Guam § 93102 - Definitions.

§ 93102. Definitions.

As used in reference to the planning, implementation, and evaluation of

the Guam System of Care Council for Children with Serious Emotional

Disturbance, the following terms are defined:

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(a) ‘Access to services’: the right to, and ease in 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 the needed and

desired activities.

(c) ‘Case Management/Care Coordination’: the task of

coordinating various service components and ensuring that service

needs are assessed and reassessed over time. In systems of care, case

management also denotes the actual provision of services, as opposed

to the limited ‘brokering’ of services in traditional mental health

systems. In some settings, the term ‘care coordination’ is used instead

of case management to connote broader job requirements and to

describe the actual case management model being used.

(d) ‘Care coordination’: the task of coordinating various service

components and ensuring that service needs are assessed and reassessed

over time. In systems of care, care coordination also denotes the actual

provision of services, as opposed to the limited ‘brokering’ of services

in traditional mental health systems.

(e) ‘Care Coordinator’: an individual assigned with the

responsibilities of coordinating the care of the child 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 serve.

(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 person who is

under the age of eighteen (18) years old, or is under 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 following

characteristics for more than six (6) months:

(1) has received a DSM-IV diagnosis on axis I or II; or

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(2) exhibits severe behavioral, emotional or social disabilities

that cannot be attributed solely to intellectual, physical or sensory

deficits, such as, but not limited to:

(A) behaviors that are sufficiently intense or severe

enough to be considered seriously detrimental to the child’s

growth, development, or welfare, or to the safety or welfare

of others;

(B) behaviors that, although possibly provoked, are

judged to be extreme or out of proportion to the provocation,

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) behaviors that

require interdisciplinary services and intensive, well-

coordinated care to be successfully managed.

(h) ‘CMHI qualifying child with a serious emotional disturbance’:

for the purposes of the Child Mental Health Initiative cooperative

agreement, the target population for CMHI/ Project I Famagu'onta is:

Children and Adolescents who: a) are under twenty-two (22) years of

age; b) have an emotional, behavioral, or mental disorder diagnosable

under DSM-IV or its ICD-9-CM equivalents, or subsequent 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 such that the child or

adolescent requires multiagency intervention involving two (2) or more

community service agencies, such as mental health, education, child

welfare, juvenile justice, substance abuse, and health; 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 intervention, is expected to

last more than one (1) year.

(i) ‘Child Mental Health Initiative, (CMHI)’: a Congressionally-

funded program initiative under the U.S. Department of Health and

Human Services, managed by its Substance Abuse and Mental Health

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Services Administration (SAMHSA), and designed to provide funding

for the infrastructure development needed to create a system of care.

(j) ‘Child at risk for serious emotional disturbance’: a child or

adolescent is considered to be at risk for a serious emotional

disturbance, as defined by this Act, if the child would be subject to a

serious emotional disturbance for any length of time.

(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, 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 together those who

have a stake in children’s mental health for the purpose of

interdependent problem-solving that focuses on improving 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 environments which are

within or close to the child’s home environment.

(n) ‘Culturally competent’: a set of behaviors, attitudes and

policies of a system, agency, or among service providers that enables

them to work effectively in cross-cultural situations.

(o) ‘Early identification and intervention’: a process for

recognizing warning signs that children are at risk for emotional

disabilities and taking early action against factors that put them at risk.

Early intervention can have a significant effect on the course of

emotional disturbance in children and can help prevent problems from

reaching serious proportions.

(p) ‘Family’: is defined by its members and each family defines

itself. Families can include biological and adoptive parents and their

partners, siblings, extended family members and friends who provide a

significant level of support to the child or primary caregiver.

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(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 strengths 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. This

approach is seen as a commitment to support families in their role as

caregivers and to preserve family integrity to the greatest possible

extent.

(r) ‘FILAK’: a grant awarded to Guam to build consensus 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 Council

established by this Act is responsible for policy development and

implementation of plans and strategies to foster collaboration among

stakeholders so that the system of care policy is substantially embraced

in every program ministering to children with serious emotional

disturbances, and as otherwise provided by this Act.

(t) ‘Individualized services’: services that are designed specifically

to address the unique needs and strengths of each child and family.

(u) ‘Integrated services’: services that are provided in a

community through multiple agencies with decreased overlap and

decreased gaps in services.

(v) ‘Least restrictive setting’: means that children and adolescents

are served in as normal an environment as possible. Preferred

interventions are those that provide the needed services and at the same

time are minimally intrusive in the normal day-to-day routine of the

child and family. An implicit goal of the system of care is to maintain

as many children as possible in their own homes by providing a full

range of family-focused and community-based services and supports.

(w) ‘Ombudsmen’: government of Guam agency representatives

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 system of care in their

agencies.

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(x) ‘Parent’: biological and adoptive mother or father, or the legal

guardian of the child, or a responsible relative or primary caregiver,

including foster parents, with whom the child regularly resides.

(y) ‘PROCEED’: Parents Reaching Out for Children Experiencing

Emotional Disturbance, a non-profit parent support organization

founded on Guam to help parents of children with severe emotional

disturbance and to promote systems change and family empowerment.

(z) ‘System of Care’ (‘SOC’): a comprehensive spectrum of

mental health and other necessary services which are organized into a

coordinated network to meet the multiple and changing needs of

children and adolescents with severe emotional disturbances and their

families. A system of care not only includes the program and service

components, but also encompasses mechanisms, arrangements,

structures or processes to ensure that the services are provided in a

coordinated, cohesive manner.

(aa) ‘Wraparound’: a philosophy of care that includes a definable

planning process involving the child and family that results in a unique

set of community services and natural supports, individualized for that

child and family to achieve a positive set of outcomes.