Donna Fernandez Program Manager

1. OVERVIEW OF LOS ANGELES COUNTY’S EFFORTS TO IMPLEMENT CAPTA REQUIREMENT Donna Fernandez Program Manager

2. Formal planning initiated by DCFS in January 2006 • DCFS Internal Stakeholders involved in planning and implementation efforts: • Education and Mentoring Division • Bureau of the Medical Director – PHN Program, Health, Mental Health and Substance Abuse Services, Regional Center Coordinator • Policy Section • Bureau of Information Services

3. Leadership/Assistance with Direction has come from: • California Department of Social Services • CHAMP Group • Early Identification and Intervention (EII) Collaborative for Los Angeles County; Child Welfare and EII Committee • Regional Centers (RCs), with lead from Eastern Los Angeles, and San Gabriel/Pomona RCs • MDs of Medical Hubs • Education Coordinating Council’s Early Childhood Committee

4. EII COLLABORATIVE • Is a broad Countywide coalition that works to improve early identification & intervention for all children by improving policy, practices, and learning/training • Supports high-quality parental-report screening tools: e.g., ASQ, PEDS & PEDS:DM • Responded to a Jan. 2006 request from DCFS Medical Director Charles Sophy to be a “neutral convener” to bring together all CAPTA/IDEA stakeholders in Los Angeles County 4

5. Created a Child Welfare & EII Committee that meets monthly to focus on implementing CAPTA and IDEA screening and referral provisions • Members include: DCFS, Early Start/Regional Centers, DHS, Medical Hubs, Out-of-Home Care, CHDP, Alliance for Children’s Rights, Children’s Law Center, and Caregivers • Has convened LA “mini-summits” (i.e. brainstorming sessions) for all stakeholders to participate

6. Why Care About Early Identification and Invention • Early intervention works • About 17% of all children – 1 in 6 – have disabilities or developmental problems, including speech and language delays, mental retardation, learning disabilities, autism spectrum disorders or emotional/behavioral problems • Only 30% are detected before the child enters school

7. A child in foster care is 4 times more likely to have a disability than a child living with a parent • Less than 2% of California children 36 months old get early intervention through the Early Start Program (Part C of the IDEA program) (reference sources available)

8. Child Welfare and EII Committee: Important Factors • It is not possible for 1 pathway to provide developmental screens for children • Need multiple pathways for different families with different needs • Ensure that screening is completed through one of these pathways, and referral, assessment and services are procured as needed

9. Need appropriate points for developmental screens to be conducted • Child shouldn’t be in emotional duress e.g after just being taken into protective custody • Caregiver needs to have a basic knowledge about the child's abilities • Timeliness is important – can’t be too early or too late

10. 3. Need for streamlined referral procedures between DCFS and Regional Center Early Start Programs • Concise forms that are both simple to complete, yet provide required information • Ensure child’s history and legal paperwork sent with the referral

11. DATA ON DCFS POPULATION Total Number of Children in HOP and Out-of-Home Care, 0 to 3 years: 6,262, as of May 2006 Children 0 – 36 months with Substantiated Allegations of abuse and neglect: 5,413, period of January 2007 to September 2007

12. EFFORTS AND ACTIONS THAT SUPPORT CAPTA IMPLEMENTATION • MOU between County of Los Angeles and RCs: • Addresses seven RCs and and four County Departments (CAO, DCFS, DMH, Probation) • Defines and confirms roles and responsibilities to work together to provide coordinated services • Utilizes WIC definition of Developmental Disability • Commits to enhanced communication and organizational effectiveness to provide responsive, appropriate and high quality services 12

13. Emphasizes service delivery that is strengths-based, family-focused, culturally competent and tailored to meet unique needs of families • Highlights use of available resources that are cost effective and innovative • Promotes focus on administrative and operational enhancements to optimize sharing of information, resources and best practices while protecting privacy rights of individuals • Endorses involving families in the process to determine service plans and proactively provide families with coordinated and comprehensive information, services and resources 13

14. Roles and responsibilities in MOU include: • Implementation of a Liaison at RCs and Departments • Provision for cross training • Development and implementation of resource plans • Under Referral Function, addresses the referrals of children from birth through 2, in accordance with Part C of IDEA • Implemented in 2005 • Term is 3 years, with 2 one-year options to renew 14

15. 2. EII Collaborative has convened key partners across professional disciplines in neutral setting and facilitated a commitment to multiple pathways for children to be screened • 3. Establishment of DCFS RC Teams: • Members comprised of: • RC Liaison (DCFS line operations staff) • D-Rate Schedule representative • Public Health Nurse • County Counsel representative

16. RC Teams address issue of our clients with developmental disabilities, in our line operations offices • RC Liaison in each office responsible for activating Team • DCFS RC Coordinator holds regularly scheduled meetings to discuss best practices, resources, services and legal matters • RC Teams reconfigured in 2007 from previous Team structure

17. 4. Implementation in DCFS of policy directive to document in CWS/CMS when child is currently reviewing RC services, or has previously received RC services. • Implemented in October 2007

18. CURRENT PLAN TO IMPLEMEMT CAPTA • REQUIREMENT • Use of Medical Hubs (refer to handout) • Initial Medical Exam, Forensic Evaluation, and age-appropriate mental health screening • Requirement of 0-36 months within 72 hours of placement • Use of MAT Program (refer to handout) • Comprehensive assessment, including developmental functioning/status

19. Use of Joint Response Referral • Referrals on 0-36 months; or child has/or is suspected of having medical or developmental condition; referrals with allegations of severe neglect • Consultation of CSW and SCSW with PHN • Use of Team Decision Making • Requests can be made by participants on a child 0-36 months for referral to RC when identifying strengths and needs

20. Referral to Project ABC, where applicable • SAMHSA-funded SOC for 0-5 • Use of Head Start Programs • Head Start Programs must ‘‘use research-based developmental screening tools that have been demonstrated to be standardized, reliable, valid, and accurate for the child being assessed, to the maximum extent practicable, for the purpose of meeting the relevant [Head Start quality standards]” • EII Collaborative had key role

21. NEXT STEPS* • Continue to expand/develop use of multiple pathways: • As MAT Program expands, solidify pathways of Medical Hubs and MAT Program • CHDP Providers • First 5 LA • Training for Caregivers • 2. Identify tracking mechanism to ensure CAPTA requirement. • *Role of EII Collaborative is key to moving forward.

22. FOR FURTHER INFORMATION, CONTACT • Donna Fernandez, Program Manager • Phone: 213-351-5729 • Email: fernads@dcfs.lacounty.gov • Jeff Dorsey, CSA III, CAPTA Program Manager • Phone: 213-351-5538 • Email:dorsej@dcfs.lacounty.gov