10 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE CHAPTER 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE § 93100. Purpose & Legislative Findings. § 93101. Policy. § 93103. Creation of the Guam System of Care Counci l. § 93104. GSOCC Powers, Responsibilities and Duties. § 93100. Purpose and Legislative Findings . As mandated by Public Law 25-141, a Guam System of Care Council (GSOCC) was established to create a comprehensive S ystem of Care Plan for the treatment of children with a serious emotio nal disturbance (SED), and their families, on Guam. This legislation was the culmination of collaborative efforts by community stakeholders to improve services to children with a severe emotional disturbance and th eir families. The Council was able to create a true collaborative effort amon g families, service providers, and other community stakeholders, and fr om this collaboration grew a common vision and shared set of values and p rinciples. Partnering with and supporting community resources such as PRO CEED, FILAK, and the agency Ombudsmen, the Council held a series of meetings, workshops, ision and shared set of values and p rinciples. Partnering with and supporting community resources such as PRO CEED, FILAK, and the agency Ombudsmen, the Council held a series of meetings, workshops, conferences, and working sessions to develop a comm unity-based, family- driven plan for creating a unified system of care t o better provide services to children with SED. The Council held a public heari ng on its draft plan in August of 2002, and delivered the final plan to I L iheslatura and I Maga’lahi in September 2002. The GSOCC, upon completing the System of Care Plan , assisted the Guam Behavioral Health and Wellness Center, as the lead agency, in the writing of the Child Mental Health Initiative (CMH I) Grant application to the U.S. Department of Health and Human Services. Through its resources, the Council was instrumental in ensuring that the a pplication was submitted. Guam was awarded this highly competitive, Nine Mill ion Dollars ($9,000,000), six (6) year grant in September of 20 02. Funds from this grant will be used to develop the infrastructure and capa city to serve children with SED and their families. Mill ion Dollars ($9,000,000), six (6) year grant in September of 20 02. Funds from this grant will be used to develop the infrastructure and capa city to serve children with SED and their families. A fundamental requirement of the grant is that a co mmunity governance body be established to carry out a System of Care f or children and COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE adolescents and their families. The re-establishme nt of the GSOCC will not only fulfill the requirement for the cooperative ag reement but will also ensure that Guam’s initiative is sustained and cont inues well beyond the six (6) year grant period. The establishment of the GS OCC is a reflection of Guam’s commitment to its children and their familie s, and towards true system reform. The GSOCC is to be Guam’s community collaborative body addressing the broader encompassing issues of child ren’s mental health needs and services. It is therefore the intention of I Liheslaturan Guåhan [the Legislature] to permanently establish a ‘Guam System of Care Cou ncil’ to implement and expand the Guam System of Care Plan, to seek Federa l is therefore the intention of I Liheslaturan Guåhan [the Legislature] to permanently establish a ‘Guam System of Care Cou ncil’ to implement and expand the Guam System of Care Plan, to seek Federa l and/or foundation funding for its sustainability, to ensure continued collaboration among families, public and private service providers, and other stakeholders, and to act as the governing body for the CMHI cooperative agreement. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed an d reenacted by P.L. 27-047:1 (Dec. 17, 2003). 2013 NOTE: Pursuant to P.L. 32-024:2 (May 6, 2013) which rena med the Department of Mental Health and Substance Abuse (DMHSA) to the Guam Behavioral Health and Wellness Center, all references to DMHSA were alter ed to the Guam Behavioral Health and Wellness Center. § 93101. Policy . A child with, or at risk of, a serious emotional di sturbance shall be provided access to a comprehensive system of care t ailored to meet the child’s unique needs. The system of care shall be child-centered and family- focused; culturally competent; and non-discriminato ry. The system also shall provide services in the child’s own community to the maximum degree possible with are shall be child-centered and family- focused; culturally competent; and non-discriminato ry. The system also shall provide services in the child’s own community to the maximum degree possible with available and appropriate resources, or shall refer off-Island until such services are available on Guam. These s ervices shall be provided in the least restrictive setting. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed an d reenacted by P.L. 27-047:1 (Dec. 17, 2003). § 93102. Definitions . As used in reference to the planning, implementatio n, and evaluation of the Guam System of Care Council for Children with S erious Emotional Disturbance, the following terms are defined: COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (a) ‘Access to services’: the right to, and ease i n securing desired and needed services. (b) ‘Capacity building’: refers to a component of the system of care that provides information, training, education or other resources to enable people (family and personnel) to carry out t he needed and desired activities. refers to a component of the system of care that provides information, training, education or other resources to enable people (family and personnel) to carry out t he needed and desired activities. (c) ‘Case Management/Care Coordination’: the task of coordinating various service components and ensurin g that service needs are assessed and reassessed over time. In sy stems of care, case management also denotes the actual provision of ser vices, as opposed to the limited ‘brokering’ of services in tradition al mental health systems. In some settings, the term ‘care coordina tion’ is used instead of case management to connote broader job requireme nts and to describe the actual case management model being use d. (d) ‘Care coordination’: the task of coordinating various service components and ensuring that service needs are asse ssed and reassessed over time. In systems of care, care coordination a lso denotes the actual provision of services, as opposed to the limited ‘b rokering’ of services in traditional mental health systems. (e) ‘Care Coordinator’: an individual assigned wit h the responsibilities of coordinating the care of the ch ild and family. the limited ‘b rokering’ of services in traditional mental health systems. (e) ‘Care Coordinator’: an individual assigned wit h the responsibilities of coordinating the care of the ch ild and family. The care coordinator is key to ensuring that the system is truly responsive to the needs of the individuals it is designed to serv e. (f) ‘Child and Family Team’: members identified by the parents of a child with a serious emotional disturbance to work together as a team to help the child and family meet their needs. (g) ‘Child with serious emotional disturbance’: a p erson who is under the age of eighteen (18) years old, or is und er the age of twenty- two (22) years old and has been receiving services prior to the age of eighteen (18) years old that must be continued for maximum therapeutic benefits, and who exhibits any of the f ollowing characteristics for more than six (6) months: (1) has received a DSM-IV diagnosis on axis I or II ; or COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (2) exhibits severe behavioral, emotional or social disabilities that cannot be attributed solely to intellectual, p hysical or SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (2) exhibits severe behavioral, emotional or social disabilities that cannot be attributed solely to intellectual, p hysical or sensory deficits, such as, but not limited to: (A) behaviors that are sufficiently intense or seve re enough to be considered seriously detrimental to th e child’s growth, development, or welfare, or to the safety o r welfare of others; (B) behaviors that, although possibly provoked, are judged to be extreme or out of proportion to the pr ovocation, or an inappropriate age reaction; (C) behaviors that have been judged sufficiently disruptive to lead to exclusion from school, home, therapeutic or recreational settings; or(iv) behavi ors that require interdisciplinary services and intensive, w ell- coordinated care to be successfully managed. (h) ‘CMHI qualifying child with a serious emotional disturbance’: for the purposes of the Child Mental Health Initia tive cooperative agreement, the target population for CMHI/ Project I Famagu'onta is: Children and Adolescents who: a) are under twenty-t wo (22) years of age; b) have an emotional, behavioral, or mental di sorder diagnosable under target population for CMHI/ Project I Famagu'onta is: Children and Adolescents who: a) are under twenty-t wo (22) years of age; b) have an emotional, behavioral, or mental di sorder diagnosable under DSM-IV or its ICD-9-CM equivalents, or subseq uent revisions with the exception of DSM-IV ‘V’ codes, substance use disorders and developmental disorders, unless they co-occur with another diagnosable serious emotional, behavioral, or mental disorder; c) are unable to function in the family, school, or community, or in a combination of these settings; or, the level of functioning is suc h that the child or adolescent requires multiagency intervention involv ing two (2) or more community service agencies, such as mental health, education, child welfare, juvenile justice, substance abuse, and hea lth; and d) have a disability that must have been present for at least one (1) year, or on the basis of diagnosis, severity, or multi-agency inter vention, is expected to last more than one (1) year. (i) ‘Child Mental Health Initiative, (CMHI)’: a C ongressionally- funded program initiative under the U.S. gnosis, severity, or multi-agency inter vention, is expected to last more than one (1) year. (i) ‘Child Mental Health Initiative, (CMHI)’: a C ongressionally- funded program initiative under the U.S. Department of Health and Human Services, managed by its Substance Abuse and Mental Health COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE Services Administration (SAMHSA), and designed to p rovide funding for the infrastructure development needed to create a system of care. (j) ‘Child at risk for serious emotional disturbanc e’: a child or adolescent is considered to be at risk for a seriou s emotional disturbance, as defined by this Act, if the child w ould be subject to a serious emotional disturbance for any length of tim e. (k) ‘Child-centered’: a core value of the system of care whereby the needs of the child and family dictate the type and mix of services provided rather than expecting the child and family to conform to preexisting service configurations. This approach is seen as a commitment to providing services in an environment and in a manner that enhances the personal dignity of children and families, nform to preexisting service configurations. This approach is seen as a commitment to providing services in an environment and in a manner that enhances the personal dignity of children and families, respects their wishes and goals, and maximizes opportunities for involvement and self-determination in the planning and delivery of services. (l) ‘Collaboration’: the process of bringing toget her those who have a stake in children’s mental health for the pu rpose of interdependent problem-solving that focuses on impr oving services to children and families. (m) ‘Community-based (Based in the Community)’: a core value of the system of care which emphasizes the need for services provided to children in less restrictive, more normative env ironments which are within or close to the child’s home environment. (n) ‘Culturally competent’: a set of behaviors, at titudes and policies of a system, agency, or among service prov iders that enables them to work effectively in cross-cultural situatio ns. (o) ‘Early identification and intervention’: a pro cess for recognizing warning signs that children are at risk for emotional disabilities and taking early action against factor s that put them at s. (o) ‘Early identification and intervention’: a pro cess for recognizing warning signs that children are at risk for emotional disabilities and taking early action against factor s that put them at risk. Early intervention can have a significant effect on the course of emotional disturbance in children and can help prev ent problems from reaching serious proportions. (p) ‘Family’: is defined by its members and each f amily defines itself. Families can include biological and adopti ve parents and their partners, siblings, extended family members and fri ends who provide a significant level of support to the child or primar y caregiver. COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (q) ‘Family-focused’: an approach to designing and providing care that supports all family members involved with the child’s care; decisions about services are made considering the s trengths and needs of the family as a whole, as well as the individual child with a severe emotional disturbance. Further, family members are also involved in all aspects of planning and evaluating the service delivery system. amily as a whole, as well as the individual child with a severe emotional disturbance. Further, family members are also involved in all aspects of planning and evaluating the service delivery system. This approach is seen as a commitment to support familie s in their role as caregivers and to preserve family integrity to the greatest possible extent. (r) ‘FILAK’: a grant awarded to Guam to build conse nsus for using the ‘wraparound’ approach as a best practice service delivery process and to pilot its implementation. (s)’Guam System of Care Council’ (‘GSOCC’): the Co uncil established by this Act is responsible for policy d evelopment and implementation of plans and strategies to foster co llaboration among stakeholders so that the system of care policy is s ubstantially embraced in every program ministering to children with serio us emotional disturbances, and as otherwise provided by this Act . (t) ‘Individualized services’: services that are de signed specifically to address the unique needs and strengths of each c hild and family. (u) ‘Integrated services’: services that are provi ded in a community through multiple agencies with decreased overlap and decreased gaps in the unique needs and strengths of each c hild and family. (u) ‘Integrated services’: services that are provi ded in a community through multiple agencies with decreased overlap and decreased gaps in services. (v) ‘Least restrictive setting’: means that childre n and adolescents are served in as normal an environment as possible. Preferred interventions are those that provide the needed ser vices and at the same time are minimally intrusive in the normal day-to-d ay routine of the child and family. An implicit goal of the system o f care is to maintain as many children as possible in their own homes by providing a full range of family-focused and community-based service s and supports. (w) ‘Ombudsmen’: government of Guam agency represen tatives chosen to act as systems of care liaisons for their agencies. They are given decision-making powers for their agencies and act as a resource and trouble-shooter for those involved with the sys tem of care in their agencies. COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (x) ‘Parent’: biological and adoptive mother or fa ther, or the legal guardian of the child, or a HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (x) ‘Parent’: biological and adoptive mother or fa ther, or the legal guardian of the child, or a responsible relative or primary caregiver, including foster parents, with whom the child regul arly resides. (y) ‘PROCEED’: Parents Reaching Out for Children Ex periencing Emotional Disturbance, a non-profit parent support organization founded on Guam to help parents of children with se vere emotional disturbance and to promote systems change and famil y empowerment. (z) ‘System of Care’ (‘SOC’): a comprehensive spec trum of mental health and other necessary services which ar e organized into a coordinated network to meet the multiple and changi ng needs of children and adolescents with severe emotional dist urbances and their families. A system of care not only includes the p rogram and service components, but also encompasses mechanisms, arrang ements, structures or processes to ensure that the services are provided in a coordinated, cohesive manner. (aa) ‘Wraparound’: a philosophy of care that includ es a definable planning process involving the child and family tha t results in a that the services are provided in a coordinated, cohesive manner. (aa) ‘Wraparound’: a philosophy of care that includ es a definable planning process involving the child and family tha t results in a unique set of community services and natural supports, ind ividualized for that child and family to achieve a positive set of outco mes. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed an d reenacted by P.L. 27-047:1 (Dec. 17, 2003). 2013 NOTE: Pursuant the authority granted by 1 GCA § 1606, n umbers and/or letters were altered to adhere to the Compiler’s al pha-numeric scheme. § 93103. Creation of the Guam System of Care Counci l . There is hereby created the Guam System of Care Cou ncil (‘GSOCC’). The GSOCC shall be composed of the following: (a) eleven (11) family representatives appointed by I Maga’lahen Guåhan , to include nine (9) parents of children with seri ous emotional disturbance; one (1) of the nine (9) parent represe ntatives shall be from PROCEED, Inc.; one (1) shall be an adult consumer w ho has experienced serious emotional disturbance and is co gnizant of issues and barriers in the current delivery system; and tw o (2) young persons who shall be non-voting all be an adult consumer w ho has experienced serious emotional disturbance and is co gnizant of issues and barriers in the current delivery system; and tw o (2) young persons who shall be non-voting members who are less than e ighteen (18) years old who have been diagnosed as having a serious emo tional disturbance, at least one (1) of whom is currently a student; and COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (b) one (1) representative from each of the followi ng entities, designated by their respective appointing authoriti es: (1) Department of Education; (2) Department of Public Health and Social Services ; (3) Guam Behavioral Health and Wellness Center; (4) Department of Integrated Services for Individua ls with Disabilities (DISID); (5) Department of Youth Affairs; (6) Superior Court of Guam; (7) Mayors Council; and (8) The Chairperson of the Committee on Health or h is/her designee from I Liheslaturan Guåhan . (c) The Council members shall select a Chairperson, always from the family representatives, and a Vice-Chairperson from the Council membership. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Guåhan . (c) The Council members shall select a Chairperson, always from the family representatives, and a Vice-Chairperson from the Council membership. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed an d reenacted by P.L. 27-047:1 (Dec. 17, 2003). NOTE: P.L. 28-045:10 (June 6, 2005) changed the name of the Department of Education to the Guam Public School System. The pa ssage of P.L. 30-050:2 (July 14, 2009) reverted the name to the Department of Educat ion. Pursuant to P.L. 32-024:2 (May 6, 2013) which renam ed the Department of Mental Health and Substance Abuse (DMHSA) to the Guam Beha vioral Health and Wellness Center, all references to DMHSA were altered to the Guam Behavioral Health and Wellness Center pursuant to P.L. 32-024:4. § 93104. GSOCC Powers, Responsibilities and Duties. The Council shall: (a) Monitor the development and implementation of G uam’s System of Care Plan for children with SED and work to ensure its sustainability. (b) Act as the Governing Body for the CMHI cooperat ive agreement, including, but not limited to: COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (1) make policy or the CMHI cooperat ive agreement, including, but not limited to: COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (1) make policy decisions for the CMHI cooperative agreement; (2) create liaisons with the legislative and execut ive branches of the government of Guam to ensure that needed law s and orders can be obtained in a timely manner; (3) develop and uphold formal agreements and memora nda of understanding between the collaborating child servi ce agencies; (4) hold the system of care accountable for meeting high standards of care, including standards for cultural competence and family involvement, as well as standards of practic e that have been shown to be effective through research and evaluati on studies (such as the ‘Wraparound’ approach to create indivi dual child/family specific service plans); (5) ensure that cooperative agreement funds are exp ended appropriately within the community; (6) regularly monitor the clinical and functional o utcomes of the children to insure that services are making a p ositive contribution; (7) be aware of relevant reform efforts on Guam and incorporate them into the onitor the clinical and functional o utcomes of the children to insure that services are making a p ositive contribution; (7) be aware of relevant reform efforts on Guam and incorporate them into the system of care; and (8) all departments and agencies of the government shall fully respond to requests for information from the Counci l within ten (10) days, and if unable to fully respond therein, shall provide a reason for inability to timely respond and expected full response date. (c) Act as a coordinating body for all system of ca re resources for children with serious emotional disturbance on Guam , and act as the repository for the collection and distribution of r esearch, findings, and best practice models of treatment for children with SED. (d) Ensure collaboration and coordination between a ll stakeholders serving children with a serious emotional disturban ce and their families, and establish positive working relationsh ips with elected officials, courts, directors, and community organiz ations. COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (e) Establish and enforce uniform standards of care for the munity organiz ations. COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (e) Establish and enforce uniform standards of care for the treatment of children with a serious emotional dist urbance, set the policy and objective purposes for monitoring and as sessing the provision of services to children with a serious em otional disturbance, and ensure that this monitoring takes place. (f) Serve as the primary advocate for the system of care on Guam, serve as the primary family/consumer interface for feedback and conflict resolution, and coordinate outreach to and the education of the entire Guam community regarding the system of care and serious emotional disturbance. (g) Contribute to the interpretation of generated d ata on the system of care and on children with SED, interpret generat ed reports on the system of care and on children with SED, based on t his interpretation make recommendations and reports to the proper agen cies on service provision, and play a lead role in legislation and policy concerning children with SED and the services they receive. nterpretation make recommendations and reports to the proper agen cies on service provision, and play a lead role in legislation and policy concerning children with SED and the services they receive. (h) Work collaboratively with the community to esta blish a Human Resources Development Plan to address the need for on-going assessment of issues surrounding recruitment, super vision, training and retention of system of care workers in the Pacific region, and to free the island from the need to hire mainland workers who l ack the cultural competency, knowledge of local methods and traditio ns, and permanency of ‘home grown’ workers. (i) Establish contact and relationships with approp riate regional, national, and international agencies and organizati ons which could support and benefit Guam’s system of care. (j) Work to expand the system of care model to serv e all children in the community, not just children with a serious emotional disturbance. (k) The Council shall submit a report biannually to I Maga’lahen Guåhan [the Governor] and the Speaker of I Liheslaturan Guåhan [the Legislature] outlining its accomplishments, specifi c findings and recommendations to improve Guam eport biannually to I Maga’lahen Guåhan [the Governor] and the Speaker of I Liheslaturan Guåhan [the Legislature] outlining its accomplishments, specifi c findings and recommendations to improve Guam compliance with thi s policy. SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed an d reenacted by P.L. 27-047:1 (Dec. 17, 2003). COL37201410 GCA HEALTH AND SAFETY CH. 93 GUAM SYSTEM OF CARE COUNCIL FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE 2013 NOTE: Pursuant the authority granted by 1 GCA § 1606, n umbers and/or letters were altered to adhere to the Compiler’s al pha-numeric scheme. -------- COL372014
Guam Legal Code