DFCS Online Policies & Procedures

  DFCS Online Policies & Procedures

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Handbook 13: Cross Program Protocols
13-13 Children Discharged from Psychiatric Hospitals  *Protocol for Expedited Services
Cross Program Protocols
13-13 Children Discharged from Psychiatric Hospitals
Reference Points
Overview
Criteria for an Expedited Protocol Referral
Hospital Social Worker's Role
Mental Health Liaison's Role
CCF Unit Supervisor's Role
DI Control Clerk's Role
DI Social Worker's Role
CCF Social Worker's Role
List of Psychiatric Hospitals
Contacts for the Expedited Protocol
Other References


Reference Points
Effective Date: TBA
Last Updated: 04/20/2005


Overview   There are occurrences of children having been admitted to a psychiatric hospital and, at the time of discharge, the parents or guardians acknowledge that the child’s mental health needs are beyond their ability to provide adequate care and supervision for the child. A referral to the Department of Family and Children’s Services (DFCS) may be appropriate in these situations. If a referral is made, it is critical that the designated Mental Health Department Hospital Liaison, Child Abuse and Neglect Center (CANC) Screening social worker and Dependent Intake (DI) social worker coordinate a response.
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Criteria for an Expedited Protocol Referral  

An expedited protocol has been developed between the Mental Health Department and the Department of Family and Children's Services (DFCS) regarding children who are discharged from psychiatric hospitals and are unable to return home. The purpose of the protocol is to:

  • Maximize the time for the DI social worker to conduct an assessment and service evaluation.
  • Avoid last minute referrals and discharge planning in a crisis modality.

All of the following criteria must be present at the time of the referral to DFCS to qualify under the expedited protocol:

  • The child has extensive mental health needs as evidenced by multiple inpatient psychiatric hospitalizations or mental health crisis contacts, and...
  • The child does not currently meet the criteria for Chapter 26.5 (AB 3632) of the Government Code, which would otherwise allow service via Mental Health, and...
  • There are no current allegations of abuse or neglect.
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Hospital Social Worker's Role  

The hospital social worker:

  • Identifies the referring incident of abandonment as early in the discharge planning process as possible.
  • Discusses the case with the Mental Health Expedited Protocol (EP) liaison in terms of mental health services and coordination with DFCS.
  • Calls the DFCS Child Abuse and Neglect Center (CANC) with the referral, after confirming with the Mental Health EP liaison that an EP referral is indicated.
    • Tele:(408) 299-2071 in San Jose.
    • (408) 683-0601 in South County.
    • (650) 493-1186 in North County.
     
  • Faxes to the CANC the EP referral letter, written by the attending psychiatrist.
    • Include any pertinent clinical data, i.e. previous discharge summaries or psychological testing, related to discharge planning and treatment for the child.

    • Fax /CANC: (408) 975-5851.
     
  • Faxes a copy of the referral letter and all other pertinent clinical data to the Community Care Facility (CCF) Unit supervisor, Beth McGhee.
    • Fax: (408) 975-5862.
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CANC Screening Social Worker's Role  

When receiving a referral from a psychiatric hospital social worker that meets the criteria for the expedited protocol, the CANC Screening social worker:

  • Takes a report.
  • Assesses risk to the child.
  • Determines the level of Emergency Response.
  • Creates a Mental Health Special protocol Emergency Response referral in CWS/CMS.
  • Submits the referral packet to the ER clerical staff for ID-ing and assignment.
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Mental Health Liaison's Role  

The Mental Health Expedited Protocol (EP) liaison may identify a child as meeting the EP criteria, while the child is still on a psychiatric hold at the hospital. The child is not eligible to be placed in temporary custody, while on a hold. To expedite services, after identifying a child who is on a hospital hold and who may be appropriate for a referral to DFCS, the Mental Health liaison:

  • Meets with the parents/guardians, along with the hospital social worker and discusses a possible referral to the DFCS.
  • Obtains parental consent to release information to DFCS, including a signed release of information.
  • Faxes the referral packet and any signed consents or releases to the Community Care Facility (CCF) Unit supervisor.
  • Holds a pre-CANC referral consultation with the CCF Unit supervisor.
    • The CCF supervisor will also contact the parents to discuss the situation with them.
     
  • Informs the hospital staff about the outcome of the parents’ and CCF supervisor’s discussion, after the CCF supervisor has talked to the parents and related that discussion to the liaison.
  • Provides case management consultation to the inpatient hospital team.
  • Assists in the coordination of outpatient mental health services for Medi-Cal and unsponsored youth from Santa Clara County.
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CCF Unit Supervisor's Role  

If the Community Care Facility (CCF) Unit supervisor receives a call from the Mental Health liaison regarding a child who meets the criteria for the expedited protocol and who remains on a psychiatric hospital hold, the CCF supervisor:

  • Calls the parents/guardians within 24 hours and discusses the possible outcomes of a referral to DFCS, including legal and fiscal implications.
  • Contacts the Mental Health EP liaison regarding the outcome of the discussion with the parents/guardians.
  • Notifies the RISC Coordinator of a possible Expedited Protocol referral, in order to expedite a RISC referral, if a decision is reached to make a referral.
  • Provides a written memo or goes in-person to the Emergency Response Screening Unit to advise the unit of the forthcoming referral.
  • Considers the need for a TDM or family conference and makes a referral, if necessary.
    • A TDM referral is appropriate in those cases where the parents are ambivalent about DFCS involvement.
     
  • Receives and reviews a copy of the referral packet from either the hospital social worker or the mental health liaison.
  • Identifies a CCF social worker for the pre-dispositional assignment, after being contacted by the DI social worker.
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DI Control Clerk's Role  

The DI Control Clerk:

  • Lists the new case on the upcoming case assignment log for DI supervisors’ case assignment.
  • Prepares the referral packet for DI case assignment, after receiving the Emergency Response/Mental Health referral.
  • Makes the pre-dispositional secondary assignment of the CCF social worker in CWS/CMS.
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DI Social Worker's Role  

At Assignment
Upon being assigned a mental health expedited protocol referral, the DI social worker:

  • Contacts the CCF supervisor for additional information, including the name of the pre-dispositionally assigned CCF social worker.
  • Conducts a dependency investigation.
  • Confers with the CCF pre-dispo social worker and social work supervisor and considers one of the following options or recommendations:
    • Return home with referrals to other community agencies.
    • Voluntary Family Reunification (VFR).
    • File a petition, if a dependency is necessary, and return home.
      • Refer to the proposed allegation language.
    • Files a petition, if a dependency is necessary, and recommends that the  child be detained in out-of-home care.
      • Preference for out-of-home care is with relatives or non-relative extended family members.

If Filing a § 300 Petition
If an assessment is made that Juvenile Court intervention is required, the DI social worker:

  • Continues with the investigation and prepares the Detention Packet.
  • Requests Interim CCF Placement orders at the Initial Petition (Detention) Hearing.
  • Includes the following information, whenever possible, in the Jurisdictional/Dispositional report:
    • Current Diagnosis on all five axes.
    • IEP designation and the child’s IQ.
    • Current psychotropic medications.
    • Previous psychiatric hospitalizations (when, where, why).
    • Current and past behavior (be specific).
    • Medical issues (if any).
    • Placement history (if any).
    • Service history (Mental Health, Drug and Alcohol, Juvenile Probation, Wraparound, Private therapist, or Therapeutic Behavioral Service (TBS).
     
  • Follows guidelines for pre-dispositional transfer to the Community Care Facility (CCF) Units, including conferring with the CCF supervisor before pre-dispositional transfer.
  • Develops a case plan.
  • Makes a recommendation for placement, with input from the CCF social worker.
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CCF Social Worker's Role  

The Community Care Facility (CCF) social worker:

  • Completes a RISC referral and sends it to the RISC Coordinator for review at the next RISC meeting.
  • Gives input to the DI social worker regarding recommendation for placement of child.
  • Is responsible for case management and placement.
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List of Psychiatric Hospitals  

Psychiatric hospitals that provide services for children include:

Mills-Peninsula Medical Center
1783 El Camino Real, Burlingame 94010
Ages 13-17

BHC Fremont Hospital
39001 Sundale Drive, Fremont 94538
510.796.1100
Ages 12-17
Mt. Diablo Medical Pavilion
2740 Grant Street, Concord 94520
925. 680.6500
Ages 5-17
California Specialty Hospital
525 Oregon Street, Vallejo 94590
707.649.4040
Ages 5-17
Sutter Hospital
7700 Folsom Blvd., Sacramento 95826
916.386.3000
Ages 2-17
Cedar Vista Hospital
7171 N. Cedar Ave, Fresno 93720
559.449.8000
Ages 13-17 (emergency child admissions 5-12)
BHC Heritage Oaks Hospital
4250 Auburn Blvd., Sacramento 95841
916.489.3336
Ages 13-17
 
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Contacts for the Expedited Protocol  
  • Child Abuse and Neglect (CAN) Center / Santa Clara County
    373 W. Julian St.
    San Jose, CA 95110
    Tele: (408) 299-2071
    (408) 683-0601 in South County
    (650) 493-1186 in North County
    Fax: (408) 975-5851
  • DFCS Community Care Facility (CCF) Unit Supervisor
    Beth McGhee
    373 W. Julian St., 4th flr.
    San Jose, Ca 95110
    Tele: (408) 975-5494
    Fax: (408) 975-5862
  • Mental Health Department Expedited Protocol Liaison
    Margaret Ledesma
    650 South Bascom Avenue
    San Jose, CA 95128
    Tele: (408) 284-9070
    Pager: (408) 280-9216
    Fax: (408) 971-6932
  • DFCS RISC Coordinator
    373 W. Julian St., 4th flr.
    San Jose, CA 95110
    Tele: (408) 975-5436
    Fax: (408) 975-5860
  • Dependent Intake Control Clerk
    Fax: (408) 369-4170
    (408) 848-1496 in South County
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Other References  
MS Word EP Referral Letter
MS Word Proposed Allegation Language Document
PDF Department of Family and Children's Services/Department of Mental Health Expedited Protocol For Children Whose Mental Health Needs Are Beyond their Parent's Ability to Provide Safety and Care
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