take care and please keep in touch with the board xx
Can there by a backup plan in place for the weekend? Like if he becomes violent, he leaves. Is he on meds? Getting therapy? Any improvements. If he is getting some treatment and making any improvements, I can see why your husband would want to give him a chance to be with the family for a visit, but if not, I can't see putting the other children in danger.STEPHANIE
UNFORTUNATELY HE IS ON SOME MEDS, SERAQUEL AND CONCERTA, BUT HE IS GETTING WORSE INSTEAD OF BETTER, ESPECIALLY LATELY. THEY RECENTLY TOOK HIM OFF OF DEPAKOTE, FOR REASONS WE DON'T COMPLETELY UNDERSTAND, AND HE HAS BEEN DOING WORSE BUT THEY WON'T PUT HIM BACK ON IT AND THEY SAY THEY DON'T NEED OUR PERMISSION BECAUSE OF THE TYPE OF DRUG DEPAKOTE IS. HE IS OPENING UP IN THERAPTY MORE, HE HAS A THERAPTIST BECAUSE HE WAS SEVERELY ABUSED AND NEGLECTED BY HIS BIRTHMOTHER AND ALSO SUFFERS FROM PTSD AND RAD. BUT HIS BEHAVIOR SEEMS TO WORSEN WITH AGE. I FEEL THAT I HAVE TALKED MYSELF BLUE IN THE FACE AND THEY WON'T LISTEN TO MY PLEAS. I FEAR THAT BY TIME THEY DO LISTEN TO ME THAT IT WILL BE TOO LATE AND ONE OF MY SONS WILL BE SEVERELY HURT. DON'T GET ME WRONG, I TRUELY LOVE MY STEPSON AND HAVE BEEN HIS MOM SINCE HIS BIRTHMOM ABANDONED HIM BUT IT IS HARD WHEN YOU BOTH LOVE AND FEAR THAT CHILD. I FEEL STUCK.
Tammie,
Hi. I have a question. I know from personal experience having bipolar disorder myself and ADHD that when i was on drugs like concerta it caused me to go into manic states. The reason being is that Concerta is a stimulant simular to anphetamines. I would question his medications. Mania can cause anger and aggression and behavior that is life threatening to oneself and others. Especially in children because of the lack of knowing how to express oneself. You are rigth to question why he was taken off of the depakote ESPECIALLY since he is still taking the concerta. Depakote can sometimes alleviate the aggression effects of the concerta because depakote is used a lot for bipolar disorder. I myself personally will never again take a stimulant because of the fact that I am bipolar also. I at one time was on Seraquel also and it was not a drug that they used for my bipolar. It was used for my PTSD. It sounds to me like he needs bipolar drugs and if It were my kid....I would get him off the stimulant because of the fact that he is bipolar. Just my opinion.
Karrie
NAOMI
THANK YOU FOR YOUR RESPONSE. I DO HATE LIVING IN FEAR OF MY OWN STEPSON WHO I DO LOVE. BUT IT IS WORSE TO SEE MY 8 YEAR OLD SON DJ, WHO HAS SUFFERED MOST FROM EJ'S ILLNESS. HE WANTS SO BADLY TO LOVE HIM BUT I THINK HE IS CONFUSED BECAUSE HE ALSO FEARS HIM. MY 5 Y/O BJ HAS NOT HAD TO SUFFER AS MUCH BECAUSE EJ WAS PLACED SHORTLY AFTER HE WAS BORN. AND MY 2 Y/O AJ ALSO HAS BEEN FORTUNATE. BUT THE VISITS SEEM TO GOING WORSE EACH TIME. WHAT CAN I DO TO GET THEM TO LISTEN TO ME? UNFORTUNATELY MY HUSBAND I THINK HE FEELS SO SORRY FOR MY STEPSON BECAUSE OF HIS HORRIBLE PAST WITH HIS MOTHER, ABUSE AND NEGLECT, THAT HE IS IN SORT OF A DENIAL STAGE. I DONT'T FEEL THAT HE CAN SEE THE TRUE DANGER OR WON'T ADMIT IT. I CAN SOME WHAT UNDERSTAND HIS EMOTIONS BUT WE STILL NEED TO KEEP OUR SONS SAFE AS WELL. THANK YOU
KARRIE
THANK YOU FOR YOUR HELP. I'M AWARE OF THE EFFECTS OF STIMULATES ON BIPOLOR SUFFERERS. UNFORTUNATELY MY STEPSONS DRS TELL ME THEY KNOW BEST BUT I HAVE QUESTIONED THEM MANY TIMES. WE LEARNED THE HARD WAY OF WHAT STIMULATES CAN DO. BEFORE HE WAS DX BIPOLOR HE WAS BEING TREATED FOR ADHD, WHICH HE STILL HAS. HE WAS PUT ON ADDERALL, AND IT MADE HIM EXTREMELY VIOLENT. BUT IT SEEMS THE DRS HAVE NOT LEARNED THEIR LESSON. AND LIKE I SAY IT IS FRUSTRATING TO FEEL LIKE YOUR NOT BEING HEARD BECAUSE " YOU ARE NOT A PROFESSIONAL", EVEN THOUGH YOU HAVE SEEN THE EFFECTS YOURSELF AND LIVED THROUGH THEM. EJ HAS BEEN ON AND OFF SO MANY MEDS THAT HE IS A WALKING PHARMACY. IT SEEMS LIKE THEY RATHER GET HIM OFF MEDS LATELY THAN PUT HIM ON THEM. THEIR REASON FOR THE CONCERTA IS STILL ADHD BUT I DON'T SEE ANY BENEFITS FOR HIM WHILE ON IT. THANK YOU
Hi Tammie Welcome to the board. Sounds like a big mess you are in!
First off what type of facility is your step son placed in and WHO placed him there? It sounds like maybe you need to look into a different placement for him especially if they are not addressing his needs. (Kind of like changing doctors if you dont like the care) I would check into that.
I understand the concern for safety of your other children and yourselves as well as for your step son. How long has he been receiving therapy? Has there also been family therapy? What about IN HOME therapy? WHo decides about his visits home and how frequent are they and how long they last?
Heres what I see without any background info. Holidays are already stressful for EVERYONE. Alot of people around alot of commotion. It especially upsets our kids. I don't know about other autistic kids, but My son can't stand the sound of all the fireworks and doesnt enjoy watching the displays he become aggitated angry and usually stressed out to where he displays aggression or self injurious behaviors.
How verbal is your step son? can he communicate his wants needs and fears? Does he remember his home and who his family members are?
I would think the facility he is in would first start with family visits and counseling. Then small visits working from a few hour outtings to a full day on occassion eventually leading up to one overnight visit and gradually add up to a weekend visit as things progressed and went well. Without testing the waters and working up to a full visit I think they are setting EVERYONE involved up for failure.
If this has been done who is monitoring the progress of these visits? Who is reporting how things went?
It sounds to me like you and his father are on different pages on this. Maybe dad is in denial, maybe not. Things are never going to be perfect. Meds do not take away all the problems. They help to manage them. Kids will still become violent, aggressive, tantrum, etc. while on meds. NOTHING cures all.
You mention knifes beign put to your other child's throat! Does the place he is in know this happened? What did you do to handle the situation???! This is NOTHING to play with especially given his diagnosis. ALL knifes and any other dangerous materials need to be put up out of his reach or locked in a cabinet or drawer. YES I do know and undersrtand it is a pain in the neck. I HAVE HAD TO DO THIS MYSELF. But believe me when I tell you it is a MUST! You (already knowing he has a potential for violence or self injury) will be held liable if something happens! Was the incident reported?
In the future, anytime you have him with you for a visit and he does ANYTHING like this you MUST call 911 and have him taken to the hospital for a psychiatric evaluation IMMEDIATELY. Failing to do so is NOT helping him or the rest of your family. The other children who live this fear will then too have issues! By having him put in the hospital for an evaluation the HOSPITAL psychiatrist will determine what meds are best for him to be on and their dosage.
MICHELLE
MY STEPSON IS IN A GROUP HOME FOR CHILDREN WITH SPECIAL NEEDS. IT DOES HAVE A GOOD REPUTATION BUT I NOW I'M STARTING TO WONDER. BEFORE THERE HE SPENT 3 WEEKS IN A SHORT TERM HOSPITAL (THEY DX HIM W/PDD-NOS) WHERE WE HAD HIM ADMITTED AFTER WE FOUND OUT THAT HE WAS SEXUALLY MOLESTING OUR OLDEST SON AT NIGHT WHEN WE WERE SLEEPING. BEFORE THAT HE WAS IN A REGULAR FOSTER HOME WHERE SOCIAL SERVICES PLACED HIM BECAUSE HE WAS TOO DANGEROUS TO BE AT HOME. SO HE HAS BEEN OUT OF THE HOME FOR APPROX. 5 YRS NOW. WE WANTED HIM PLACED IN A TREATMENT FACILITY AT THE START BUT SOCIAL SERVICES WOULD NOT DO IT. AFTER WE TOOK HIM TO THE SHORT TERM HOSP. SOCIAL SERVICES FINALLY PUT HIM IN A LONG TERM FACILITY.
HE HAS BEEN WITH A THERAPIST EVER SINCE HE WAS 2-3, BUT NOT THE SAME ONE. THE ONE HE HAS NOW HE HAS HAD FOR ALMOST A YEAR. WE HAVE HAD SEVERAL HOME THERAPIST OVER THE LAST 5-6 YEARS. USUALLY IT IS ONLY ME WHO CAN ATTEND BECAUSE OF MY HUSBANDS WORK SCHEDULE, ALSO, MY OLDEST SON WORKS WITH HER AS WELL.
THINGS STARTED TO TURN AROUND WHEN HE WAS IN A FOSTER HOME BUT WE PULLED HIM OUT BECAUSE WE BELIEVED THAT HE WAS BEING MOLESTED BY AN OLDER FOSTER CHILD, IT LATER WAS FOUND OUT TO BE TRUE. HE STAYED WITH US FOR 3 MONTHS. BUT I KNEW SOMETHING WAS WRONG WHEN MY OLDEST SON STARTED TO DEFACAT IN HIS PANTS SEVERAL TIMES A DAY. MY HUSBAND DISMISSED IT AS LAZINESS. HE FINALLY GOT THE COURAGE TO TELL ME THAT EJ WAS TOUCHING HIM AT NIGHT WHEN WE WERE SLEEPING. HE HAS BEEN TOO AFAID TO TELL ME BEFORE EVEN WHEN I ASKED BECAUSE OF EJ'S THREATS. WHEN HE TOLD THE SOCIAL WORKER WHAT HE HAD TOLL ME THEY AGREED TO GET HIM SOME TREATMENT.
EVERYTHING HE HAS DONE TO MY SON HAS BEEN REPORTED TO SOCIAL SERVICES AND THE GROUP HOME BY ME. SO THEY ARE FULL AWARE.
EJ HAS BEEN THERE FOR NEARLY 2 YRS NOW. THIS IS A FACILITY THAT DOESN'T LIKE TO KEEP KIDS OVER A YR BECAUSE THEY HAVE A WAITING LIST. BUT THEY DON'T KNOW WHERE THEY CAN SAFELY PUT HIM.
BUT THEY STILL SEND HOME ON VISITS ONCE TO TWICE A MONTH.
If he sexually molested your son why would you want him back in your home? I thought they had procedures in place where the molester couldn't be around the victim.
Tammy
TABITHIA
YOU TOOK THE WORDS RIGHT OUT OF MY MOUTH! BUT THEY STILL INSIST HE "NEEDS" TO COME HOME FOR VISITS. THEY KNOW WHAT HE HAS DONE BUT THEY STILL DO IT. THEY TELL US THAT HE NEEDS 100% SUPERVISION 100% OF THE TIME AND EVEN ADMIT THEY UNDERSTAND THAT WE CANNOT DO IT BECAUSE OF OUR BOYS AND HAVE ADMITTED THAT THEIR 24 HOUR SUPERVISION FAILS AT TIMES AND HE COMITTS ACTS OF VIOLENCE THERE AS WELL. GO FIGURE!
MICHELLE
I REALIZED I DID NOT GIVE YOU ALL THE INFO YOU ASKED ABOUT.
THE VISITS ARE ARRANGED BEWEEM MY HUSBAND AND THE GROUP HOME. I DO NOT HAVE PHYISICAL CUSTODY, JUST MY HUSBAND.
MY HUSBAND DOWN PLAYS THESE INICIDENTS AS "ISOLATED". THE GROUP HOME, SOCIAL SERVICES AND THE THERAPIST WILL EVEN TELL YOU THAT THEY KNOW THEY DON'T GET THE WHOLE STORY FROM HIM. AND YES ME AND MY HUSBAND ARE ON TOTALLY DIFFERENT PAGES.
WHEN HE COMES HOME FOR VISITS I MAKE SURE ALL OBJECTS THAT CAN BE USED AS WEAPONS ARE PUT AWAY. BUT THE TIMES HE HAS DONE THESE THINGS I HAVE BEEN AT WORK AND ONLY DAD IS ONLY HOME WITH THEM. HE KNOWS THAT DAD DOESN'T WATCH HIM AS CLOSE AS I DO. MY HUSBAND GETS DISTRACTED VERY EASILY. HIS MOM AND I BOTH THINK HE SUFFERS FROM ADHD TOO. EJ IS VERY SNEAKING AND WAITS FOR RIGHT MOMENT TO MAKE HIS MOVE. THE ONE TIME HE GOT THE KNIFE FROM GRANDMAS HOUSE.
Tammie, Im sorry but if what you say has happened in the way you describe you need IMMEDIATE help.
A child who has been molested should never have to fear sharing the home with the molester again. There are laws to protect the victim and I would be asking about HIS rights. Understandably Your step son has been molested as well and should receive protection from his molester and ALL individuals need intensive counseling! If the social services arent providing this then you need to take it to the next level.
I would start making calls to the higher ups. You may not have any sort of legal custody over your step son, but you have custody and obligations over your own children. If that means getting a restraining order, or moving out, or leaving the home on the weekends the step son is there until it can be worked out then so be it. You need to do WHATEVER it takes to protect your kids from being threatened and molested or the cycle WILL continue to repeat itsself. I dont know what state you are in but there are places to turn for help. Start by calling the battered womans shelter as they have many contacts and much experience is advocating for the victims. Call the local police department if necessary. But protect the other kids from molestation at all costs.
Is your husband the father of the other boy(s) being molested? How does he feel for them?
MICHELLE
MY STEPSON WAS SEXUALLY MOLESTED BY HIS BIRTHMOM, A STEPGRANDPA AND A OLDER FOSTER BOY IN THE LAST FOSTER HOME HE WAS IN, HE HAS NOT BEEN AROUND ANY OF THEM FOR A LONG TIME AND WILL NOT HAVE ANY CONTACT WITH THEM AGAIN EITHER.
I FEEL LIKE A BROKEN RECORD WHEN I TRY TO PLEAD MY SONS RIGHTS TO THE GROUP HOME AND SOCIAL SERVICES. I'M TRYING TO LOOK UP STATUES TO FIND OUT THEIR LAWFUL RIGHTS EXACTLY. THIS MIGHT GET EASIER SINCE I HAVE NOW STARTED TO WORK AT THE LOCAL SHERIFFS OFFICE AS A JAILOR/DISPATCHER. THIS WILL BE MY STEPSONS FIRST VISIT SINCE I STARTED TO WORK HERE. I DO HAVE A LAW ENFORCEMENT DEGREE AND HOPE TO GET ON AS A DEPUTY. NOW I HAVE BETTER ACCESS TO LAWS AND STATUES, SO I HOPE TO EDUCATE MYSELF MORE ON FAMILY LAW. I HAVE ALWAYS BEEN AWARE THAT MY BOYS HAVE RIGHTS BUT DID NOT KNOW WHOELSE TO GET TO HELP ME PLEAD THEIR CASE, BECAUSE I ALONE HAVE NOT BEEN HEARD. I HAD NEVER THOUGHT OF THE BATTERED WOMENS SHELTER, I WILL GIVE THEM A CALL. DO YOU KNOW OF ANY OTHER GROUPS I MAY TURN TO? I LIVE IN MN. I HAVE ALSO THOUGHT OF THE SHERIFF HIMSELF FOR ADVISE BUT AM VERY NERVOUS ABOUT THAT BECAUSE HE DOES KNOW MY FAMILY WELL, HE IS NOT AWARE OF THIS SITUATION IN OUR LIVES THOUGH.
MY SON DID SEE A COUNSELOR FOR AWHILE AND STILL SEES HER ABOUT EVERY 2 WEEKS AS WELL AS ME AND THE YOUNGER BOYS AS WELL. SHE COMES TO OUR HOME. IT IS HARD FOR MY HUSBAND TO ATTEND THESE SESSIONS BECAUSE OF HIS WORK SCHEDULE BUT I TRY TO URGE HIM TO TRY TO ATTEND. MY SON IS DOING VERY WELL NOW BUT IT IS SOMETHING THAT IS IN THE BACK OF HIS MIND AND HE WILL NEVER FORGET.
MY HUSBAND IS THE FATHER OF OUR THREE BOYS. I FEEL HIS PITY FOR MY STEPSON IS BLINDING HIM. HE SO BADLY WANTS EJ TO BE NORMAL THAT HE TREATS HIM LIKE NORMAL AND I THINK HE IS IN DENIAL SOMETIMES THAT HE IS NOT NORMAL. UNFORTUNATELY I DO NOT TRUST MY HUSBAND TO PROVIDE THE NEEDED CARE FOR ALL OF THE BOYS WHEN EJ IS HOME BECAUSE OF HIS EMOTIONS TOWARD MY STEPSON. SOCIAL SERVICES AND THE GROUP HOME ARE AWARE OF THIS. MY HUSBAND DOES LOVE OUR BOYS DEARLY BUT WHEN IT COMES TO EJ HE DOES PUT THEIR SAFETY IN JEOPARDY.
I WELCOME YOUR RESPONSE SOON.
What do you expect law enforcement to do? He is 11 years old. And if he has pdd-nos, along with bipolar. there is a whole host of other issues going on with that. Maybe the 11 year old perceives the 8 year old as lying about him. So of course he would hate him. Especially if he suffers from delusional, grandiose thinking or some form of schizophrenia associated with the bipolar. All law enforcement could do is put him in a mental facility and have an psych eval done on him. I seriously doubt your hubby would go along with that. You said the kids mom and you think he has adhd. Well if his mom molested him and has no contact with him how would you know what she thinks? And if she did molest him why would her opinion matter anyway? You said you and your hubby got the boy when he was 2. But he was in foster care before the molestation took place? Then he was returned and after the molestation took place removed again? Maybe your hubby knows your feelings and attitudes toward the 11 year old and just doesn't discuss his treatment plans with you. You said the visits are arranged between your husband and the group home. Maybe your husband is keeping you out of the loop. In one of your previous posts you made a comment about depakote. I know depakote is given to children with bipolar and it is also used for mood stabilizers and seizures. You said something about the group home didn't need your permission on depakote, whether he takes it or not, because of the way that drug is. What do you mean?
Also how many visits home has he had? Is this his first one or what? And finally if he did molest your oldest son, why would you want him to hug his molester anyway? That seems to me to be sending mix signals. I mean do you leave your oldest son at the house when you go to work when the 11 year old is home? There are just several pieces missing to the puzzle still.
Tammy
TABITHA
I AM GOING TO ASK LAW ENFORCEMENT WHAT/IF THEY KNOW OF ANY ACTION I CAN TAKE TO PROTECT MY SONS SINCE THE GROUP HOME AND SOCIAL SERVICES DON'T STOP THE VISITS.
ALSO I SAID BEFORE THAT MY MOTHER IN LAW AND I BELIEVE THAT MY HUSBAND, HER SON, SUFFERS FROM ADULT ADHD. NOT MY STEPSONS MOM AND I. HIS BIRTH MOM HAS CHOOSEN TO ABANDON MY STEPSON. THERE HAS BEEN NO CONTACT WITH HER IN OVER 9 YEARS.
WE BELIEVE THAT MY STEPSON WAS SEXUALLY MOLESTED BY THE BIRTH MOM AND HER STEPDAD, HE IS A CONVICTED CHILD MOLESTER AND NOT SUPPOSED TO BE AROUND KIDS PERIOD. THIS IS BEFORE HE WAS TAKEN AWAY FROM HER AND WE GOT CUSTODY. THEN IN THE LAST FOSTER HOME MY STEPSON WAS IN (2001-2003)THERE WAS AN OLDER BOY WHO HAD A HISTORY OF ACTING OUT SEXUALLY. MY STEPSON HAS RECENTLY REVEALED IN THERAPTY THAT THAT OLDER BOY SEXUALLY MOLESTED HIM.
THE GROUP HOME SAITHAT DEPAKOTE'S CLASSIFIED AS A CERTAIN TYPE OF DRUG, I CAN'T REMEMBER THE NAME BUT I HAVE TO FIND OUT TOMORROW WHEN I TALK TO THEM. THERFORE THEY DO NOT NEED OUR PERMISSION TO TAKE HIM OFF OF IT.
I'M NOT SURE WHERE YOU GOT THE HUGGING THING, I NEVER SAID ANY THING ABOUT HUGGING. I WOULD NEVER FORCE ANY OF MY BOYS TO HUG ANYONE THEY AE UNCOMFORTABLE WITH.
IF I HAVE TO WORK ON A WEEKEND, THAT IS WHEN THE VISITS TAKE PLACE, (1-2 WEEKENDS/MONTH) MY HUSBAND WATCHES THE BOYS BECAUSE HE HAS THE WEEKENDS OFF. SO HE IS LEFT TO WATCH ALL 4 OF THE BOYS HIMSELF. I NEVER LEAVE MY KIDS ALONE NO MATTER WHAT THE SITUATION IS. HE HAS HAD MANY VISITS SINCE BEING PALCED IN THIS GROUP HOME. MY HUSBAND DOESN'T DISCUS VISITS BECAUSE HE KNOWS HOW I FEEL, AND THAT I WILL TRY AND STOP THE VISIT BECAUSE IT IS TOO DANGEROUS.
I ALSO GET "YOUR ONLY THE STEPMOM" TREATMENT FROM THE GROUP HOME AND SOCIAL SERVICES.
AS I POST MORE AND MORE POSTINGS THE MISSING PIECES WILL BE PUT TOGETHER FOR YOU. THERE IS JUST SO MUCH HISTORY TO GO THROUGH THAT I COULD TYPE AND TYPE FOR HOURS AND HOURS.
http://www.revisor.leg.state.mn.us/stats/245/4871.html
245.4871 Definitions.
Subdivision 1. Definitions. The definitions in this
section apply to sections 245.487 to 245.4887.
Subd. 2. Acute care hospital inpatient treatment.
"Acute care hospital inpatient treatment" means short-term
medical, nursing, and psychosocial services provided in an acute
care hospital licensed under chapter 144.
Subd. 3. Case management services. "Case management
services" means activities that are coordinated with the family
community support services and are designed to help the child
with severe emotional disturbance and the child's family obtain
needed mental health services, social services, educational
services, health services, vocational services, recreational
services, and related services in the areas of volunteer
services, advocacy, transportation, and legal services. Case
management services include assisting in obtaining a
comprehensive diagnostic assessment, if needed, developing a
functional assessment, developing an individual family community
support plan, and assisting the child and the child's family in
obtaining needed services by coordination with other agencies
and assuring continuity of care. Case managers must assess and
reassess the delivery, appropriateness, and effectiveness of
services over time.
Subd. 4. Case management service provider. (a) "Case
management service provider" means a case manager or case
manager associate employed by the county or other entity
authorized by the county board to provide case management
services specified in subdivision 3 for the child with severe
emotional disturbance and the child's family.
(b) A case manager must:
(1) have experience and training in working with children;
(2) have at least a bachelor's degree in one of the
behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an
accredited college or university or meet the requirements of
paragraph (d);
(3) have experience and training in identifying and
assessing a wide range of children's needs;
(4) be knowledgeable about local community resources and
how to use those resources for the benefit of children and their
families; and
(5) meet the supervision and continuing education
requirements of paragraphs (e), (f), and (g), as applicable.
(c) A case manager may be a member of any professional
discipline that is part of the local system of care for children
established by the county board.
(d) A case manager without a bachelor's degree must meet
one of the requirements in clauses (1) to (3):
(1) have three or four years of experience as a case
manager associate;
(2) be a registered nurse without a bachelor's degree who
has a combination of specialized training in psychiatry and work
experience consisting of community interaction and involvement
or community discharge planning in a mental health setting
totaling three years; or
(3) be a person who qualified as a case manager under the
1998 Department of Human Services waiver provision and meets the
continuing education, supervision, and mentoring requirements in
this section.
(e) A case manager with at least 2,000 hours of supervised
experience in the delivery of mental health services to children
must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year, of which at least one
hour per month must be clinical supervision regarding individual
service delivery with a case management supervisor. The other
26 hours of supervision may be provided by a case manager with
two years of experience. Group supervision may not constitute
more than one-half of the required supervision hours.
(f) A case manager without 2,000 hours of supervised
experience in the delivery of mental health services to children
with emotional disturbance must:
(1) begin 40 hours of training approved by the commissioner
of human services in case management skills and in the
characteristics and needs of children with severe emotional
disturbance before beginning to provide case management
services; and
(2) receive clinical supervision regarding individual
service delivery from a mental health professional at least one
hour each week until the requirement of 2,000 hours of
experience is met.
(g) A case manager who is not licensed, registered, or
certified by a health-related licensing board must receive 30
hours of continuing education and training in severe emotional
disturbance and mental health services every two years.
(h) Clinical supervision must be documented in the child's
record. When the case manager is not a mental health
professional, the county board must provide or contract for
needed clinical supervision.
(i) The county board must ensure that the case manager has
the freedom to access and coordinate the services within the
local system of care that are needed by the child.
(j) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case
management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent;
and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the
behavioral sciences or human services;
(ii) be a registered nurse without a bachelor's degree;
(iii) have three years of life experience as a primary
caregiver to a child with serious emotional disturbance as
defined in section 245.4871, subdivision 6, within the previous
ten years;
(iv) have 6,000 hours work experience as a nondegreed state
hospital technician; or
(v) be a mental health practitioner as defined in
subdivision 26, clause (2).
Individuals meeting one of the criteria in items (i) to
(iv) may qualify as a case manager after four years of
supervised work experience as a case manager associate.
Individuals meeting the criteria in item (v) may qualify as a
case manager after three years of supervised experience as a
case manager associate.
(k) Case manager associates must meet the following
supervision, mentoring, and continuing education requirements;
(1) have 40 hours of preservice training described under
paragraph (f), clause (1);
(2) receive at least 40 hours of continuing education in
severe emotional disturbance and mental health service annually;
and
(3) receive at least five hours of mentoring per week from
a case management mentor. A "case management mentor" means a
qualified, practicing case manager or case management supervisor
who teaches or advises and provides intensive training and
clinical supervision to one or more case manager associates.
Mentoring may occur while providing direct services to consumers
in the office or in the field and may be provided to individuals
or groups of case manager associates. At least two mentoring
hours per week must be individual and face-to-face.
(l) A case management supervisor must meet the criteria for
a mental health professional as specified in section 245.4871,
subdivision 27.
(m) An immigrant who does not have the qualifications
specified in this subdivision may provide case management
services to child immigrants with severe emotional disturbance
of the same ethnic group as the immigrant if the person:
(1) is currently enrolled in and is actively pursuing
credits toward the completion of a bachelor's degree in one of
the behavioral sciences or related fields at an accredited
college or university;
(2) completes 40 hours of training as specified in this
subdivision; and
(3) receives clinical supervision at least once a week
until the requirements of obtaining a bachelor's degree and
2,000 hours of supervised experience are met.
Subd. 5. Child. "Child" means a person under 18
years of age.
Subd. 6. Child with severe emotional disturbance.
For purposes of eligibility for case management and family
community support services, "child with severe emotional
disturbance" means a child who has an emotional disturbance and
who meets one of the following criteria:
(1) the child has been admitted within the last three years
or is at risk of being admitted to inpatient treatment or
residential treatment for an emotional disturbance; or
(2) the child is a Minnesota resident and is receiving
inpatient treatment or residential treatment for an emotional
disturbance through the interstate compact; or
(3) the child has one of the following as determined by a
mental health professional:
(i) psychosis or a clinical depression; or
(ii) risk of harming self or others as a result of an
emotional disturbance; or
(iii) psychopathological symptoms as a result of being a
victim of physical or sexual abuse or of psychic trauma within
the past year; or
(4) the child, as a result of an emotional disturbance, has
significantly impaired home, school, or community functioning
that has lasted at least one year or that, in the written
opinion of a mental health professional, presents substantial
risk of lasting at least one year.
The term "child with severe emotional disturbance" shall be
used only for purposes of county eligibility determinations. In
all other written and oral communications, case managers, mental
health professionals, mental health practitioners, and all other
providers of mental health services shall use the term "child
eligible for mental health case management" in place of "child
with severe emotional disturbance."
Subd. 7. Clinical supervision. "Clinical supervision"
means the oversight responsibility for individual treatment
plans and individual mental health service delivery, including
that provided by the case manager. Clinical supervision does
not include authority to make or terminate court-ordered
placements of the child. Clinical supervision must be
accomplished by full-time or part-time employment of or
contracts with mental health professionals. The mental health
professional must document the clinical supervision by cosigning
individual treatment plans and by making entries in the client's
record on supervisory activities.
Subd. 8. Commissioner. "Commissioner" means the
commissioner of human services.
Subd. 9. County board. "County board" means the
county board of commissioners or board established under the
Joint Powers Act, section 471.59, or the Human Services Act,
sections 402.01 to 402.10.
Subd. 9a. Crisis assistance. "Crisis assistance"
means assistance to the child, the child's family, and all
providers of services to the child to: recognize factors
precipitating a mental health crisis, identify behaviors related
to the crisis, and be informed of available resources to resolve
the crisis. Crisis assistance requires the development of a
plan which addresses prevention and intervention strategies to
be used in a potential crisis. Other interventions include:
(1) arranging for admission to acute care hospital inpatient
treatment; (2) crisis placement; (3) community resources for
follow-up; and (4) emotional support to the family during
crisis. Crisis assistance does not include services designed to
secure the safety of a child who is at risk of abuse or neglect
or necessary emergency services.
Subd. 10. Day treatment services. "Day treatment,"
"day treatment services," or "day treatment program" means a
structured program of treatment and care provided to a child in:
(1) an outpatient hospital accredited by the Joint
Commission on Accreditation of Health Organizations and licensed
under sections 144.50 to 144.55;
(2) a community mental health center under section 245.62;
(3) an entity that is under contract with the county board
to operate a program that meets the requirements of section
245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to
9505.0475; or
(4) an entity that operates a program that meets the
requirements of section 245.4884, subdivision 2, and Minnesota
Rules, parts 9505.0170 to 9505.0475, that is under contract with
an entity that is under contract with a county board.
Day treatment consists of group psychotherapy and other
intensive therapeutic services that are provided for a minimum
three-hour time block by a multidisciplinary staff under the
clinical supervision of a mental health professional. Day
treatment may include education and consultation provided to
families and other individuals as an extension of the treatment
process. The services are aimed at stabilizing the child's
mental health status, and developing and improving the child's
daily independent living and socialization skills. Day
treatment services are distinguished from day care by their
structured therapeutic program of psychotherapy services. Day
treatment services are not a part of inpatient hospital or
residential treatment services. Day treatment services for a
child are an integrated set of education, therapy, and family
interventions.
A day treatment service must be available to a child at
least five days a week throughout the year and must be
coordinated with, integrated with, or part of an education
program offered by the child's school.
Subd. 11. Diagnostic assessment. "Diagnostic
assessment" means a written evaluation by a mental health
professional of:
(1) a child's current life situation and sources of stress,
including reasons for referral;
(2) the history of the child's current mental health
problem or problems, including important developmental
incidents, strengths, and vulnerabilities;
(3) the child's current functioning and symptoms;
(4) the child's diagnosis including a determination of
whether the child meets the criteria of severely emotionally
disturbed as specified in subdivision 6; and
(5) the mental health services needed by the child.
Subd. 12. Mental health identification and intervention
services. "Mental health identification and intervention
services" means services that are designed to identify children
who are at risk of needing or who need mental health services
and that arrange for intervention and treatment.
Subd. 13. Education and prevention services. (a)
"Education and prevention services" means services designed to:
(1) educate the general public and groups identified as at
risk of developing emotional disturbance under section 245.4872,
subdivision 3;
(2) increase the understanding and acceptance of problems
associated with emotional disturbances;
(3) improve people's skills in dealing with high-risk
situations known to affect children's mental health and
functioning; and
(4) refer specific children or their families with mental
health needs to mental health services.
(b) The services include distribution to individuals and
agencies identified by the county board and the local children's
mental health advisory council of information on predictors and
symptoms of emotional disturbances, where mental health services
are available in the county, and how to access the services.
Subd. 14. Emergency services. "Emergency services"
means an immediate response service available on a 24-hour,
seven-day-a-week basis for each child having a psychiatric
crisis, a mental health crisis, or a mental health emergency.
Subd. 15. Emotional disturbance. "Emotional
disturbance" means an organic disorder of the brain or a
clinically significant disorder of thought, mood, perception,
orientation, memory, or behavior that:
(1) is listed in the clinical manual of the International
Classification of Diseases (ICD-9-CM), current edition, code
range 290.0 to 302.99 or 306.0 to 316.0 or the corresponding
code in the American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM-MD), current
edition, Axes I, II, or III; and
(2) seriously limits a child's capacity to function in
primary aspects of daily living such as personal relations,
living arrangements, work, school, and recreation.
"Emotional disturbance" is a generic term and is intended
to reflect all categories of disorder described in DSM-MD,
current edition as "usually first evident in childhood or
adolescence."
Subd. 16. Family. "Family" means a child and one or
more of the following persons whose participation is necessary
to accomplish the child's treatment goals: (1) a person related
to the child by blood, marriage, or adoption; (2) a person who
is the child's foster parent or significant other; (3) a person
who is the child's legal representative.
Subd. 17. Family community support services. "Family
community support services" means services provided under the
clinical supervision of a mental health professional and
designed to help each child with severe emotional disturbance to
function and remain with the child's family in the community.
Family community support services do not include acute care
hospital inpatient treatment, residential treatment services, or
regional treatment center services. Family community support
services include:
(1) client outreach to each child with severe emotional
disturbance and the child's family;
(2) medication monitoring where necessary;
(3) assistance in developing independent living skills;
(4) assistance in developing parenting skills necessary to
address the needs of the child with severe emotional
disturbance;
(5) assistance with leisure and recreational activities;
(6) crisis assistance, including crisis placement and
respite care;
(7) professional home-based family treatment;
(8) foster care with therapeutic supports;
(9) day treatment;
(10) assistance in locating respite care and special needs
day care; and
(11) assistance in obtaining potential financial resources,
including those benefits listed in section 245.4884, subdivision
5.
Subd. 18. Functional assessment. "Functional
assessment" means an assessment by the case manager of the
child's:
(1) mental health symptoms as presented in the child's
diagnostic assessment;
(2) mental health needs as presented in the child's
diagnostic assessment;
(3) use of drugs and alcohol;
(4) vocational and educational functioning;
(5) social functioning, including the use of leisure time;
(6) interpersonal functioning, including relationships with
the child's family;
(7) self-care and independent living capacity;
(8) medical and dental health;
(9) financial assistance needs;
(10) housing and transportation needs; and
(11) other needs and problems.
Subd. 19. Individual family community support plan.
"Individual family community support plan" means a written plan
developed by a case manager in conjunction with the family and
the child with severe emotional disturbance on the basis of a
diagnostic assessment and a functional assessment. The plan
identifies specific services needed by a child and the child's
family to:
(1) treat the symptoms and dysfunctions determined in the
diagnostic assessment;
(2) relieve conditions leading to emotional disturbance and
improve the personal well-being of the child;
(3) improve family functioning;
(4) enhance daily living skills;
(5) improve functioning in education and recreation
settings;
(6) improve interpersonal and family relationships;
(7) enhance vocational development; and
(8) assist in obtaining transportation, housing, health
services, and employment.
Subd. 20. Individual placement agreement.
"Individual placement agreement" means a written agreement or
supplement to a service contract entered into between the county
board and a service provider on behalf of a child to provide
residential treatment services.
Subd. 21. Individual treatment plan. "Individual
treatment plan" means a written plan of intervention, treatment,
and services for a child with an emotional disturbance that is
developed by a service provider under the clinical supervision
of a mental health professional on the basis of a diagnostic
assessment. An individual treatment plan for a child must be
developed in conjunction with the family unless clinically
inappropriate. The plan identifies goals and objectives of
treatment, treatment strategy, a schedule for accomplishing
treatment goals and objectives, and the individuals responsible
for providing treatment to the child with an emotional
disturbance.
Subd. 22. Legal representative. "Legal
representative" means a guardian, conservator, or guardian ad
litem of a child with an emotional disturbance authorized by the
court to make decisions about mental health services for the
child.
Subd. 23. Repealed, 1991 c 94 s 25
Subd. 24. Local system of care. "Local system of
care" means services that are locally available to the child and
the child's family. The services are mental health, social
services, correctional services, education services, health
services, and vocational services.
Subd. 24a. Mental health crisis services. "Mental
health crisis services" means crisis assessment, crisis
intervention, and crisis stabilization services.
Subd. 25. Mental health funds. "Mental health funds"
are funds expended under sections 245.73 and 256E.12, federal
mental health block grant funds, and funds expended under
section 256D.06 to facilities licensed under Minnesota Rules,
parts 9520.0500 to 9520.0690.
Subd. 26. Mental health practitioner. "Mental health
practitioner" means a person providing services to children with
emotional disturbances. A mental health practitioner must have
training and experience in working with children. A mental
health practitioner must be qualified in at least one of the
following ways:
(1) holds a bachelor's degree in one of the behavioral
sciences or related fields from an accredited college or
university and:
(i) has at least 2,000 hours of supervised experience in
the delivery of mental health services to children with
emotional disturbances; or
(ii) is fluent in the non-English language of the ethnic
group to which at least 50 percent of the practitioner's clients
belong, completes 40 hours of training in the delivery of
services to children with emotional disturbances, and receives
clinical supervision from a mental health professional at least
once a week until the requirement of 2,000 hours of supervised
experience is met;
(2) has at least 6,000 hours of supervised experience in
the delivery of mental health services to children with
emotional disturbances;
(3) is a graduate student in one of the behavioral sciences
or related fields and is formally assigned by an accredited
college or university to an agency or facility for clinical
training; or
(4) holds a master's or other graduate degree in one of the
behavioral sciences or related fields from an accredited college
or university and has less than 4,000 hours post-master's
experience in the treatment of emotional disturbance.
Subd. 27. Mental health professional. "Mental health
professional" means a person providing clinical services in the
diagnosis and treatment of children's emotional disorders. A
mental health professional must have training and experience in
working with children consistent with the age group to which the
mental health professional is assigned. A mental health
professional must be qualified in at least one of the following
ways:
(1) in psychiatric nursing, the mental health professional
must be a registered nurse who is licensed under sections
148.171 to 148.285 and who is certified as a clinical specialist
in child and adolescent psychiatric or mental health nursing by
a national nurse certification organization or who has a
master's degree in nursing or one of the behavioral sciences or
related fields from an accredited college or university or its
equivalent, with at least 4,000 hours of post-master's
supervised experience in the delivery of clinical services in
the treatment of mental illness;
(2) in clinical social work, the mental health professional
must be a person licensed as an independent clinical social
worker under section 148B.21, subdivision 6, or a person with a
master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's
supervised experience in the delivery of clinical services in
the treatment of mental disorders;
(3) in psychology, the mental health professional must be
an individual licensed by the board of psychology under sections
148.88 to 148.98 who has stated to the board of psychology
competencies in the diagnosis and treatment of mental disorders;
(4) in psychiatry, the mental health professional must be a
physician licensed under chapter 147 and certified by the
American board of psychiatry and neurology or eligible for board
certification in psychiatry;
(5) in marriage and family therapy, the mental health
professional must be a marriage and family therapist licensed
under sections 148B.29 to 148B.39 with at least two years of
post-master's supervised experience in the delivery of clinical
services in the treatment of mental disorders or emotional
disturbances; or
(6) in allied fields, the mental health professional must
be a person with a master's degree from an accredited college or
university in one of the behavioral sciences or related fields,
with at least 4,000 hours of post-master's supervised experience
in the delivery of clinical services in the treatment of
emotional disturbances.
Subd. 28. Mental health services. "Mental health
services" means at least all of the treatment services and case
management activities that are provided to children with
emotional disturbances and are described in sections 245.487 to
245.4887.
Subd. 29. Outpatient services. "Outpatient services"
means mental health services, excluding day treatment and
community support services programs, provided by or under the
clinical supervision of a mental health professional to children
with emotional disturbances who live outside a hospital.
Outpatient services include clinical activities such as
individual, group, and family therapy; individual treatment
planning; diagnostic assessments; medication management; and
psychological testing.
Subd. 30. Parent. "Parent" means the birth or
adoptive mother or father of a child. This definition does not
apply to a person whose parental rights have been terminated in
relation to the child.
Subd. 31. Professional home-based family treatment.
"Professional home-based family treatment" means intensive
mental health services provided to children because of an
emotional disturbance (1) who are at risk of out-of-home
placement; (2) who are in out-of-home placement; or (3) who are
returning from out-of-home placement. Services are provided to
the child and the child's family primarily in the child's home
environment. Services may also be provided in the child's
school, child care setting, or other community setting
appropriate to the child. Services must be provided on an
individual family basis, must be child-oriented and
family-oriented, and must be designed using information from
diagnostic and functional assessments to meet the specific
mental health needs of the child and the child's family.
Examples of services are: (1) individual therapy; (2) family
therapy; (3) client outreach; (4) assistance in developing
individual living skills; (5) assistance in developing parenting
skills necessary to address the needs of the child; (6)
assistance with leisure and recreational services; (7) crisis
assistance, including crisis respite care and arranging for
crisis placement; and (8) assistance in locating respite and
child care. Services must be coordinated with other services
provided to the child and family.
Subd. 32. Residential treatment. "Residential
treatment" means a 24-hour-a-day program under the clinical
supervision of a mental health professional, in a community
residential setting other than an acute care hospital or
regional treatment center inpatient unit, that must be licensed
as a residential treatment program for children with emotional
disturbances under Minnesota Rules, parts 9545.0900 to
9545.1090, or other rules adopted by the commissioner.
Subd. 33. Service provider. "Service provider" means
either a county board or an individual or agency including a
regional treatment center under contract with the county board
that provides children's mental health services funded under
sections 245.487 to 245.4887.
Subd. 33a. Culturally informed mental health
consultant. "Culturally informed mental health consultant" is
a person who is recognized by the culture as one who has
knowledge of a particular culture and its definition of health
and mental health; and who is used as necessary to assist the
county board and its mental health providers in assessing and
providing appropriate mental health services for children from
that particular cultural, linguistic, or racial heritage and
their families.
Subd. 34. Therapeutic support of foster care.
"Therapeutic support of foster care" means the mental health
training and mental health support services and clinical
supervision provided by a mental health professional to foster
families caring for children with severe emotional disturbance
to provide a therapeutic family environment and support for the
child's improved functioning.
Subd. 35. Transition services. "Transition services"
means mental health services, designed within an outcome
oriented process that promotes movement from school to
postschool activities, including postsecondary education,
vocational training, integrated employment including supported
employment, continuing and adult education, adult mental health
and social services, other adult services, independent living,
or community participation.
HIST: 1989 c 282 art 4 s 38; 1990 c 568 art 5 s 11,34; 1991 c
292 art 6 s 13-15,58 subd 1; 1992 c 526 s 2; 1992 c 571 art 10 s
11; 1993 c 339 s 3; 1Sp1993 c 1 art 7 s 8; 1995 c 207 art 8 s
2-4; 1996 c 451 art 5 s 5; 1998 c 407 art 4 s 4; 1999 c 86 art 1
s 57; 1999 c 159 s 30; 1999 c 172 s 16; 1999 c 245 art 5 s 6,7;
2000 c 474 s 4; 2000 c 499 s 33; 1Sp2001 c 9 art 9 s 10-12; 2002
c 375 art 2 s 6; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 11 s
11
Copyright 2004 by the Office of Revisor of Statutes, State of Minnesota
http://www.revisor.leg.state.mn.us/stats/260C/007.html
260C.007 Definitions.
Subdivision 1. Scope. As used in this chapter, the
terms defined in this section have the same meanings given to
them.
Subd. 2. Agency. "Agency" means the responsible
social services agency or a licensed child-placing agency.
Subd. 3. Case plan. "Case plan" means any plan for
the delivery of services to a child and parent or guardian, or,
when reunification is not required, the child alone, that is
developed according to the requirements of section 245.4871,
subdivision 19 or 21; 245.492, subdivision 16; 256B.092;
260C.212, subdivision 1; or 626.556, subdivision 10.
Subd. 4. Child. "Child" means an individual under 18
years of age.
Subd. 5. Child abuse. "Child abuse" means an act
that involves a minor victim and that constitutes a violation of
section 609.221, 609.222, 609.223, 609.224, 609.2242, 609.322,
609.324, 609.342, 609.343, 609.344, 609.345, 609.377, 609.378,
617.246, or an act committed in another state that involves a
minor victim and would constit