Family & Children First Council

SERVICE COORDINATION MECHANISM

Approved by Steering Committee:October 16, 2024

Approved by Lake County Family and Children First Council: October 22, 2024

INTRODUCTION:

The Mission of the Lake County Family and Children First Council (LCFCFC) and the purpose of service coordination are to ensure access to a seamless system of community services and resources for Lake County children, adolescents and families. The guiding principles of the LCFCFC as outlined by the bylaws include:

The service delivery system shall empower parents and families to be responsible and informed decision makers for their children.
Human and financial resources should be developed and appropriately organized to best meet the health, educational, and social service needs of families, allowing all children to develop to their full potential.
Service delivery and development shall be comprehensive, multidisciplinary, integrated, community based and child/family focused.
Services and interventions shall be focused on family preservation, family reunification, community commitment, and family/peer supports.
The service delivery system of care should ensure quality through ongoing evaluation and accountability and be accessible in a timely and responsive manner to ensure the effective and efficient delivery of services.

Lake County Service Coordination will support Ohio’s Commitments to Child Wellbeing, including:

Expectant parents and newborns thrive.
Infants and toddlers thrive.
Children are ready for school.
Children and youth succeed in school.
Youth chose healthy behaviors.
Youth transition successfully into adulthood.

O.R.C. 121.37(C): Each county shall develop a county service coordination mechanism. The county service coordination mechanism shall serve as the guiding document for coordination of services in the county. For children who also receive services under Ohio’s Early Intervention program, the main provider of service coordination shall be an Early Intervention Service Coordinator to ensure compliance with section 5123.02 of the Revised Code. All family service coordination plans shall be developed in accordance with the county service coordination mechanism. The mechanism shall be developed and approved with the participation of the county entities representing Child Welfare; Developmental Disabilities; Alcohol, Drug Addiction, and Mental Health Services; health; Juvenile Judges; Education; the county Family and Children First Council; and the county Early Intervention Collaborative established pursuant to the federal Early Intervention program operated under the ” Individuals with Disabilities Education Act of 2004,” 20 U.S.C.A. 1400; The county shall establish an implementation schedule for the mechanism. The cabinet council may monitor the implementation and administration of each county’s service coordination mechanism.

All required participants, as outlined in ORC 121.37, worked through a collaborative process to plan, develop and implement LCFCFC’s Service Coordination Mechanism. Included were representatives of child welfare, education, health, the board of developmental disabilities, juvenile court, Early Intervention (the Early Childhood Coordinating Committee), alcohol, drug addiction and mental health services, as well as family representatives.

ELIGIBILITY:

LCFCFC and the Lake County community make every possible effort to work collaboratively to identify, develop and provide resources to adequately meet the needs of children, adolescents, and families. Current populations that may need additional services and/or resources in Lake County may include homeless families and children who have been dually diagnosed with profound developmental disabilities and mental health issues. LCFCFC strives to identify and address potential gaps in services to continuously improve the service delivery system.

The Service Coordination Mechanism shall serve as the guiding document for coordination of services in the county when a child is referred to LCFCFC for assistance. To assure consistency in the county service coordination approach, and to assure that the process meets the requirements established in the law, all persons or entities providing service coordination on behalf of the LCFCFC must follow the processes, policies, practices, and procedures as they are outlined in the Service Coordination Mechanism.

To optimize a finite set of resources, it is necessary to prioritize the population in terms of individuals who are not being served or whose needs are being inadequately met.

Admission Criteria:

0 – 21 years of age.
Residents of Lake County.
Family is requesting service coordination.
Multi-System need children whose service and support needs are not met while working with the family outside the Service Coordination Mechanism.

Child Protective Services – Youth in Custody

Regardless of youth/family involvement with county child protective services, FCFC Service Coordination can still be accessed for any youth with needs across multiple systems. Due to the restrictions of FCFC funding, county FCFCs are not permitted to utilize FCSS funding for service coordination activities for youth in custody, but that does not mean that FCFC Service Coordination cannot be accessed for youth who are in custody of child protective services.

OhioRISE Care Coordination
On July 1, 2022, as a part of Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM launched OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multisystem needs. A Child and Adolescent Needs and Strengths (CANS) assessment is required to determine a child or youth’s eligibility for OhioRISE.

Regardless of youth/family enrollment with OhioRISE, FCFC Service Coordination can still be accessed for any youth with needs across multiple systems. Due to restrictions with FCSS funding, county FCFC’s are not permitted to utilize FCSS funding for service coordination activities for youth enrolled in OhioRISE that are receiving Care Coordination through a CME – Care Management Entity. If an FCFC provides Care Coordination for a youth enrolled in OhioRISE, the care coordinator must coordinate benefits with Aetna Care Coordination directly. Youth may also be referred to FCFC Service Coordination at any time at the request of the family.

Youth in Juvenile Justice System

As outlined in ORC 121.37(E), the FCFC Service Coordination process and the FCFC Service Coordination Plan (IFSCP) must account for youth alleged unruly and identify methods to divert a youth from the juvenile court system. FCFC service coordination must be available for youth that are adjudicated unruly or delinquent.

Early Intervention Service Coordination

All children who receive services under Ohio’s Early Intervention program, and who are also being served under the county Service Coordination Mechanism, must be assured that the services received under Early Intervention (EI) Service Coordination are consistent with the laws and rules of Early Intervention requirements per federal regulations and DODD policy and procedures. If a child is being served by FCFC Service Coordination and a referral is made to EI Service Coordination, upon the determination of eligibility, the lead provider of service coordination should be the EI Service Coordination provider to assure compliance with O.R.C. 5123.02. The identified county FCFC Service Coordinator and/or FCFC Service Coordination Team should support and assist with the family’s IFSP/Early Intervention Plan as needed. If a child/family enrolled in EI Service Coordination is in need of supports across multiple systems, the county FCFC Service Coordinator and/or FCFC Service Coordination team should be available to support and assist as needed.

In Lake County, Early Intervention Service Coordination transitions all children to a chosen setting (selected by their parents) by age three. It should be noted that families with children prenatal to age three who meet program eligibility requirements receive service coordination primarily through Early Intervention (EI). If a family with a child up to age three does not meet eligibility requirements for Early Intervention, families can receive service coordination through LCFCFC.

Not all families exiting from EI in need of services would need to be entered into FCFC SC. Those with needs across multiple systems at the time of exit can be considered for FCFC SC.

With these requirements as a given, a priority rating will be given to individuals meeting one or more of the following criteria:

Have not yet been able to access needed services.
Have exhausted all local resources and/or courses of action.
Have significant barriers to services.

Criteria for Continued Service Coordination (may meet some or all criteria):

The child/youth is under the age of 21.
The family is an active team participant.
The family continues to make progress towards the goals listed on their Individualized Family Service Coordination Plan (IFSCP).
The child/youth remains involved with two or more systems.

Criteria for Transitioning out of Service Coordination and/or case closure (may meet some or all criteria):

The child is over the age of 21.
The family is no longer requesting service coordination.
Goals have been met and the team agrees that the family has stabilized.
The child/youth is involved with only one system.
The family has not received service coordination or services from LCFCFC for a period of 3 months.
The team decides that service coordination is making no progress.
The child is no longer a resident of Lake County.
The family has failed to participate in the development of and/or review of their Individualized Family Service Coordination Plan (IFSCP).
The family has failed to sign and return necessary paperwork required for continued service coordination through LCFCFC.

REFERRAL PROCESS:

O.R.C. 121.37(C)(1): A procedure for an agency, including a juvenile court, or a family voluntarily seeking service coordination, to refer the child and family to the county council for service coordination in accordance with the county service coordination mechanism;

Any Lake County agency, including juvenile court and the school districts, or a family voluntarily seeking services may refer a child or adolescent for service coordination by contacting the LCFCFC Service Coordinator. A professional making the referral is designated as the Point Person for the family. The Service Coordinator guides the Point Person through the referral process and provides assistance as necessary. The Service Coordinator plays a major role in the navigation of the referral process for families who are not connected to a service professional or Point Person within the community.

A referral process is required to be used by an agency or family to refer a family to Service Coordination. It is required that there is documentation of the following:

The date of the receipt of the referral.
Contact information for the person being referred.
Age of the person being referred at the time of referral.
A brief description of the problems being experienced.
Systems/agencies that have been involved with the person to date.
Contact information for the person referring.
Identification of Medicaid managed care plan or private insurance.
Council response to the referral or the outcome of the referral.

The family will be contacted no more than 10 days after a referral is made, within which the initial family meeting is scheduled. A referral will be closed due to no contact or transfer to the CME of OhioRISE. The outcome will be noted on the family’s referral form.

SYSTEM OF CARE:

A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with multiple needs and their families. In Lake County, Service Coordination and Wraparound are collaborative, coordinated, cross-system team-based planning processes implemented to address the needs of youth and families where those needs are multiple and complex. Service Coordination and Wraparound build upon the strength of services in the community that are currently working for families, and when needed, propose new services, supports, and/or strategies to be added to address unmet needs. The processes should be based and addressed within a System of Care that must account for:

Broad array of services/supports available.
Coordinated at both the system and service level.
Individualized plan.
Family-driven, youth-guided.
Least restrictive setting.
Emphasize early identification and early intervention.

The FCFC Service Coordination statutory mandate has driven the development of arrays of coordinated care options previously non-existent in most communities. FCFC-driven service coordination has united service providers without dismantling systems. Information is shared while also assuring the confidentiality of the child and family.

LCFCFC LEVELS OF INTERVENTION:

Information and Referral Services (I&R):

Not all families who are referred or who refer themselves to FCFC Service Coordination require the same level of assistance. A family may be referred whose only need is to be connected to another community resource or support (Information and Referral). Less intensive or intrusive options may be more appropriate, and these community options or supports should be pursued before more intensive coordination is initiated. This Service Coordination Mechanism supports the least intrusive response, while still adequately addressing a family’s need.

In Lake County, families who may not require a team-based response can contact the LCFCFC Service Coordinator for I&R.

All families referred will be contacted by the Council Coordinator within ten (10) business days from the receipt of the initial contact or receipt of the completed referral form and signed release form. Currently involved agencies continue to provide service coordination with consultation from the Council Coordinator as needed. In the absence of a currently involved agency, Council Coordinator may provide service coordination or refer to appropriate agency.

O.R.C. 121.37(C)(7): A procedure for assessing the needs and strengths of any child or family that has been referred to the council for service coordination, including a child whose parent or custodian is voluntarily seeking services, and for ensuring that parents and custodians are afforded the opportunity to participate.

The Child and Adolescent Needs and Strengths (CANS) tool will be used to assess the needs and strengths of any child or family referred to LCFCFC for service coordination or a higher level of care. The CANS is used by a wide variety of providers to inform care planning and decision-making for children and adolescents with behavioral health needs. The Council Coordinator will be a Certified CANS assessor and is expected to use the CANS to gather all information about the child and family in order to describe their strengths and needs.

It is a requirement that each youth/family referred to FCFC Service Coordination be assessed prior to the start of the development of the formal plan to determine the level of need/care. The assessment should be conducted every 90 days or more often as needed. If a youth/family has been recently assessed within the last 30 days with a formal assessment tool, those results can be obtained for assistance in determining a youth/family’s level of need/care.

For those youth/families with higher intensity needs across the continuum, the Ohio Children’s Initiative CANS assessment tool is required to determine eligibility of Ohio RISE and/or apply for MSY funds for out of home treatment and entered to the Ohio Children’s Initiative CANS Information Technology (IT) System.

Additional professional assessments may be offered by the Point Person as indicated. Additional screenings/assessments offered to the family may include those that address developmental delays/disabilities, COEDI/adaptive behaviors, educational multi-factored evaluations, medical exams, psychological/psychiatric evaluations, neuropsychiatric evaluations, specialized mental health assessments, substance abuse assessments, sexual offender assessments, violence risk assessments and/or fiscal information as needed. Information gathered through any of these resources should be included in the referral packet.

O.R.C. 121.37(C)(2): A procedure ensuring that a family and all appropriate staff from involved agencies, including a representative from the appropriate school district, are notified of and invited to participate in all family service coordination plan meetings;

The Service Coordinator will invite the family to participate in the development of an Individual Family Service Coordination Plan (IFSCP). The IFSCP meeting will include available supportive services staff, school staff, and any support person identified by the family. The Service Coordinator, unless another individual is chosen by the family, will facilitate the meeting and track the progress of the service coordination plan. An Individualized Family Service Coordination Plan will be developed for each family and will include an individualized crisis plan.

Service Coordination/Clinical Services:

Service providers or families who are seeking clinical services or service coordination will initially be provided information about Medicaid OhioRISE Services and referred to the local Care Management Entity (CME) for an eligibility assessment. If the family is denied OhioRISE services, the same referral process described above would be followed. Council Coordinator will work in collaboration with currently involved agencies and the family to alleviate risk. If the family is approved for the OhioRISE menu of benefits, the family and CME will coordinate Service Coordination and therapeutic needs outside of the FCFC process.

For families not eligible for OhioRISE services, Council Coordinator will consult with Wraparound members to ensure active interagency collaboration and facilitation. Wraparound membership consists of designees representing the primary child/family serving systems within Lake County. These systems include Wraparound’s fiscal agent, the Lake County Board of Developmental Disabilities, the Lake County Alcohol, Drug Addiction, and Mental Health Services Board (ADAMHS), the Lake County Educational Services Center (ESC), the Lake County Department of Job and Family Services and the Lake County Juvenile Court. Consultation with the Wraparound committee members is initiated by the Council Coordinator through phone or electronic communication. Monthly case updates will be sent via electronic communication to all Wraparound members, including case information on current and new clients. The Wraparound committee will meet as needed. In the event of a high-risk, high need situation, the Wraparound committee may convene outside of regularly scheduled meeting dates. This may occur via conference call or in person, depending on the urgency of the situation.

If needed, the Council Coordinator will schedule a presentation before the LCFCFC Children’s Committee (Wraparound).

The mission of Wraparound is to ensure that high quality, family focused services are provided to Lake County children, adolescents, and their families. As a result of many years of collaboration between family serving agencies, the local network of services has become well developed and highly synthesized. This process has resulted in fewer out of county residential placements and a decrease in the number of children who are referred for service coordination at the Wraparound level. More services have become available and more accessible to families, which decreases the need to progress to this level of service.

A referral for services may be received from either a professional working with the family (the Point Person) or through direct contact with the family seeking services by contacting the LCFCFC Service Coordinator at 440-350-4345 to obtain a referral packet. The referral packet contains the following documentation:

LCFCFC Referral form
Authorization of Release of Confidential Records form
LCFCFC Dispute Resolution Process

If a formal presentation to the Wraparound committee is necessary, the Point Person summarizes the child and family’s history, strengths, and rationale for requesting services. All meeting participants are given the opportunity to provide information about the child and family’s history, strengths, challenges, needs, etc. Open discussion is encouraged to explore viable service and support options. A culturally sensitive approach is utilized in all meetings when assessing strengths and needs. This approach must also demonstrate sensitivity to racial or gender specific issues. Family members are assured that it is the intention of the Wraparound committee to provide solutions that are family centered, community and strengths based.

O.R.C. 121.37(C)(6): A procedure for protecting the confidentiality of all personal family information disclosed during service coordination meetings or contained in the comprehensive family service coordination plan.

All personal family, healthcare, treatment and educational information disclosed and discussed during the meeting is confidential and is shared with others for professional purposes only. All parties sign a Service Coordination Confidentiality Statement at each meeting.

It is the philosophy of the LCFCFC that all children and families in the community should have access to a complete continuum of high-quality care, which creates an environment for family driven services and progression toward less or more intensive services as indicated by need. The Council Coordinator will make recommendations to address service gaps or barriers. If all possible community support and treatment options have been exhausted, residential placement may be considered by the Council Coordinator with oversight from the Wraparound committee.

O.R.C. 121.37(C)(4): A procedure for ensuring that a family service coordination plan meeting is conducted for each child who receives service coordination under the mechanism and forwhom an emergency out-of-home placement has been made or for whom a nonemergency out-of-home placement is being considered. The meeting shall be conducted within ten days of an emergency out-of-home placement. The meeting shall be conductedbefore a non-emergency out-of-home placement. The family service coordination plan shall outline how the county council members will jointly pay for services, where applicable, and provide services in the least restrictive environment.

On occasion the health and/or safety of a child may be at risk, or that of a family member or member of the community. If all other supportive service systems are restricted by regulations and/or lack of funding from acting on behalf of a child to ensure his/her safety, this would qualify as an emergency. If an emergency occurs indicating an immediate need for placement, consultation with the Wraparound committee members is initiated by the Service Coordinator by phone or through electronic communication. Emergency placements are rare and are typically initiated through a filing at Lake County Juvenile Court or through police intervention and not as a result of service coordination through the LCFCFC or Wraparound. In the event of an emergency placement, the Council Coordinator will schedule a family service coordination plan meeting within ten (10) days of placement.

Managing Levels of Coordination Across a Continuum:

Information and Referral FCFC Service Coordination Wraparound

X X X

(Least intensive Coordination)

FCFC-managed bridge from coordination to intervention and vice versa as needed

Managing Levels of Intervention Across a Continuum:

X X X

Residential Placement High Risk Intervention Team Community Based Family Treatment

(Most intensive Intervention)

O.R.C. 121.37(C)(8): A procedure for development of an individual family service coordination plan described in division (D) of this section.

The Service Coordinator will invite the family to participate in the development of an Individual Family Service Coordination Plan (IFSCP). The IFSCP meeting will include appropriate supportive services staff, school staff, and any support person identified by the family. The Service Coordinator, unless another individual is chosen by the family, will facilitate the meeting and track the progress of the service coordination plan. A written IFSCP will be developed for each family. The IFSCP will outline how the LCFCFC will provide services in the least restrictive environment, how services will be funded, and will include an individualized crisis plan. IFSCPs will be reviewed every ninety (90) days for the duration of time a family is receiving service coordination.

INDIVIDUAL FAMILY SERVICE COORDINATION PLAN/PLAN OF CARE:

O.R.C. 121.37(D)(1): Designates service responsibilities among the various state and local agencies that provide services to children and their families, including children who are abused, neglected, dependent, unruly, or delinquent children and under the jurisdiction of the juvenile court and children whose parents or custodians are voluntarily seeking services;

The responsibilities of all involved parties will be clearly identified in the IFSCP. If, for any reason, needed services or supports are not available, the plan should show how priorities are chosen and what efforts will be undertaken to address such gaps.

O.R.C. 121.37(D)(2): Designates an individual, approved by the family, to track the progress of the family service coordination plan, schedule reviews as necessary, and facilitate the family service coordination plan meeting process;

To coordinate plan management across systems, typically the LCFCFC Service Coordinator will be the designated individual to track the progress of the family service plan, schedule needed reviews of the plan and facilitate the family service plan meeting process. The family will be consulted to approve the LCFCFC Service Coordinator designated for this responsibility and approval will be documented on the IFSCP.

O.R.C. 121.37 (D)(3): Ensures that assistance and services to be provided are responsive to the strengths and needs of the family, as well as the family’s culture, race, and ethnic group, by allowing the family to offer information and suggestions and participate in decisions. Identified assistance and services shall be provided in the least restrictive environment possible.

The family and other IFSCP team members will be consulted to identify strengths and needs within the family. Additionally, the family will be asked to identify issues related to racial/ethnic/cultural identity and to gender.

O.R.C. 121.37(D)(4): Includes a process for dealing with a child who is alleged to be an unruly child. The process shall include methods to divert the child from the juvenile court system. O.R.C. 121.37(E): Includes items that may be included in the individual family service coordination plan of an alleged unruly child. Items to highlight include: (E)(1) The process provided for under division (D)(4) of this section may include, but is not limited to, the following: (a) Designation of the person or agency to conduct the assessment of the child and the child’s family as described in Division (C)(7) of this section and designation of the instrument or instruments to be used to conduct the assessment. (b) An emphasis on the personal responsibilities of the child and the parental responsibilities of the parents, guardian, or custodian of the child. (c) Involvement of local law enforcement agencies and officials. (E)(2) The method to divert a child from the juvenile court system that must be included in the service coordination process may include, but is not limited to, the following: (a) Preparation of a complaint under section 2151.27 of the Revised Code…notifying the child and the parents, guardian, or custodian that the complaint has been prepared to encourage the child and the parents, guardian, or custodian to comply with other methods to divert the child from the juvenile court system. (b) Conducting a meeting with the child and parents…and other interested parties to determine the appropriate methods to divert the child from the juvenile court system. (c) A method to provide the child and the child’s family a short-term respite… (d) A program to provide a mentor to the child… (e) A program to provide parenting education… (f) An alternative school program…

Early identification and intervention are critical factors in preventing a child from becoming further involved in the juvenile court system. The IFSCP team will ascertain if a child is on probation. If a child is not currently on probation, but displaying unruly behaviors, then the child will be referred to the Juvenile Court for an intake conference to evaluate the problems and design appropriate solutions.

DIVERSION:

Early identification and intervention are key elements in preventing a child from becoming involved in the Juvenile Court system. Although many adolescents are already involved with this system prior to a referral for service coordination, procedures are in place to address issues related to unruly juveniles. If a family’s Individualized Family Service Coordination Plan identifies that a child is displaying unruly behavior, and the youth is not already involved with the Lake County Juvenile Court a referral will be made to the family by the Service Coordinator to request an appointment with the Juvenile Court Intake Department. Intervention is designed to meet the child and family’s needs through the least restrictive and intrusive method possible. Many referrals consist of adolescents and families who have communication problems that can be addressed without the aid of official court programs.

Through appropriate assessment by the Intake Department many adolescents are diverted from official court programming. If a child or adolescent is determined to need the accountability of the Court a complaint will be filed.

O.R.C. 121.37(D)(5): Includes timelines for completion of goals specified in the plan with regular reviews scheduled to monitor progress toward those goals;

The family’s IFSCP should be reviewed every 90 days to monitor progress. Additionally, the family/youth should be provided the opportunity to schedule a meeting at any time and during a time convenient to the family with the assistance of the designated team leader.

O.R.C. 121.37(D)(6): Includes a plan for dealing with short-term crisis situations and safety concerns.

Planning for a short-term crisis or a safety concern establishes the understanding among team members that family crises and safety issues are a possibility and will not be considered a plan/child/family/team failure if they should occur. Examples of crisis/safety planning include calling local law enforcement or EMS, contacting the child’s mental health providers or contacting the Crisis Hotline through the Lake County ADAMHS Board.

ROLE OF THE SERVICE COORDINATOR/LEAD CASE MANAGER:

In partnership with families the Service Coordinator will serve as the Lead Case Manager for children and adolescents who are referred to LCFCFC for service coordination. The responsibilities of the Service Coordinator are to:

Receive and process referrals for services from agencies and families.
Assure that families are informed of their rights and responsibilities.
Conduct home visits as necessary, and otherwise assess, enroll and process requests for services for children and adolescents receiving LCFCFC services.
Assure that necessary forms are completed and signed, including the Authorization of Release of Confidential Records form, LCFCFC Referral form, and Individual Family Service Coordination Plan.
Arrange for necessary services and advocate for quality services on behalf of children and adolescents receiving LCFCFC services.
Maintain confidential records pertaining to children, adolescents and families receiving LCFCFC services.
Keep families advised of the status of children receiving funded services, including the identification of any gaps in services or barriers to services.
Maintain accurate charting and documentation as required by current program and state standards.

The Service Coordinator will maintain records of each referral for service coordination, including self-referring families. These records shall include documentation of the referral, releases of information and confidentiality agreements, Individualized Family Service Coordination Plans, contracts for funded services, correspondence pertaining to the family, copies of educational, medical and social/psychological information provided to support the need for services, and any additional documentation gathered through the provision of service coordination. Records will be secured in a locked area and will only be accessed by the Service Coordinator or his/her direct supervisor to maintain confidentiality. All information shared with Wraparound committee members or LCFCFC members will be done with respect to the family and in a confidential manner. Releases of information will be requested from and signed by parents and maintained in the case record. As stated previously, all parties sign a Service Coordination Confidentiality Statement at each Wraparound presentation.

The Service Coordinator also provides education to families and service providers regarding service coordination by providing onsite education and training, upon request, to the staff of community agencies, including Lake County Juvenile Court, Lake County Department of Job & Family Services, Lake County Board of Developmental Disabilities, Lake County ADAMHS Board’s network of provider agencies, and local school districts. Literature is made available to families in accessible locations throughout the community. Efforts to inform families of the availability and purpose of service coordination will be coordinated with other community, educational or social marketing efforts for programs including, but not limited to, local behavioral health agencies, school districts, Juvenile Court, Job and Family Services, Women, Infants, and Children (WIC), Head Start/Early Head Start and Children with Medical Handicaps (CMH). The County Service Coordination Mechanism is posted on the County’s Job and Family Services website.

OUTCOME MEASUREMENT AND TRACKING:

Once it is determined that a family will receive service coordination and an Individual Family Service Coordination Plan is created, the plan will be reviewed formally every ninety (90) days until services have been successfully completed or the case has been officially closed by the LCFCFC Service Coordinator.

O.R.C. 121.37(C)(3): A procedure that permits a family to initiate a meeting to develop or review the family’s service coordination plan and allow the family to invite a family advocate, mentor, or support person of the family’s choice to participate in any such meeting;

A family member may request the review of the Individual Family Service Coordination Plan at any time. Progress toward the designated outcomes/goals listed within the context of the Individual Family Service Coordination Plan is closely monitored by the Service Coordinator. This includes close tracking of children in out-of- home placements to assure continued progress, appropriateness of the placement, and continuity of care after discharge from placement with appropriate arrangements for housing, continued support and treatment, and appropriate educational services. The Service Coordinator will review the progress of children and adolescents who are receiving service coordination with the Wraparound committee on a monthly basis.

O.R.C. 121.37(C)(5): A procedure for monitoring the progress and tracking the outcomes of each service coordination plan requested in the county, including monitoring and tracking children in out-of–home placements to assure continued progress, appropriateness of placement, and continuity of care after discharge from placement with appropriate arrangements for housing, treatment, and education. O.R.C. 121.376 (A) The Ohio family and children first cabinet council state office shall establish and maintain the Ohio Automated Service Coordination Information System (OASCIS). The information system shall contain county family and children first council records detailing funding sources and information regarding families seeking services from a county council including: (1) Demographics including: (a) number and relationship of family members; (b) genders of youth; (c) ages of youth; (d) races of youth; (e) education of youth; (2) Youth financial resource eligibility information; (3) History and desired outcomes; (4) Youth’s physical and behavioral health histories, when available; (5) Names of youth’s insurers and physicians, when available; (6) Individualized plans including: (a) referrals made to services; (b) services and supports received; (c) crisis plans; (d) safety plans; (7) All Relevant case file documents; (8) Any other information related to families served, services provided, or the financial resources used to provide the services. O.R.C. 121.376 (B) Each county family and children first council shall enter and update all information in the Ohio Automated Service Coordination Information System as information becomes available or within five business days of acquiring new information. Access to and use of data in the Ohio Automated Service Coordination Information System shall be limited to the extent necessary to carry out the duties of the family and children first cabinet council and the county family and children first councils established in section 121.37 of the Revised Code.

The OFCFC requires data pertaining to Lake County youth enrolled in Service Coordination.Data will be collected by the Council Coordinator and added to OASCIS. Data will also be tracked utilizing OASCIS.

Child, adolescent and family outcome information and other informative data collected through the monitoring process shall be utilized to inform the decision making process of the LCFCFC as it fulfills the responsibility to annually evaluate and prioritize services, fill service and resource gaps, and design new approaches to achieve better results for Lake County children, adolescents and families, as required by ORC 121.37 (B) (2) (b).

DISPUTE RESOLUTION PROCESS:

O.R.C. 121.37(C)(9): A local dispute resolution process to serve as the process that must be used first to resolve disputes among the agencies represented on the county council concerning the provision of services to children, including children who are abused, neglected, dependent, unruly, alleged unruly, or delinquent children and under the jurisdiction of the juvenile court and children whose parents or custodians are voluntarily seeking services. The local dispute resolution process shall comply with section 121.38 of the Revised Code. The local dispute resolution process shall be used to resolve disputes between a child’s parents or custodians and the county council regarding service coordination. The county council shall inform the parents or custodians of their right to use the dispute resolution process. Parents or custodians shall use existing local agency grievance procedures to address disputes not involving service coordination. The dispute resolution process is in addition to and does not replace other rights or procedures that parents or custodians may have under other sections of the Revised Code. O.R.C. 121.381, 121.382: Families must have access to the dispute resolution process. Not later than sixty days after the parent or custodian initiates the dispute process, the council shall make findings regarding the dispute and issue a written determination of its findings. Each agency represented on a county family and children first council that is providing services or funding for services that are the subject of the dispute initiated by a parent shall continue to provide those services and the funding for those services during the dispute process. Nothing in division (C) (4) of this section shall be interpreted as overriding or affecting decisions of a juvenile court regarding an out-of-home placement, long-term placement, or emergency out-of-home placement.

Systems and agencies in Lake County diligently work together daily so that children, adolescents and families have access to the quality services they need. However, it is inevitable that on occasion there may be differences regarding the provision of services or the assignment of responsibilities toward implementing services. The following process has been established, and access will be made available to all families receiving LCFCFC services to ensure swift and equitable resolutions. Parents will be informed in writing of the dispute resolution process at the time of referral. Parents, and the child or adolescent if applicable and appropriate, will be included in all aspects of this process. Parents or guardians shall use existing local agency grievance procedures to address disputes not involving service coordination. The dispute resolution process is in addition to and does not replace other rights or procedures parents or guardians may have under other sections of the Ohio Revised Code.

Disputes can occur between agencies, between families and agencies, or between families and LCFCFC.

Early Intervention Issues:

If the dispute involves an EI Service, parents have the right to file a written complaint. The quickest way to resolve a concern is to talk with the EI Service Coordinator or their supervisor. If that does not work, you can contact EI staff at the Ohio Department of Developmental Disabilities at (614) 466-6879 or [email protected]. You can file a signed written complaint. Complaints should be mailed to:
Early Intervention
Ohio Department of Developmental Disabilities

246 N. High St.Columbus, Ohio 43215

The complaint will be investigated; a response will be provided to the complainant within 60 calendar days. While the complaint is being investigated, the child can continue to receive EI services.

Family/Individual Issues:

A parent or guardian who disagrees with a decision rendered by the LCFCFC regarding services for a child may initiate the dispute resolution process. Whenever possible, families should be encouraged to work closely with the Service Coordinator to get differences resolved without a formal complaint. However, when the Service Coordinator has made a concerted effort for no more than ten (10) business days, exploring all avenues within his/her authority, and the issue remains unresolved, the parent or guardian will be advised to put their complaint in writing to the Service Coordinator for review by the Wraparound committee members. The written complaint should include:

Name, address, & phone number of parent/guardian.
Name of the child receiving service coordination.
Full name of the parties/agencies involved in the dispute.
Dates of all incidents.
Desired remedy being sought by the parent/guardian.

From the date the Service Coordinator receives the written complaint, Wraparound has six (6) business days to convene with the family and the family’s advocate (if desired). At this meeting, areas of dispute are presented by the family. Open discussion is encouraged by everyone present to negotiate a resolution. Meeting minutes will be utilized to document areas discussed and the outcome of the Wraparound meeting.

If the issue remains unresolved after review by Wraparound and the parent or guardian wants to continue the dispute resolution process, then the parent/guardian will notify the Service Coordinator who will forward a summary of the pertinent information to the LCFCFC Chairperson. The LCFCFC Chairperson will assign one or more individuals from LCFCFC who do not have a direct interest in the matter to review the complaint. The assigned members have seven (7) business days from notification by the Chairperson to review all documentation related to the complaint and to hear the petition of the parent/guardian with an advocate present, if desired. No later than sixty (60) days after the parent or guardian initiates the dispute resolution process, the LCFCFC shall make a final determination regarding the dispute and issue a final written determination of the findings to be provided to the family and other involved parties.

All Individual Family Service Coordination Plans in effect for the child and family at the time of the complaint will remain in effect until the dispute is resolved. The Service Coordinator will track all timeframes involved and will keep full documentation throughout the process to ensure compliance with the timeframes established.

Systems Issues:

Each agency has its own unique set of Federal and State laws, rules, regulations, and policies by which it is obligated to operate. An agency represented on LCFCFC that disagrees with LCFCFC’s decision (through the recommendation of Wraparound) concerning services or funding for services a child or adolescent is to receive from agencies represented on the LCFCFC, may initiate the local dispute resolution process.

The agency should present the complaint in writing within ten (10) days of the recommendation to LCFCFC’s Chairperson with a copy to the Service Coordinator. The LCFCFC Chairperson will call a meeting of designated LCFCFC members in an attempt to bring about a resolution which reflects the best interest of the family, following guidance provided in ORC 121.38. A written determination will be submitted by the LCFCFC Chairperson to the complainant and the Service Coordinator within sixty (60) days of the initial referral of the matter to the LCFCFC Chairperson. An agency subject to the determination, shall immediately comply with the determination, unless the agency objects by filing action with the Lake County Juvenile Court as specified in ORC 121.38(B)(2). This must be done no later than seven (7) days after the date the written determination was issued. The Lake County Juvenile Court will proceed with the resolution of the dispute according to ORC 121.38.

While the dispute resolution process or any Juvenile Court proceedings are pending, each agency shall provide services and funding as recommended by LCFCFC or Wraparound prior to the dispute resolution procedure being initiated. If the agency providing services or funding is found to not be responsible for providing the service as a result of the dispute resolution process, the agency shall be reimbursed for the cost of providing the services by the agency or agencies determined to be responsible for service provision. If the reason for the agency’s disagreement with the recommendation is due to a Federal or State rule, an interagency agreement, or a memorandum of understanding prohibiting the provision of this service, then LCFCFC can choose to apply to OFCFC for an exemption.

FISCAL STRATEGIES FOR SUPPORTING SERVICE COORDINATION:

For children who are receiving service coordination the following fiscal resources are used:

Third Party Resources:

Third party sources are always thoroughly researched by the Point Person or Service Coordinator and utilized in the funding process whenever possible. It is the intention of the LCFCFC to avail themselves of grants and other funding sources to enhance local services to children, adolescents, and families. All such prospective funding sources will be reviewed by the LCFCFC. All funds will be used in accordance with their stated guidelines.

Funding Package Resources:

Funding packages are often developed with a variety of funders, since no singular funder often has the resources to meet the entire cost of a service or intervention. When more than one funder is responsible for the cost of a service or intervention, the list of responsible funders is included on the family’s Service Coordination Plan and agreed upon by various funders prior to the implementation of the plan.

Primary Community Resources:

Additional funding is available through three primary community funders: the Lake County Alcohol, Drug Addiction, and Mental Health Services Board (ADAMHS), the Lake County Department of Job and Family Services (LCDJFS), and the Lake County Board of Developmental Disabilities. The decision to share funds was made jointly by the involved funders. The funds are divided proportionately between the ADAMHS Board and LCDJFS unless the child is eligible to receive services through the Board of Developmental Disabilities. If the child is eligible for and receiving these services, then the funds are divided proportionately between the three agencies. Other LCFCFC member agencies provide a portion of funding such as the Lake County Juvenile Court when funding is available.

Parental Resources:

Use of parental resources should also be pursued such as the availability of insurance coverage including Medicaid.

Multi-System Youth (MSY) Resources:

Finally, Service Coordinator may apply for Multi-System Youth (MSY) funding through the Ohio Department of Medicaid as a funder of last resort, and if no other comparable services are available within Lake County and not otherwise covered by the family’s insurance. Completion of MSY applications will be at the discretion of the Council Coordinator and updated as required. Council Coordinator will determine the best use of MSY – PCSA funds allocated to the local FCFC.

QUALITY ASSURANCE:

To ensure the highest level of quality assurance to families, members of the LCFCFC Children’s Executive Committee will monitor and review the Service Coordination Mechanism on an annual basis. This review will be conducted to ensure that the local mechanism is kept up to date, is effective and reflects the most current process practiced in Lake County.

The LCFCFC Service Coordinator collects data and updates the Children’s Executive Committee monthly regarding progress being made in individual cases. The data collected helps the Children’s Executive Committee determine gaps in services that may exist and is used to prioritize the use of funding. This information is provided to the LCFCFC on a quarterly basis.

LCFCFC assures that upon request, service coordination information will be submitted to the state for evaluation.

CEC 10/22/2024

Service Coordination Mechanism