandonment will occur. Human Trafficking alleged person responsible isn t required to be a caregiver or other person responsible.

27 Background Workup of Reports: The following is generally researched and added to each file: Prior abuse report records Prior child-welfare services in Florida Prior criminal records in Fl and nation Review of DOH birth records in Florida Statewide Court Record Pending County criminal Court cases Review of Broward Sheriff jail records Review of Department of Corrections Review of FDLE sexual predator/offender Review of Dept. of Juvenile Justice

28 Core Tenets of Florida Practice Model

29 Collaborations Mental Health Henderson Behavioral Health Substance Abuse Henderson Family Engagement Program FEP Domestic Violence Women In Distress, Inc. Child Protection Team Broward Sexual Assault Treatment Ctr. Law Enforcement Response Family Resource Specialist Multidisciplinary Assessment staffings: Substance Exposed Newborns Human Trafficking Child-on-child Ungovernable youth CPT elevated cases Foster Care Institutional Cases Child Protective Investigator. Family Strengthening Services Children s Services Council of Broward

30 Multidisciplinary Staffing Forensic Medical Examinations Psychosocial / Family Assessments Medical Consultation Specialized Interviews & Forensic Interviews Psychological Evaluations & Consultation

31 maltreatment Information Domains Maltreatment Nature & circumstances Surrounding incident Child Functioning Adult General Functioning Parenting Discipline Parenting General

32 Florida DCF Danger Threats - Parent/Legal Guardian/Caregiver is not meeting child s basic and essential needs for food, clothing and/or supervision, AND child is/has already been seriously harmed or will likely be serious harmed. Parent/Legal Guardian/Caregiver s intentional and willful act caused serious physical injury to the child, or the caregiver intended to seriously injury the child. Parent/Legal Guardian/Caregiver is violent, impulsive, or acting dangerously in ways that have seriously harmed the child or will likely seriously harm the child. Parent/Legal Guardian/Caregiver is threatening to seriously harm the child; Parent/Legal Guardian is fearful he/she will seriously harm the child. Parent/Legal Guardian/Caregiver views child and/or acts toward the child in extremely negative ways AND such behavior has or will result in serious harm to the child. Child shows serious emotional symptoms requiring immediate intervention and/or lacks behavioral control and/or exhibits self-destructive behavior that parent/legal guardian/caregiver is unwilling or unable to manage. Child has a serious illness or injury (indicative of child abuse) that is unexplained, or the Parent/Legal Guardian/Caregiver explanations are inconsistent with the illness or injury. The child s physical living conditions are hazardous and a child has already been seriously injured or will likely be seriously injured. The living conditions seriously endanger a child s physical health. There are reports of serious harm and the child s whereabouts cannot be ascertained and/or there is a reason to believe that the family is about to flee to avoid agency intervention and/or refuses access to the child and the reported concern is significant and indicates serious harm. Parent/Legal Guardian/Caregiver is not meeting the child s essential medical needs AND the child is/has already been seriously harmed or will likely be seriously harmed.

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34 Safe or Unsafe? Children are determined to be unsafe if there are one or more present or impending danger threats that cannot or will not be controlled by a non-maltreating caregiver. Only those children in the home that are determined to be vulnerable to impending danger are unsafe.

35 Intake Received pre-commencement actions Jointly commence with Law Enforcement First contact complete Present Danger Assessment If Present Danger Threats exists immediately complete and initiate a Safety Plan Information Collection & Investigation Actions proceed resulting in identification of maltreatment & Impending Danger Threats Any Danger Threat with vulnerable child that can not be managed by non-offending caregiver represents a requirement to implement a SAEFTY PLAN safety plans are managed by case-management

36 Allegation Maltreatment - Finding:

37 Emergency removal or other safety action Removal of children done only if less restrictive actions can t ensure safety of child. Removal of children must be with efforts to have parents assist with identifying relatives or non-relatives to assume care of children after home study & related checks. Actions to take children into protective custody must have a dependency court hearing within 24-hours of such action. The actions in dependency court are not to punish parent but protect children. Dependency court involves a case plan corresponding to the orders for compliance on tasks focused on remedying underlying issues with caregivers.

38 Use of Prevention & Intervention Services: Families requiring assistance should be provided with the necessary interventions. Interventions should offered in as less intrusive manner as possible, culturally competent, child-centered, family focused. Homemaker care, day care, protective supervision, or other services to stabilize the home environment, including intensive family preservation services through the Family Strengthening programs shall first be offered for voluntary acceptance unless there are high risk factors that may impact the ability of the parents or legal custodians to exercise judgment. Such factors may include the parents' or legal custodians' young age or history of substance abuse or domestic violence. Children s Service Council contracts since 2006 with over a dozen local community agencies for Family Strengthening Programs that BSO CPIS uses. All such agencies have formal agreements with BSO for record sharing.

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40 Should hotline be called? What is the reasonable cause to suspect?

41 Sexual abuse - incest Domestic violence Potential: inadequate supervision

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43 Sara Sexual abuse victim Substance addiction issues Criminal history Lacks progress in therapy Exposed to DV

44 Rafael Exposed to domestic violence Mental health diagnosis Scared of father & Fearful of mom s health condition

45 Gabriella Exposed to domestic violence Attention seeking behavior No mental health involvement Scared of father & Fearful of mom s health condition Trauma symptoms

46 Rosa Chronic health issues Domestic Violence Victim Overwhelmed with parenting, Finances, job & failing health

47 Jose Batterer in denial & blames victim Non-compliant in $ support Undermines mother s efforts Refuses cooperation

48 Rosa hasn t Effectively dealt with ungovernable & delinquent behaviors of Sara. Has plan to lock-out teen at 18. Rosa failed to address Gabriella s extreme behaviors

49 Joint custody issues significantly negatively impact children Father minimally involved & Has his children estranged by parental actions. Mom now resistant to added appointments & professionals

50 Law Enforcement Domestic Violence Professional School System Mental Health Providers DJJ system Nancy J Cotterman Center/CPT Voc. Rehab In-home Services

51 ChildNet Gayle Mctighe (954)

52 Florida Department of Juvenile Justice Circuit 17: Broward County Where Excellence is Expected & Achieved Cassandra L. Evans, Chief Probation Officer Terria Flakes, Acting Regional Director

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54 Dept. of Juvenile Justice Delinquency Continuum

55 Definitions ReYouth Released The youth is released from DJJ Custody either with or without continued supervision. Commitment to a Residential Facility A residential facility is a place where a child is sent to live and receive treatment after a Juvenile Court Judge rules on that child s law-breaking behavior. A residential commitment program promotes that child's rehabilitation and helps the child learn not to break the law again. The residential facility promotes community safety. Meet with JPO to Develop a YES Plan The Youth-Empowered Success (YES) Plan assist the Juvenile Probation Officers and contracted case managers to use the information gathered through the PACT assessment to establish meaningful goals and actions in collaboration with the youth and family. Case Dropped "Nolle Prossed" A discontinued prosecution. A formal entry by the state attorney that a case will not be prosecuted. Adjudication Withheld The court finds that a youth committed a delinquent act, but withholds an adjudication of delinquency. The court places the youth on community supervision. Youth Adjudicated The court finds a youth guilty of committing a delinquent act. The court can commit the youth or place the youth on community supervision. Secure Detention Center Depending on the risk level, youth may be required to stay in a secure detention center until further action is determined. Await Court Date At Home with Conditions Depending on the risk level, youth may be allowed to await their court dates at home under certain conditions. Detention Risk Assessment Instrument (DRAI) The instrument used to determine if a youth meets detention criteria and to determine whether a youth should be placed in secure, non-secure, or home detention care prior to a detention hearing. Referral to Juvenile Detention Alternatives Initiative (JDAI) A detention reform and juvenile justice system improvement initiative that focuses on moving low-risk youth from secure detention into community-based alternative programs. JDAI is a comprehensive initiative of eight strategies involving system-wide change in philosophy, practice and policy in coordination with the local jurisdiction level and state level. Taken into Custody and Referred to DJJ by Officer In the juvenile justice system youth are taken into custody; whereas, adults are arrested. Once in custody, youth are referred to their local Juvenile Assessment Center or an on-call screener and the family is notified. Referral to Diversion Program A program designed to keep a youth from entering the juvenile justice system through the legal process. Youth has Contact With Law Enforcement The youth is discovered participating in a delinquent act and a law enforcement officer gets involved. Civil Citation Issued A new program designed to addresses a youth s behavior at his or her first encounter with the juvenile justice system providing an alternative to arrest. Referral to Adult Court Court for adults over the age of 18 or for a youth charged with a crime as an adult. Youth in adult court may be sentenced to either youth or adult sanctions.

56 For More Information Call (954)

57 Behavioral Health Shari Thomas- Henderson Behavioral Health Susan Nyamora- South Florida Wellness Maribel Quiala-UHS Debra Lynskey-Lake- Chrysalis Beverly and Doug- Parent and Youth representatives

58 Behavioral Health System The system that looks out for our mental health and substance abuse needs

59 Behavioral Health System Provider agencies offer a wide array of services to meet the community s needs Agency type & funding Federal government State of Florida Broward Behavioral Health Coalition Broward County Children s Services Council United Way Private foundations

60 Behavioral Health & Substance Abuse Resources 211- First Call for Help 24/7 information/referral line Dial 211 or (954) Henderson Behavioral Health (954) Behavioral health resources Centralized CM for children with complex needs Wraparound Individual provider agencies PCP referral

61 Behavioral Health System Levels of Care Community-Based Therapeutic Foster Care (Medicaid funded) Therapeutic Group Home Residential Treatment -Statewide Inpatient Psychiatric Placement (SIPP) (Medicaid funded) -Community based substance abuse program -Private pay

62 Crisis Intervention Services Call 911 Henderson s Mobile Crisis or Youth Emergency Services (YES Team) (954) x3 Family Services Planning Team (FSPT) Interdisciplinary team meetings Access to behavioral health residential services

63 Benefits Rebecca Miele- Florida KidCare Stephanie Bell- 211 Ismael Martinez-Family Success

64 Broward County Health Department Florida KidCare Outreach Program Presented by Rebecca Miele

65 Who Are Our Nation s Uninsured Children? 90% have one or more parents who work Three in five live in two-parent families Two-thirds have family incomes above poverty level, but 76% have incomes below 200% of the FPL 23% of children eligible for Medicaid are uninsured One in four workers today has no access to employment-based family health coverage, at any price.

66 Why Are They Uninsured? The most common reason children do not get needed health care is because their families cannot afford it Their parents earn too much to qualify for Medicaid but too little to afford private coverage Parents lack of awareness that they are eligible for the Florida KidCare Program Parents lack of understanding of the importance of regular check-ups and preventive care

67 What is the Florida KidCare Program? The Florida KidCare Program was created by the 1998 Florida Legislature in response to federal CHIP legislation The Florida KidCare Program includes: Medicaid for Children MediKids Children s Medical Services Network Healthy Kids (Private)

68 Who is Eligible for Florida KidCare? Florida KidCare offers programs for children from birth through age 18 Subsidized coverage for children up to 200% of the federal poverty level Must be uninsured at time of application A single application for all programs English, Spanish and Creole available

69 Who Can Apply? Child must reside in Florida Application must reflect household in which the child permanently resides If second parent does not live in household, their information is not required

70 Income Documentation Applicants are required to document all sources of income at time of application. Examples: Wages and Salaries Self Employment Income Child Support Alimony Social Security Any other income, earned or unearned Electronic verification will be implemented when possible. 70

71 How Do I Apply? Florida KidCare Website Online application Applications by Fax Download and print an application from the web Call the Broward County Hotline and request an application be mailed to you; or make an appointment for a representative to assist with an online application or toll free at

72 Stephanie Bell, MSW Community Relations Specialist

73 I can t pay my rent, my husband left me My child is on drugs I want to kill myself I need to find childcare I need service hours to graduate school We can t help with that We only do senior daycare We don t need volunteers On hold for 30 minutes then oh sorry, we don t do those services. I don t know about those resources I don t know, please hold. We only know about domestic violence programs We don t serve your area

74 I can t pay my rent, my husband left me My child is on drugs I want to kill myself I need to find childcare I need service hours to graduate school 2-1-1, how may I help you? Yes, I can connect you with someone who can help Drug Rehabilitation Center Volunteer Center Rental Assistance Program Child Care Resource And Referral Suicide Prevention Hotline

75 dial: TeenSpace211 Homeless Services Special Needs Hotline Access to Benefits Program

76 FREE Access to Benefits Program Helping families gain and maintain the income supports they need Comprehensive Face-to-Face Services Connections to Resources Flexible Appointment Hours Contact Person: Mica with referrals

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78 Family Success Centers Providing assistance with: Rent or Mortgage Electric or water bills Becoming self-sufficient Housing assistance Community Action (employment, education and tuition assistance) North- Annie Weaver Health Ctr. (Pompano Beach) Northwest-(Coral Springs) South-(Carver Ranches) Central-Edgar Mills Center (Fort Lauderdale)

79 Transition to Adulthood Kristen Guerisse- Flite Center Tania Hamilton- Gulfcoast Jose Pinto-Children s Services Council Jim Lopresti-Sunserve Lou Rucollo-School Board of Broward County

80 Continued Needs Educational Support Adult Supports Data Extracurricular Activities TIL SYSTEM OF CARE Affordable Housing Self Sufficiency Needs Disability Services Mental Health Services Health Care Essential Skills Training Career & Employment Additional Supports 12/9/2014 1

81 One Community Partnership 2 (OCP2) Focus on Wellness & Recovery for Youth and Families In Broward County

82 What is OCP2? Builds on OCP1 system of care framework and wraparound services OCP1: ; focused on children all ages OCP2: focuses on youth in transition, ages youth with "serious emotional disturbance (SED)" or mental health/co-occurring substance use challenges history of trauma Helps the entire System of Care education and support for counselors, educators, case managers, peers, family members, friends who work with and support youth

83 OCP 2: Planning for Expansion 5 Core Strategic Goals Values Guided by 1. Identify and implement policy, administrative and regulatory changes 2. Develop and expand services/supports based on the SOC philosophy and approach 3. Create or improve financing strategies 4. Provide training, technical assistance, and coaching 5. Generating support for the system of care approach Youth & Families Recipients of services Peer Support/Family Advocates Community Based Partnering with Child and Adult systems Recovery & Wellness Evidence-based practices Cultural and linguistic competence Technology Social Marketing A strong collective, trained Workforce

84 Next Steps April/May 2015 apply for the 4-5 year Expansion Grant (SAMHSA) You can help by: Implement the Expansion activities that may include: Increasing evidence-based practices for youth like Peer Support Supported Employment Supportive Housing Family Partners Developing new treatment, early intervention, prevention programs for youth Data and Funding sharing among systems Referring youth and families who want to have a voice! Encouraging youth or families to participate in planning, committees, leadership opportunities Inviting us to present OCP2 at your meetings for more info:

85 Thank you for Joining us!