DFCS Online Policies & Procedures

  DFCS Online Policies & Procedures

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Handbook 13: Cross Program Protocols
13-7 Consent for Mental Health Treatment
Cross Program Protocols
13-7 Consent for Mental Health Treatment
Reference Points
Overview
Policy
Reasonable Efforts
Signed Consent for Child's Mental Health Treatment
Application and Order
Maintaining Ongoing Communication

Other References



Reference Points
Effective Date: TBA
Last Updated: 11/29/2005
 Non CWS/CMS Forms:
MS Word Consent for Mental Health Treatment(SCZ 243)
MS Word Authorization for Use and Disclosure of Protected Health Information (SCZ 244)
PDF Standing Court Order for Ordinary Medical, Mental Health and Dental Treatment for Dependent Children in Temporary and Out-of-Home Placement - 10/03/01
MS Word Notice of Ex Parte Application to the Court (SCZ 170)
   MS Word Attachment to Notice (SCZ 170a)
 CWS/CMS Forms:
bullet Court Management Section: Ex Parte Application and Order


Overview  

To arrange mental health treatment for a child supervised by DFCS, a consent for treatment form must be signed either by a legal parent, legal guardian, the child, the social worker, or the court, depending on the circumstances of the case.  This policy outlines procedures required to obtain signed consent for the child's mental health treatment under different circumstances, such as when a parent's whereabouts is unknown or the treatment is for a child age 12 years or older.

This policy also concerns obtaining authorization for medical, mental health or drug treatment providers to release diagnosis and treatment records, or other specified information related to treatment concerning children, parents or legal guardians, to the Department of Family and Children's Services. 

Two forms are used by social workers, as necessary, to obtain consent for treatment and  authorization to obtain specific information about a child's or parent's mental health treatment: 

  • Consent for Mental Health Treatment (SCZ 243)
  • Authorization for Use and Disclosure of Protected Health Information (SCZ 244)

NoteIf the parent or legal guardian participates in the intake process with the mental health treatment facility/practitioner, he or she will be asked to sign the facility's own forms to consent to the child's treatment and authorize the use and disclosure of the child's protected health information. The DFCS forms are not necessary in this circumstance.

The person who consents to treatment is the only person who can authorize use and disclosure of this protected health information. 

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Policy  

It is DFCS policy that, whenever possible, the social worker must obtain written consent from the child's parent or legal guardian for mental health treatment for the child and for authorization, use and disclosure of protected health information.  Written consent by the parent facilitates the timely provision of mental health services and enables the social worker to obtain and share all necessary information regarding the child. 

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Reasonable Efforts  

Parents/legal guardians have a constitutional right to make decisions related to their child's mental health treatment, even when the child is a dependent.  Social workers must document all efforts to contact the parents for their consent for their child's mental health treatment.  Copies of letters sent to parents should be kept in the case file.  Those letters and contact notes on phone calls made or attempts at home visits are critical in proving that reasonable efforts were made in the event of future litigation on the matter.

Reasonable efforts means that the social worker has made at least three attempts to contact a parent by phone, home visit or letter with a deadline to respond.  No reasonable efforts are required to be offered an alleged father.  Neither are reasonable efforts required if the parents/legal guardians have been unavailable since the beginning of the court process.  The exception to that is in a pre-dispositional case, when it is advisable for the Dependent Intake (DI) social worker to continued efforts to locate the parents, included initiating a Due Diligence search.

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Signed Consent for Child's Mental Health Treatment  

The guidelines below are followed to obtain signed consent for mental health treatment any time a child is assessed as needing this type of treatment.  Also see flowchart outline of the guidelines. The request for consent and authorization should first be made to the parents. 

If..

Then..

A legal parent or guardian is available and willing to sign the Consent and the Authoriza-

tion 

The social worker encourages the parent or legal guardian to participate in the mental health facility/practitioner intake process, if at all possible and appropriate.  The facility /practitioner will have the parent sign their consent and authorization (specifying approval to release of treatment information to the Department).

If the parent's or legal guardian's participation in the intake process is impossible or inappropriate, the social worker obtains the parent's signature on the Consent for Mental Health Treatment(SCZ 243) and Authorization for Use and Disclosure of Protected Health Information (SCZ 244), and provides them to the facility/practitioner. 

The parent or legal guardian refuses to sign the Consent and the Authorization forms

The child's social worker submits an Application and Order, with the Consent and Authorization forms attached, to ask the Court to consent to the child's treatment and to authorize the use and disclosure of protected health information to the Department.

If the family is receiving services under the Informal Supervision or Voluntary Family Maintenance Program, the social worker must decide if the parent's refusal to consent to the child's treatment should be considered for court intervention at a Joint Case Staffing

The parent or legal guardian is unavailable (e.g. cannot be located or is unresponsive to the request to sign the consent, after reasonable efforts by the social worker to locate/obtain cooperation

The social worker documents efforts to obtain consent from the parent., e.g.: 

  • Telephone calls
  • Home visit
  • Mailed form to parent with deadline to respond

and

If.. Then..
The child is under the age of 12 years

The child's social worker signs the consent per the standing order of the Court filed October 3, 2001.

The child is age 12 years or older and appears to understand and appreciate the nature and consequences for the proposed treatment

The child's social worker facilitates, and participates as necessary, in the mental health facility/practitioner intake process with the child, where the child signs the facility's/ practitioner's consent and authorization (specifying approval to release of treatment information to the Department).

If the child age 12 or older refuses to sign the consent for his/her treatment and the social worker believes the treatment is required

The child's social worker submits an Application and Order to ask the Court to consent to the child's treatment and to authorize use and disclosure of protected health information to DFCS.

Note:  The person who consents to treatment is the only person who can authorize the use and disclosure

of the protected health information. 

If the mental health facility or practitioner requires a signed authorization for disclosure of protected health information form prior to providing information  to DFCS about the mental health treatment of either the: 

  • child
  • parent or
  • legal guardian

then, the signed authorization of the person who consented to the child's treatment must be provided to the facility/practitioner. 

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Application and Order  

The social worker prepares an Ex Parte Application and Order to obtain the judicial officer's signature on the Department Consent and/or Authorization forms when: 

  • The parent refuses to sign the Consent and/or Authorization for the child's mental health treatment
  • The parent is unavailable and the child age 12 years or older refuses to sign the Consent and Authorization and the social worker believes that mental health treatment should nevertheless be provided.
  • The mental health facility/practitioner requires an authorization to release information about the parent's or legal guardian's court-ordered mental health treatment to the Department and the parent refuses to sign the Authorization for Use and Disclosure of Protected Health Information (SCZ 244).

Steps to obtain the judicial officer's signature on the forms via Application and Order:

  1. Create an Ex Parte Application and Order in the Court Management Section of the the child's CWS/CMS case.
  2. Select "Other" in the "Ex Parte Application and Order- Document  Options" dialogue box.

  3. Delete all marginal headings and text beginning with "Reason for Application" and ending with "Executed at, California this day of." 

  4. Click on Report Contents.
  5. Copy the text of Report Contents and paste it in the CWS/CMS Application and Order before the social worker's and supervisor's signature/date lines.
  6. Add text to explain the circumstances as indicated in the blue hidden text.    
    • You must have your computer set to "Show" on the "Show/Hide" icon to see hidden text.
  7. Save the Application and Order to the CWS/CMS database. 
  8. Follow usual procedures to notify parties of the Applications and Order and document the party's response on the Declaration RE: Notice of Ex Parte Application (SCZ 170 and 170a).
  9. Submit the Application and Order with the Consent and Authorization concerning the child's mental health treatment, or the Authorization concerning the parent's or legal guardian's treatment, and the Notice of Ex Parte Application to the Court. 
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Maintaining Ongoing Communication  

Social workers are responsible for:

  • Maintaining regular contact with mental health providers in order to obtain and  provide necessary information.  The information includes, but is not limited to: 
    • Current concerns and risk factors for the child
    • Updates on concerning the status of the child's court case
    • How the parent(s) or legal guardian(s) can or should be included in the child's therapeutic process.

  • Relaying information concerning the child's general status in mental health treatment to:
    • The parent receiving Family Reunification Services
    • The child's attorney
    • The child's court advocate

  • Informing the Court of the child's mental health services and provider information in court reports.
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Other References  
bullet2 Report Contents
MS Word Signed Consent for Mental Health Treatment (Flowchart)
bullet2 OPP Chapter 13-1: Joint Case Staffings
bullet2 OPP Chapter 8-6: Ex Parte Application for Order (App and Order)
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