DATE: February 2, 1999
TO: Board of Supervisors
SUBJECT: Working Together for Our Children and Adolescents (ALL DISTRICTS)

SUMMARY:
On December 12, 1995 (46), at the recommendation of Supervisors Cox and Jacob, our Board approved the development and establishment of a comprehensive system of care for seriously emotionally disturbed (SED) children and adolescents, separate from the managed behavioral health care system for mentally ill adults.

On October 27, 1998 (6), again at the recommendation of Supervisors Cox and Jacob, our Board approved recommendations to further define the target population for the Children's Mental Health System of Care (Heartbeat) as well as ensure that options for the design of the mental health system will meet the needs of children, families and schools.

Approval of the following recommendations will allow this County to take an important step towards partnering with the schools to ensure that the County's probation officers and child protective services caseworkers attend and play an active role in the Individual Education Plan (IEP) meetings for delinquent and dependent children. This link must occur regardless of how the Children's Mental Health System of Care is ultimately designed if there is to be continuity between the services that the schools provide and those for which the County is responsible in regard to County wards and dependents.

RECOMMENDATIONS:
Supervisors Cox and Jacob and Judge Milliken:
1) Direct the Chief Administrative Officer (CAO) to facilitate any appropriate administrative changes in the Probation Department and the Health and Human Services Agency and establish new protocols for probation officers and child protective services (CPS) caseworkers in order to participate with the schools in the development of an Individual Education Plan (IEP) for dependent and delinquent children.

2) Direct the CAO to establish training for those probation officers and CPS caseworkers involved specifically with SED juveniles so they may facilitate immediate entry into the children's mental health system of care for assessment and mental health services for dependent and delinquent children.

3) Direct the CAO to request the assistance of school districts in training designated probation officers and CPS caseworkers to ensure an adequate understanding of the Individual Education Plan (IEP) process.

4) Direct the CAO to report back to the Board in 90 days with respect to progress in implementation of the above.

Fiscal Impacts:
These recommendations can be accomplished within existing resources.

BACKGROUND:
On December 12, 1995, our Board of Supervisors supported a series of recommendations to begin the transformation of the Children's Mental Health System of Care to be responsive to the needs of children, families (including foster families), schools and the courts. Over the past three years, a great deal of work has been done by the San Diego County Bar Association and a consortium comprised of volunteers with representation from the private, family and public sectors including schools. The "Heartbeat" Consortium has provided us with invaluable guiding principles and a vision upon which to build the Children's Mental Health System of Care.

Regardless of the final proposal that is adopted by this Board of Supervisors with respect to the design and implementation strategy for the Children's Mental Health System of Care, changes must occur within the County family to facilitate better communication and coordination with the schools. Approval of the recommendations contained in this board letter will enable the County to be more responsive to the needs of children who are legally committed to the County of San Diego. We must ensure that these children receive immediate access to mental health assessments and appropriate mental health treatment. These staffing and protocol changes will also facilitate appropriate coordination and cooperation with the school districts in this county.

These recommendations do not address the overall failure of the children's mental health system to meet the needs of school referred SED children or County wards and dependents, nor are they meant to discourage forthcoming recommendations for the redesign of the clinical children's mental health system. These recommendations simply create linkages between the County and the schools that must occur regardless of the final design of the children's mental health system if we are to address access to care and service coordination issues of dependent and delinquent children.

Respectfully submitted,

DIANNE JACOB
Supervisor, Second District

GREG COX
Supervisor, First District

JUDGE JAMES R. MILLIKEN
Presiding Judge, Juvenile Court