4533. Behavioral Rehabilitation Services

Approval: Connie Lambert-Eckel, Assistant Secretary

Effective Date: September 27, 1995 

Revised Date: July 1, 2018 

Sunset Review: July 1, 2021


Purpose

Behavior Rehabilitation Services (BRS) is a temporary intensive wraparound support and treatment program for children and youth with high-level complex service needs. BRS is intended to stabilize children and youth (in-home or out-of-home) and assist them in achieving their permanent plan.

BRS services are intended to:

  • Keep children and youth in their own homes with supports to the family.
  • Reunify or achieve alternative permanency more quickly.
  • Meet the needs of children and youth in family-based care to prevent the need for placement into a more restrictive setting.
  • Reduce length of service by transitioning children and youth to a permanent home or less intensive service.

Laws

RCW 74.13.080 Group Care Placement- Prerequisites for payments

RCW 74.13.031 Duties of Department- Child Welfare Services- Children’s Services advisory committee.

RCW 13.34.130 Order of disposition for a dependent child, alternatives- Placement with relatives, foster family home, group care facility, or other suitable persons

Policy

  1. Prior to considering or referring to BRS, children and youth must be referred for and receive a Wraparound Intensive Services (WISe) screen. 
    1. If the WISe screen shows the child or youth is eligible for services and recommended, WISe must be given priority. 
    2. If WISe cannot safely serve the youth’s need or the needs are greater than WISe can provide, consider BRS. 
    3. If the WISe agency declines or is unable to complete the screen in a timely manner and the child or youth requires intensive services to meet their needs, consider BRS.
  2. Children and youth with high-level complex service needs are eligible for BRS when they meet all of the following:
    1. Have been referred to and received a WISe screen from a provider on the WISe Referral Contact List.
    2. Meet specific BRS criteria.
    3. Have all the required approvals on the BRS referral form DSHS 10-166A.
  3. BRS can only be provided from contracted BRS service providers. BRS ongoing contracts can be issued to out-of-state agencies only if they are located within 50 miles of Washington state.
  4. When a child or youth’s individual service needs are beyond what can be provided through the BRS contract and other more intensive services are needed, follow Placement - Intensive Resources policy.
  5. The caseworker assigned to the child or youth must participate in the BRS Child and Family Team (CFT) case review meetings, and facilitate the discussion to identify a targeted discharge date and transition placement.
  6. Regional Administrator (RA) or designee Administrative Approval is required:
    1. To extend BRS beyond 12 months.
    2. For a youth enrolled in Extended Foster Care (EFC) to receive BRS.

Procedures

  1. Eligibility and Referral
    1. Before a BRS referral is made, the caseworker must:
      1. Refer the child or youth for a WISe screen from a provider on the WISe Referral Contact List, if a WISe screen has not already been completed, and obtain a copy of the screen for the case record.
      2. Consult with the regional BRS manager to determine if a BRS referral is needed, if the child or youth is not eligible to receive WISe services or WISe services are not able to meet their needs.
      3. Document the barriers to WISe in the WISe section of the BRS referral form DSHS 10-166A if a child or youth is eligible and recommended for WISe, but WISe is unable to meet the child or youth service needs.
      4. Conduct a Shared Planning Meeting or Family Team Decision Making (FTDM) meeting to identify needed supports and services for the child or youth, and family and determine if BRS is an appropriate and needed resource for the youth.
    2. If the Shared Planning Meeting or FTDM meeting determines BRS is needed, the caseworker must:
      1. Complete a BRS referral form DSHS 10-166A and BRS packet.
      2. Review the WISe results and:
        1. Include a copy of the completed WISe screen results in the BRS packet.
        2. If a copy of WISe screen result is not available, document the results on the BRS Referral form DSHS 10-166A.
        3. If a WISe screen was requested, but not completed, document the date request was made, the reason why it was not completed and the plan to complete the screen on the BRS Referral form DSHS 10-166A.
        4. Document in FamLink case notes when a WISe referral is made, WISe screening completion date and the results of the screening.
      3. Obtain supervisor and area administrator (AA) approval and send the BRS referral packet to the regional BRS manager for final approval.
      4. For out-of-state BRS contracted agencies:
        1. Complete the Interstate Compact on the Placement of Children (ICPC) paperwork for any dependent child or youth who will be place outside Washington state.
        2. Obtain court approval as required for any dependent child or youth who will be placed outside Washington state.
        3. For those children or youth requiring an out-of-state child specific contract follow Placement - Intensive Resources policy. 
    3. The regional BRS manager must:
      1. Review the BRS referral packet.
      2. Verify that a WISe screen referral was made according to WISe policy and the results are included in the BRS referral packet.
      3. If a WISe screen was not completed, verify:
        1. The date the caseworker requested the WISe screen and why it was not completed on the BRS referral form DSHS 10-166A.
        2. The plan to complete the screen.
      4. Determine the child or youth's eligibility for BRS and review the child or youth's discharge or permanency plan.
      5. Send the BRS referral packet to the contracted service provider and negotiate the service level needed.
      6. Once the provider, service level and contracted rate has been determined, notify the caseworker.
      7. When the child or youth's supervision needs exceed the BRS level of care:
        1. Negotiate one-to-one supervision as needed to address the child or youth’s specific behaviors with in-state agencies if possible.
        2. If one-to-one supervision through the BRS provider does not meet the specific needs of the child or youth, follow Placement - Intensive Resources policy for Intensive Residential Child Specific contracts.
  2. Service Period (in-home or out-of-home)
    1. The regional BRS manager must document the service type, placement if needed, and payment in FamLink.
    2. The caseworker must:
      1. Participate in CFT case review meetings at least quarterly. Actively involve the child or youth, their family and other identified supports in case planning. CFT meetings are usually held in the family's community, whenever possible and include the child or youth, parents, licensed or unlicensed caregivers, family members, community members, mental health professionals, educators, and other support individuals agreed to by the family.
      2. Focus CFT meetings on measurable outcomes related to their safety, stability, permanency and discharge planning including transition to less intensive services or a permanent home.
      3. During CFT case reviews with the BRS provider:
        1. Discuss WISe screen results every six months.
        2. Review progress and discharge reports from the provider.  WISe screen results should be included. BRS providers are required to refer child or youth for a WISe screen from the WISe Referral Contact List at least every six months and prior to discharge.
        3. Document the results of case review in FamLink case notes.
      4. Follow WISe policy as it pertains to the child or youth in BRS.
      5. Share information with the dependent child or youth about the court processes and their right to request legal representation.
      6. Assist youth age 15 years and older and in out-of-home care for more than 30 calendar days in completing the Casey Life Skills Assessment (CLSA) and Learning Plan (LP) per the CA Responsibilities to Dependent Youth 12 and Older policy.
      7. Complete a personalized, youth directed Transition Plan (for Dependent Youth 17 through 20 years).
      8. To extend BRS when barriers exist that prevent the child or youth from transitioning out of BRS within 12 months:
        1. Obtain written approval from the RA or their designee prior to the 12th month and every six months thereafter.
        2. Provide a copy of the written approval to the regional BRS manager.
      9. Follow EFC policy for a youth to remain in BRS past their 18th birthday. Obtain written approval from RA or their designee and every six months thereafter, and send a copy of the written approval to the regional BRS manager.
    3. The regional BRS manager must:
      1. Provide oversight, guidance, consultation regarding BRS provider's compliance. Including quality of service, outcomes and performance.
      2. Monitor and track regional BRS data, including but not limited to:
        1. Date of entry
        2. Exit
        3. Length of stay
        4. Placement type
        5. Service and rate
      3. Review the child or youth's service needs, level of care, expected exit date, and transition plan every six months and in collaboration with the caseworker and contracted service provider.
      4. Negotiate and approve one-to-one supervision as needed for the child or youth in group homes or staffed residential settings using the Child Specific Contract Rate form DSHS 10-490.
      5. Participate in CFT meetings when possible.
  3. Aftercare following out-of-home BRS
    1. Aftercare services may be provided to a youth transitioning out of BRS to a less restrictive environment.
    2. The caseworker must participate in CFT meetings at least quarterly to discuss aftercare wraparound planning that supports the child or youth and family to achieve stability, permanency or placement transition.
    3. The regional BRS manager must:
      1. Consult with the caseworker to develop an aftercare service plan.
      2. Negotiate with the contracted provider on an aftercare service plan.

Forms and Resources