Butler County Human Service System Guide - 2017

Accessing Behavioral Health
Services for your Child:

The Interagency Service
Planning Team (ISPT)

Meeting

Prepared by the
Pennsylvania Health Law Project
(800)274-3258 or (866) 236-6310 TTY

www.phlp.org

Copyright © 2004 Pennsylvania Health Law Project

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Tips for Parents’ Involvement in the
Interagency Service Planning Team
(ISPT) Meeting when a child is in

Health Choices

What is the Purpose of the ISPT Meeting?

? If the psychologist or psychiatrist who evaluated your
child prescribes wraparound services or an RTF
placement, the next step is an ISPT Meeting.

??The ISPT Meeting is a necessary step in the process of
getting these wraparound services or RTF placement
approved by your child’s Behavioral Health Managed
Care Organization (MCO).

? The MCO will require the following documents before
it will evaluate the medical necessity of the
services prescribed for your child:
? The most recent face-to-face psychiatric or
psychological evaluation or revaluation
? A detailed Treatment Plan
? A complete Plan of Care Summary and
? The Interagency Services Planning Team (ISPT)
Meeting Sign-In sheet

Organizing the ISPT meeting
? The person responsible for organizing the ISPT meeting may be
with the county Mental Health/Mental Retardation Office (MH/
MR), the MCO, or the provider. Sometimes, this is handled
differently from one county to the next.
? If you don’t know who should organize the ISPT meeting you
can call your child’s MCO or your county MH/MR to find out
who is responsible.

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What is My Role at the ISPT Meeting?

????You are an advocate for your child.

????Your most important role is to be an
active partner in the development of
the treatment plan.

????The treatment plan is critical both

?to the success of the services and to

getting the services approved.

??Do not allow the meeting to be rushed.
??Make sure that all of your child’s needs are discussed and

addressed, if you believe your child needs service.
??Schedule ISPT Meetings well before the date when services

are supposed to start (for example start planning as much as
two months before the start of school if your child needs the
services in school). To avoid gaps in services for children
already getting services, this means scheduling the ISPT
meeting at least 30 days before the date when your child’s
existing services are scheduled to end.

Who should be at the ISPT Meeting?

Make sure the ISPT meeting includes all the people that need to be
there, this includes:

? You
? Your child (if appropriate)
? Someone from your child’s MCO
? Someone from your county’s Mental Health/ Mental Retardation

(MH/MR) program
? Representatives from the other agencies working with your child

including your child’s school or daycare, someone from the
intermediate unit if your child receives pre-school services

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(caseworkers from Children & Youth or Juvenile Justice may also
be present if your child is involved in these systems);
? The wraparound provider agency if you have identified one (if
your child has a BSC this person should be there as well);
? Whenever possible, the wraparound prescriber (usually the
psychiatrist or psychologist who evaluated your child), even if
they can only attend by phone;
? Anyone you want have present—you can ask the person arranging
the meeting to invite the people you want to attend such as a
teacher, guidance counselor, family friend, or advocate.

What should be in the Treatment Plan?

The Treatment Plan should include:

???a vision for your child’s progress – what kind of behavior would
you like to see your child exhibiting in 6 months and 12 months,
include specific goals for your child and family and the services
requested to meet the goals;

???the strengths of your child and family;

???natural supports that exist for your child such as friends, family,
church and school, also include any supports that are not there for
your child;

???how you and other services systems will be involved in the plan;

???specific behavioral problems that your child has (as identified in
the evaluation), where those behaviors are exhibited, and goals for
improving those behaviors (goals should be behavioral not
educational*);

???the specific interventions and methods to be used to address the
behavioral goals and who will be responsible for addressing each
goal;

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???the individualized treatment plan interventions should be based on
strengths specific to your child and family and not on "typical"
interventions used for a certain diagnosis;

???measurable outcomes for the treatment provided and target dates
for achieving those outcomes (for example: child will stay on task
for 10 minutes 4 out of 5 trials during the day);

???specific information about how and where the treatment will be
provided (home, school, or other setting) and about the number of
hours the staff will work with your child in each setting and what
the staff will work on with your child in each setting;

???a plan for transferring effective techniques for working with your
child from the TSS to others including family members, school
teacher, teacher’s aide;

???standards for determining when the services to your child should
be reduced or stopped.

? NOTE:
? ? Because Medical Assistance provides health care services,
meeting educational goals is not the responsibility of your
MCO, but is the responsibility of your child’s public or
private school.
? There may be other services or programs available to your
child through the school system.
? Contact your child’s teacher, guidance counselor, or
principal to find out how to get help through the school.

? ? If your child is not yet school age, contact the Intermediate
Unit in your area to find out what early intervention services
your child is eligible for.

? You can also contact the Education Law Center at
412-391-5225 or 215-238-6970.

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You should insist that all the areas listed above are covered at the ISPT
meeting and are included in your child’s treatment plan. You should
also insist that all of your child’s problematic behaviors identified in the
psychological evaluation are included in the treatment plan, and that
treatment methods and goals are developed for each of these behaviors.

When you are updating an earlier treatment plan at an ISPT meeting,
you should discuss what progress has been made towards goals in the
earlier treatment plan, what goals have been achieved and what new
goals should be developed. If a goal has not been achieved, you may
want to discuss different interventions that could be tried to help your
child achieve that goal. Explain any new behavioral goals that you have
for your child. Discuss new interventions that will be used to help your
child reach new and previously identified goals.

If your child has shown “clinical improvement” this should be
documented in the treatment plan and the most recent psychological
evaluation. Clinical improvement is shown if your child is meeting, or
making progress toward, identified behavioral goals. The TSS, MT, or
BSC must document your child’s progress by keeping data on the
measurable goals that your child is working on.

At the ISPT Meeting, Remember:

??Have a copy of the current evaluation at the meeting—be clear
what is being prescribed and why.

??No one can change the prescription but the prescriber. The ISPT
members cannot recommend fewer services than what the
prescriber has prescribed. No one (including your BH-MCO’s
representative) but the prescriber can change the length of time
for which a service has been prescribed.

?
??Discuss other services your child is receiving—especially in the

school.

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??Highlight your child’s strengths and not just problem areas.

??NEVER sign blank forms.
?
? A team member should complete A Plan of Care Summary at the

ISPT meeting.

??Sign A Plan of Care Summary and the ISPT Sign-in Sheet at the
ISPT meeting.

??If you do not agree with the treatment plan developed at the ISPT
meeting be sure to put your initials in the box marked “disagree”
on the ISPT Sign-in Sheet.

??Ask for and get a copy of the Plan of Care Summary that
identifies the contact/responsible person for each service
identified and the ISPT Sign-in Sheet.

??You should leave the meeting with an understanding of where
things are and what is the next step.

What if there is a disagreement at the
ISPT Meeting?

Sometimes Team members disagree with the recommendations of the
psychologist who evaluated your child. While they are entitled to
disagree, the Team may not submit a request to the Managed Care
Organization (MCO) for less service than is recommended by the
psychologist. That is because the recommendation is considered a
prescription and only a psychologist or psychiatrist can prescribe
mental health services.

You should insist that the Team submit a request for the total number of
hours recommended by the prescriber even if there is disagreement. The

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Team member(s) who disagree can register their dissent in the Team
meeting notes if they choose to do so.

There may be times when the MCO representative at the meeting tells
the Team that the Managed Care Organization will not approve the
services recommended by the psychologist. That MCO representative
does not have the authority to deny the request (unless that person
is a psychologist). Again, you should insist that the Team submit a
request for the total number of service hours recommended by the
evaluating psychologist. If the MCO later denies the requested services,
you can appeal.

Copyright © 2004 by The Pennsylvania Health Law Project

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Mental Health Services

Assertive Community Treatment Team (ACT)- ACT is a team delivered,
community-based service for people with a serious and persisitent mental health
diagnosis. The team consists of 8-10 mental health professionals with various
expertise who work together with the identified individual to support them in their
recovery journey.

Behavioral Health Rehabilitation Services (BHRS)- BHRS are mental health services
that are provided to children and adolescents in their home, community, and school
setting. They are often called “wraparound” services. BHRS are for children and
adolescents who have an emotional or behavioral disorder that can best be treated in
the child or adolescents’ natural environment.

Blended Case Management (BCM)- The Blended Case Management Program is
provided in the community and is designed to assist individuals to access needed
community services. Target population is children and adults with mental health and
emotional disorders. Program goals include:

 Reduced hospitalization
 Increased independence-of-living status
 Increased vocational/educational status
 Develop of natural support systems

Crisis Intervention- Crisis services are provided for anybody who is facing a behavioral
health related crisis. Services are delivered in three ways in Butler County.

1. Crisis Telephone Service – This consists of a 24 hour a day, 7 day a week
hotline which can assess calls, provide information, and, if needed, dispatch aid.
The toll free Crisis Line is 800-292-3866.

2. Crisis Walk-in Service – This service is available at our Holly Pointe site, located
in After-hour walk-in service may be available by appointment. Walk-in
services are scheduled by calling the toll free Crisis Line (800-292-3866).

3. Crisis Mobile Service – This service is available .24 hours a day, 7 days a week.
Crisis Mobile Services are community based, providing intervention and outreach
throughout Butler County. Mobile Crisis can be reached through the toll free
Crisis Line (800-292-3866).

Family Based Mental Health Services- Family Based Mental Health Services program
is designed to provide in-home services to families at risk of having their children or
adolescents placed outside of the home. The goal of the program is to provide a more
intensive therapeutic intervention for the entire family. In doing so, it is believed that the
number of days a child needs to be out of the home in psychiatric, residential or foster
care placements will be reduced or eliminated. The program uses therapeutic teams to
deliver services to families. Most of their time is spent in direct contact with the family.

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Inpatient Mental Health Services- Inpatient services are provided in a hospital setting
for individuals who are experiencing very intense symptoms relating to their mental
illness that can not be managed in a community setting.

Intensive Outpatient Program (IOP)- IOP provides intensive counseling services
(approximately 9 hours per week) for individuals who may need more support than is
offered through outpatient services but whose situation does not indicate that Partial
Hospitalization is necessary.

Mobile Medications- Mobile Medications is a voluntary program to assist individuals in
the community who have experienced difficulty taking psychiatric medications as
prescribed. For many customers, this problem has significantly contributed to repeated
psychiatric hospitalizations. The Mobile Medications Program has been designed to
increase consumer recognition of the importance in taking medications as prescribed
and to improve skills in this area.

Outpatient Mental Health Services- Outpatient counseling services include individual,
family, and group counseling that aim to help people learn to manage issues in their
lives effectively in order to enjoy an improved quality of life.

Partial Hospitalization (for Children) This is a time-limited, active treatment program
which provides therapeutically intensive, coordinated, and structured mental-health
services within a therapeutic surrounding. The goals of the program are to provide a
safe non-judgmental, educational and supportive environment that will assist consumers
in recovery.

Psychiatric Rehabilitation (Mobile and Site-Based)- The Psychiatric Rehabilitation
Program provides an array of services targeted at helping individuals with a serious
mental illness to develop the necessary skills to live, learn, work, and socialize in the
community.

Residential Services- The multi-level residential system for adults includes intensive-
care, full-care, and partial-care group homes, and respite beds. People with severe and
chronic mental-health diagnoses who are age 18 and over and residents of Butler
County are eligible for services. Priority is given to individuals who have been
discharged from State Hospital System or diverted from admission to the state and local
hospital. The mission is to provide alternatives to psychiatric hospitalization through
support, monitoring medications, and addressing individual needs.

Residential Treatment Facility (RTF)- Residential treatment programs for children and
adolescents with a mental health diagnosis serve individuals who are able to live safely
outside the restrictiveness of an inpatient hospital setting, yet unable to reside in a less
restrictive setting such as with their family, in foster care or a group home. A team of

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mental health professionals is responsible for managing the therapeutic environment
and providing therapeutic interventions such as individual, group and family therapy.
*** See list of Special Programs for additional MH Services provided in Butler
County.

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Mental Health Special Programs

CASSP (use Greene’s definition)
Certified Peer Specialist (CPS)

The CPS Program is operated by Center for Community Resources and also Grapevine
Center. This program aims to provide peer support services that are specialized
therapeutic interactions conducted by self-identified current or former consumers of
behavioral health services who are trained and certified to offer support and assistance
in helping others in their recovery and community-integration process.
Forensic Mental Health Program

The Forensic Mental Health Program is operated by Family Psychological Associates..
This program focuses on working intensively with individuals with serious mental illness
who are incarcerated in the Butler County jail. The program provides specialized case
management and therapeutic services that focus on working with the individual to
change the situation, behaviors, etc. that may have contributed to their arrest. The
primary goal of the program is to reduce recidivism and divert individuals with mental
illness from the legal system.

Multisystemic Therapy Program (MST)
MST is a unique, goal oriented, comprehensive treatment program designed to serve
youth with multiple problems in their community. MST is the only family-focused and
community-based treatment program that has:

 Been the focus of several major research studies, and
 Demonstrated clinical and cost effectiveness for youth with complex emotional,

social and academic needs.

MST is effective in helping youth with chronic, violent, delinquent behavior and youth
with serious emotional problems, including:

 Truancy and academic problems
 Serious disrespect and disobedience
 Aggressive behavior (fighting and property destruction)
 Criminal behavior

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 Drug and alcohol problems
 Running away
Transitional Care Center for Mental Health
The Transitional Care Center for Mental Health is a long term structured residence
(LTSR) operated by Irene Stacy Community Mental Health Center. LTSR is a highly
structured mental health treatment facility designed to serve people who are eligible for
hospitalization but who can receive adequate care in the LTSR. The Transition Care
Center may enable individuals to avoid State Hospitalization and receive extended care
within their community.
This program is a 16 bed residential facility serving individuals 18 years of age and
older who are in need of support 24 hours a day, 7days per week. The average length
of stay is 6 to 12 months. Admission to the program is decided by an interagency team,
including clinical professionals, that reviews all cases and determines the appropriate
clinical level of care for an individual referred to a supervised, residential setting.

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Victims of
Violence

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Victims of Violence

The Victims of Violence system includes services and supports for those who have
experienced or witnessed domestic violence, sexual assault, or other violent crimes.
There are various entities at the state level that are involved with the Victims of Violence
system. These include the Pennsylvania Commission on Crime and Delinquency
(PCCD), Pennsylvania Department of Corrections, Pennsylvania Board of Probation
and Parole, Office of the Attorney General, and Pennsylvania Office of the Victim
Advocate (OVA).

In Butler County, the Victim Outreach Intervention Center (VOICe) is the community
organization that provides Victims of Violence services. VOICe is a non-profit systems
change organization that provides free and confidential services to individuals and
families who are survivors of violent crime. VOICe works within the Butler County
community to bring about social change and provide survivors with the ability to take
control of their lives. In addition to VOICe, the Victim/Witness Services Program in the
Butler County District Attorney’s Office helps victims of violence. This program is
designed to provide direct assistance to victims, witnesses, and significant others
through the Court process.

What Services are Provided?

The Victims of Violence system provides various services and supports to victims,
including advocacy, counseling, victim’s compensation, court accompaniment, etc.

Victim Outreach Intervention Center (VOICe) is a comprehensive victim service agency
for victims of domestic violence, sexual assault, and other violent crimes. Services and
programs offered by VOICe include, but are not limited to:

 Crisis intervention services
 Adult services

o Individual Counseling
o Group Counseling
o Survivor accompaniment
o Advocacy
o Information and referral
 Children’s services
o Children’s groups
o Individual counseling
o Self-esteem enhancement
o Safety planning
o Good touch vs. bad touch

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o Domestic violence education
o On-going support
 Prevention Education
 Community Education
 Legal advocacy
 Medical advocacy
 Civil legal representation (CLR)

VOICe supports victims of violence and abuse in the Court system by providing
emotional support, explaining legal procedures, and victim advocacy. Specifically,
VOICe can do the following:

 Be with the victim if s/he needs to go to the police department or hospital;
 Be with the victim throughout the Protection from Abuse (PFA), Sexual Violence

Protection Orders (SVPO), and Protection from Intimidation (PFI) processes;
 Be with the victims at Preliminary Hearings at the District Magistrates’ Office;
 Be a liaison with the District Attorney’s Office, County Detective, and the Victim

Witness Office; and
 Be with the victim at trials, sentencing, or any other court hearings.

VOICe can also help the victim BEFORE the Court process begins to help prepare.

The Victim/Witness Services Program in the Butler County District Attorney’s Office
provides direct assistance to victims, witnesses, and significant others. Advocates in
the program notify all crime victims of Court dates, case status, and victim rights. They
also assist the prosecutors with various matters. In providing services to victims and
witnesses in the criminal and juvenile justice systems, the Victim/Witness Services
Program follows the guidelines provided by the Pennsylvania Commission on Crime
and Delinquency (PCCD). These guidelines include, but are not limited to:

 Classroom orientation
 Courtroom accompaniment
 Supportive counseling
 Assistance with restitution issues
 Crisis intervention
 Victim compensation assistance program
 Prior comment
 Assistance with victim impact statements
 Intimidation issues
 Community referral agency

A Protection from Abuse order (PFA) is an order that protects a victim and his/her
children from the abuser. It is a civil order that the victim files on his/her own behalf
against a family or household member who is abusing him/her. Butler County Domestic
Relations is where initial PFA petitions are filed. Hours of operation to file a PFA petition
are Monday-Friday, 8:30 a.m. – 10:30 a.m. Domestic Relations is located at the County

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Government Center, Floor L , 124 West Diamond Street, Butler, PA 16003. The phone
number is 724-284-5181

Who is Eligible for Services and How Do They Access
Them?

VOICe supports survivors of:
 Domestic Violence
 Dating Violence
 Rape and/or sexual assault
 Violent crimes, including simple or aggravated assault
 Child sexual assault
 Adult survivors of sexual abuse or incest
 Sexual harassment
 Attempted homicide or families of homicide victims
 Terroristic threats
 Burglary
 Robbery

It is the policy of VOICe to hold confidential all communications, observations, and
information made by and between or about survivors, adults and children, staff,
volunteers and Board members of the organization.

VOICe can be reached through the toll-free hotline at 1-800-400-8551 or through the
business line at 724-776-5910.

How is the System Funded?

The Pennsylvania Commission on Crime and Delinquency (PCCD) allocates federal
and state funds to victims, victim service providers, and criminal and juvenile justice and
ancillary agencies. PCCD helps communities to improve the administration of justice in
a variety of ways.

Who’s Who in the System?

There are many people that you may interact with as part of the system, including the
following:

Judge
A judge is someone whose job is make decisions in a court of law.

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Magisterial district judge
A magisterial district judge is a judge in a court for minor crimes. A magisterial district
judge is also known as a magistrate or a district justice.

District attorney
A district attorney is a lawyer who works for county government and whose job is to
bring people accused of crimes to trial.

Defense attorney
A defense attorney is a lawyer who “defends” or represents a person accused of crimes
in court.

Public defender
A public defender is a lawyer who is paid by the government to defend people in court if
they cannot pay themselves.

Legal Advocate
A person who accompanies the victim to court proceedings and is there to provide
support and explain what is happening as the case moves forward in either the criminal
or juvenile justice system.

Medical Advocate
A person who accompanies the victim to the hospital to talk with him/her and explain
what s/he can expect if the person who hurt him/her is arrested and charged with a
crime and what the victims’ options are.

What are the Rights and Responsibilities relating to
the System?

Victims of violence have rights guaranteed to them. In addition, there are standards of
service that victims can expect to receive as a victim of crime. The standards help
ensure that the victim receives information, practical and emotional support, and is able
to participate fully in the criminal justice system. These standards were created to make
sure that victims are treated with dignity and respect at all times, regardless of gender,
age, marital status, race, ethnic origin, sexual orientation, disability, or religion.

Victims’ rights will be provided by several different agencies, which include a state or
local law enforcement agency, the prosecutor’s office, local correctional facility, Board of
Probation and Parole, the juvenile probation office, or the Department of Human
Services. The entity that provides specific notifications to the victim depends on where
the case is in the criminal or juvenile justice system. There are some rights that victims
will need to request in order for them to be provided. Some of the rights of victims of
violence are listed below.

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For Sexual Assault Survivors...

If you are sexually assaulted, it is not your fault. Help is
available. Sexual Assault is any type of sexual activity you do not
agree to. Sexual Assault can be visual, verbal or anything that
forces a person into unwanted sexual contact or attention. Sexual
Assault can happen in different situations, by a stranger, in an iso-
lated place or on a date, or in the home by someone you know.

In cases of rape and sexual assault, you have more control
over reporting the crime and following through with prosecution.
Here are a few important considerations:

1. The criminal justice process does not move as fast as on TV.
Please expect time for investigation, arrest, charges, hearings,
pleas and potential trial. It is a slow process. If you have ques-
tions about your case, please call VOICe.

2. As for all victims of crime, VOICe offers free and confidential
services throughout the entire process including individual and
group counseling. It helps to talk to someone who knows.

3. Even if you choose/chose not to get a “Rape Kit” completed,
receiving medical care from an OB/GYN is very important.
Questions regarding pregnancy, STD’s and other injuries that
may develop later are important to be addressed.

Reactions to Sexual Assault: *Fear
*Anger *Powerlessness
*Embarrassment *Self-blame and Doubt
*Depression *Anxiety
*Isolation *Shame
*Denial

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Survivors of Other Violent Crimes

For many victims of other violent crimes like assault,
mugging, harassment, robbery, forgery, theft etc., the preliminary
hearing will be your only involvement with the criminal justice
system. Sometimes cases are settled at the District Court level.

For those cases that are “waived to court”, meaning there
will be another hearing or possibly a trial, a VOICe advocate will
be available for you throughout the process.

Even though your life may have be-
come chaotic and difficult as a result of a
crime, in time it will get better. It is normal
to feel increased fear and anxiety. You may
re-experience the trauma with flashbacks.
You may be impatient or irritable or feel
numb and avoid all situations that remind
you of what happened. These are all normal
reactions.

Some other things to consider include:

1. Remember court dates. If you have questions, you can call a
VOICe advocate or the Butler County Victim Witness Unit.

2. Write down the police officer information that is handling
your case. Do not be afraid to call and ask questions if you
have them.

3. Keep all papers that police, the District Attorney’s Office or
VOICe advocates give to you. If you wish to have a VOICe
advocate help you understand them better, please call.

4. Know that you are entitled to Crime Victims Compensation
and/or Restitution. Ask VOICe or the Butler County Victim/
Witness Unit in the District Attorney’s Office.

5. Find support and talk about how you feel. Not feeling like
yourself is normal.

6. Make personal safety choices that make you feel safer. These
could include: changing locks, carrying a cell phone, leaving
lights on at night, never walking alone, etc.

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System
Partnership
Resources

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Housing
Resources

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