STAR FY -13 Contract Overview

1. STAR FY -13 Contract Overview

2. STAR Program Purpose • In accordance with the requirements of the Family Code §265.002, the Prevention and Early Intervention (PEI) Division of DFPS provides services for children in at-risk situations and for the families of those children. • The Division contracts for programs with the goal of providing prevention or early intervention of at-risk behavior that leads to child abuse or neglect, delinquency, running away, and truancy.

3. Need for Service • Providing crisis intervention to at-risk youth and their families is the primary role of the STAR program in restoring family stability and adaptive crisis resolution. • The inability of families to access support and guidance during a crisis situation contributes to the long-term impact on youth and families and may impact the incidence of child maltreatment and juvenile delinquency.

4. Services • Individual and family short-term counseling • Youth Skills groups • Family Skills groups (parenting classes) • Emergency care services (short-term emergency residential care) • Universal child abuse prevention (UCAP) services including outreach and awareness • Street outreach service and referral/resource services

5. Eligibility Criteria • Individual family members, as well as entire family units, may receive services if any child or youth is identified as being at-risk for child maltreatment and/or juvenile delinquency. The STAR program is intended for youth and families who manifest risk behaviors and are experiencing: • Family conflict, for children and youth ages 0-17; • Truancy, for youth ages 10-16; • Runaway/homelessness, for youth ages 10-17; and/or, • Misdemeanor offense behaviors, for youth ages 10-16. • The appropriateness of STAR services is determined through an assessment of the family and the presenting problem(s) or the reason(s) prompting the request for services. The youth's or family's presenting problem must be identified in order to provide STAR services. • Participation in services is completely voluntary and must be provided at no cost to the youth or their family, without regard to the youth's or family's income.

6. Eligibility Exceptions STAR cannot provide services to the following: CPS Involvement: • If CPS in the process of an investigation of child abuse or neglect, STAR contractors may not register the youth or family for services until the CPS investigation is closed. • A family with an open CPS case beyond the investigation stage, and with the presenting problem of family conflict, may not be registered for STAR services. • However, if the youth presents with juvenile delinquency as the presenting problem, and has an open CPS case, STAR may provide services to address the juvenile delinquency specific issue. • Youth in the conservatorship of CPS are not eligible to receive any STAR services, including emergency care services.

7. Eligibility Exceptions Juvenile Probation Involvement: • Youth who have been adjudicated and convicted of either a misdemeanor or state jail felony offense are not eligible for STAR services. • • Youth whose cases are pre-adjudicated, informally adjudicated, or whose adjudication has been deferred are eligible for STAR services.

8. Eligibility Exceptions • If you opened a youth when that youth was age 17 and that youth turns 18 while receiving services: • You may continue to serve him after his 18th birthday until he completes the program; he reaches 180 days of services within a 12-month period; or the end of the fiscal year, whichever comes first.

9. Family and Youth Short-Term Counseling • Family and Youth Short-term counseling must be designed to reduce conflict, stress, and tension among the family members so the youth can remain in or be returned to his or her home. • In addition, counseling sessions should provide guidance to families and youth to: • Avert crisis and build resiliency in the family and youth; and, • Prevent or reduce child abuse and neglect and/or juvenile delinquency.

10. Family and Youth Short-Term Counseling • Counseling services must be offered within one (1) week of the initial referral • If a family cannot be seen within the stated time period, the contractor must make the appropriate referrals for the family and youth to other community resources. • Only Face-to-Face sessions with both Primary Caregiver and Youth can be billed and be at least 35 minutes long.

11. Family and Youth Short-Term Counseling • The expectation is that the majority of families will be served as a family-based program. • In the event the Primary Caregiver refuses to participate in the STAR services, the contractor must document the reason(s) the Primary Caregiver is not participating in the case file.

12. Family and Youth Skills Groups • Curriculum based family skills groups and youth coping skills training groups must be provided to STAR clients. • Curriculums must include: • Communication • Problem-Solving • Decision-Making • Anger-Management • Conflict resolution

13. Family and Youth Skills Groups • Contractors should encourage primary caregivers and youth participating in STAR services to attend skills training groups, as appropriate. • Clients must participate in more than three group sessions, with an expected average of three (3) group sessions per client. Clients will less than three group sessions should have the justification sufficiently documented in their file.

14. Crisis Counseling • Crisis counseling for families and youth must be available 7 days a week, 24 hours a day, 365 days a year, including weekends and holidays. • Crisis intervention must include immediate access to a crisis intervention counselor or trained responder via phone. • Additionally, clients are to have a face-to-face session as soon as possible, but at least within 24 hours of the crisis referral. • Under extraordinary circumstances, if a face-to-face crisis counseling session is not feasible, justification and documentation of the reason must be placed in the phone log, case file or clinical summary.

15. Crisis Counseling • Immediate crisis counseling services must include a crisis resolution component. Furthermore, an effective crisis resolution process should contain the following critical elements: • Assessment of the crisis • Establishment of rapport • Identification of the major problem(s) • Addressing emotions and feelings • Exploration of alternatives • Implementation of steps to resolve the crisis • Follow-up with participants

16. Crisis Counseling • After the immediate crisis is allayed, the formal intake process must take place within 48 hours of the crisis referral if the contractor decides to initiate going services.

17. Emergency Care Services (Youth Shelter Services) • Emergency Care Services must be available 7 days a week, 24 hours a day, 365 days a year, including holidays. • Emergency services are short-term, and the use of the emergency shelter for the STAR program is limited to "Youth aged 10 - 17" years of age. • Emergency care services are designed to be short-term with the goal of reuniting the family as soon as possible. • It is important to note that emergency care services are a last resort and are not the focus of the STAR program. • Issues such as truancy and misdemeanor offense are not eligible presenting problems for shelter services.

18. Emergency Care Services (Youth Shelter Services) • Contractors who place or assist in the placement of a youth in emergency care services are required to do the following: • Emergency shelter placement without parental or conservator consent must, within 24 hours, include a diligent search by the contractor to locate parents or conservators. • Placement must always be preceded by an intake and brief assessment by the STAR on-call counselor to ensure the placement is appropriate and all applicable laws regarding contact with parent/guardians have been followed. • Prior to placement in an emergency shelter, every effort should be made to preserve the youth in the family home. Placement in the emergency shelter should be the last resort and be clearly discussed in the progress notes. • Contractor must arrange face-to-face contact with the youth within 24 hours if emergency care is a subcontracted service. • Contractor will be responsible for developing a STAR Action Plan.

19. Emergency Care Services (Youth Shelter Services) • Requirements continued: • The youth must be seen at least three (3) times weekly while in the shelter, with coordinated services provided by the primary contractor and subcontracted facility staff. • Family counseling sessions must occur between the youth and parent/guardian while the youth is in the shelter. • Contractor must develop a plan for the re-unification of the family. • All services must be documented and maintained in the youth's case file.

20. Universal Child Abuse Prevention (UCAP) and Street Outreach Services • Universal Child Abuse Prevention (UCAP) and Street Outreach Services are intended to promote awareness of STAR services and provide child abuse and neglect prevention information to the community at large. • UCAP services are designed to increase the knowledge and awareness of child maltreatment and promote healthy parenting and family interaction. • Street Outreach Services are directed to youth who are homeless, disenfranchised, unsupervised, or at risk of involvement with negative peer groups/gangs, particularly in major urban areas.

21. Documentation – Form 2075 • STAR contractors are required to record client data on the STAR Client Registration DFPS Form 2075A during the intake and assessment process and (1) maintain a copy of the form in the client file and (2) transfer data from all the fields in the form over to the STAR database. • Social Security Number – used by DFPS to search both youth and primary caregiver. If youth or adult will not provide SS#, you must document on 2075. • Other Family Members (page 2): Contractors are required to obtain the names of all other family members or non-family members that reside within the same residence as the youth. Contractors should indicate on Form 2075A if the other members will be participating in STAR services. • Follow-Up Due Date: The Follow-up due date is the 75th day after closure. The first follow-up date cannot be before the 75th day. The 1st, 2nd and 3rd attempts cannot be made on the same day. Contractor is required to make 3 attempts by in person, by telephone, or email, but if the attempts are unsuccessful, the contractor must make a final attempt via the postal service prior to the 106th day after case closure. All attempts to complete the follow-up must be documented on the Client Registration Form 2075A and in the STAR database within 30 days.

22. Documentation – Immediate Crisis Intervention • Crisis intervention services provided to families/youth may not always result in the need for ongoing services, i.e., the crisis is stabilized or resolved and the family/youth do not need or desire to return for counseling, skills groups or other services. In these cases, Contractor must produce the following documentation of crisis intervention services provided: • Telephone logs of calls received/answered on the toll-free 24-hour line, the on-call crisis counselor who received the call, date and length of the phone call, and the call resolution; • Clinical note summarizing the on-call counselor’s contact with the client, including an assessment of the need for emergency care services (emergency shelter) or other immediate care outside the scope of the STAR program and any referral information provided; and • Documentation of the contact in the STAR Database, under the “Crisis Intervention Services” tab. One-time crisis intervention services do not necessitate the opening of a STAR client registration or case file.

23. Minimum Documentation for On-going Services All on-going services must be documented in a client case file, and be maintained for each participating family member or youth, and must include, at a minimum, the following: • 2.7.11.1 Referral source; • 2.7.11.2 Specific intake and assessment information and Client Registration form*; • 2.7.11.3 Family and/or youth Action Plans developed with the program participants; • 2.7.11.4 Documentation of services provided/received; • 2.7.11.5 DFPS Pre-and Post-Service Protective Factors Survey Questionnaires* (for each Primary Caregiver that participated in services); • 2.7.11.6 Resource and Referral information for services outside of the scope of the STAR program; • 2.7.11.7 Case closure/discharge summary; and • 2.7.11.8 Client outcome at time of follow-up. (Services to At-Risk Youth (STAR) Client Registration Form 2075A - "Follow Up Information")*

24. Action Plans Once the intake and assessment has taken place and prior to initiating services, the Contractor must engage the participants in the development of an Action Plan. The Action Plan must be completed within 3 days of the initial assessment and include the goals and steps the youth and caregiver (if participating) have agreed to work on during services. The Action Plan should be viewed as a brief social contract but is not intended to be a diagnostic or prognostic therapeutic document.

25. Action Plan The STAR Action Plan must: • 2.7.14.1 Be family-focused; • 2.7.14.2 Identify the specific behavioral changes or actions that each participating family member has committed to make to address the issues; • 2.7.14.3 Be written in the language of the client and in a way that it is easily comprehended and clearly understood by the Target Youth or family; • 2.7.14.4 Contain specific STAR services to be provided to the youth and family members; • 2.7.14.5 Document other resources or referrals offered to the participants; • 2.7.14.6 Be updated with the client at least every 30-days with progress toward goals documented and any new goals/tasks indicated; • 2.7.14.7 Be signed by the Target Youth and all participating family members with a copy provided to all participants; and • 2.7.14.8 Be maintained in the client case file.

26. Pre-Service Protective Factors Survey Questionnaire Shortly before or at the beginning of the first service session, the Contractor must administer the Pre-Service Protective Factors Survey (PFS) Questionnaire to the Primary Caregiver for any presenting problem. Only one Primary Caregiver is designated for a Target Youth.

27. Post-Service Protective Factors Questionnaires • At the end of the last session, after services have been completed or after the Primary Caregiver has been in the STAR Program 180 days, the Contractor must administer the Post-Service Protective Factors Survey Questionnaire to the Primary Caregiver. • The post-service questionnaire may be administered more than once if a registration is closed and subsequently reopened.

28. Case Closure/Resource and Referral • When services are completed, the Contractor must document closure of the case on the STAR Client Registration Form 2075(A) and in the STAR database within 30-days from the end of the last service month along with any referrals made for additional services to other local social service providers. • At the time of case closure, the contractor must enter the Follow-Up Due Date in the Follow-Up Information section of the 2075(A).

29. Service Unit Documentation • If a counselor meets ½ of a session with the individual and ½ with the family, how is the session counted? • The STAR-registered participant will receive 1unit of Family Counseling. • Would email or phone calls between the family and counselor count as an advisory service? • Phone calls and email contacts would not be considered a service for purposes of reporting in the STAR database. You should continue tracking these interactions in the case notes. • With regards to billing, do we report time or service units? • You will report the number of service units and attach a copy of the STAR database Client Services Summary report to the freeze form when submitting for reimbursement.

30. Service Unit Documentation • If a family receives two face-to-face visits within the same month, are the service units counted as two units of service? • Yes, if they occur at two distinctly different times. • When seeing siblings (separately), are the total units entered under the oldest sibling or is each sibling separate? • No. If each sibling is registered in the STAR database, either as a STAR client or as an Other Family Member, they would each receive a unit of service. The service unit would be recorded in the STAR database separately as a whole number. • If you meet with two family members together (example: brother & sister) without a parent present, is this entered as a Family Counseling? • No. If both youth are STAR-registered participants, they each would receive one unit of Youth Counseling since there were no parents present. If only one participant is registered in the STAR database, then that youth would receive one unit of Youth Counseling.

31. Service Unit Documentation • Three youth are registered in the STAR database and the counselor has a family session with two of the youth and the primary caregiver. Would the third youth receive a family counseling unit if the STAR counselor worked with the primary caregiver about ways to deal with the third youth? • Yes. Each STAR-registered youth would receive a unit of Family Counseling. • If a counselor meets with a parent, who has children receiving STAR services, and talks to the parent about the children, (i.e., discussing the youths' action plans, etc.) without the children present, do all siblings get a unit of service and which one would they get? • Yes. Each STAR-registered youth would receive one unit of Family Counseling. • If you have three youth (siblings) who are all STAR-registered participants in a session with no parent/guardian present, should this session be reported as one unit of Youth Counseling for each youth? • Yes. Each youth will receive one unit of Youth Counseling.

32. STAR Payment Methodology • I facilitated a skills group session which required both the primary caregiver and youth to be in attendance with multiple families. How do I bill this service? • The billing rate will be Family Skills Group, even though more than one family was in attendance. • I facilitated a group session with the Primary Caregiver(s) in a session and the youth(s) in a session with different counselors. How do I bill these services? • Each Primary Caregiver in the session will be billed at the Family Skills Group rate, and the Target Youth will be billed at the Youth Skills Groups rate. • The Primary Caregiver and the Secondary Caregiver came for a session, the target youth was not in attendance. How do I bill this service? • The service will be billed as a Family Counseling Session. • The Primary Caregiver and the Target Youth had an appointment for counseling services. The Primary Caregiver did not appear, the counselor met with the youth only. How do I bill this service? • The service should be billed as an Individual Youth Counseling Session.

33. Outcomes and Resiliency • The goal of the STAR program is to provide crisis intervention to at-risk youth and their families to restore family stability and adaptive crisis resolution to prevent incidence of child maltreatment and juvenile delinquency. • Resiliency will be measured as an increase in protective factors for unduplicated families served in the Contractor's STAR Program. • 2.7.7.1 Primary Caregivers that receive services will be expected to have an increase in protective factors determined by the results of the pre/post Protective Factors Survey Questionnaire. The list of protective factors for Primary Caregivers below has been selected for all PEI child abuse and neglect prevention programs: • 2.7.7.1.1 Family functioning/resiliency • 2.7.7.1.2 Social support • 2.7.7.1.3 Concrete support and/or • 2.7.7.1.4 Nurturing and attachment.

34. Where to find specific documents • The STAR “contract” is actually more than one document and we are monitored based on all the documents. • For easy access, we’ve put everything on the intranet. • Go to the ACH intranet and click on downloadable documents. • Scroll down to grants and contracts • The first 6 STAR documents are the contract.