Presumptive transfer of children in STRTPs

The California Department of Social Services (CDSS) has issued guidance on the presumptive transfer process for foster children and youth placed outside of the their counties of original jurisdiction in Short-Term Residential Therapeutic Programs (STRTPs).

Presumptive transfer is a prompt transfer of the responsibility for providing or arranging and paying for specialty mental health services from the county of original jurisdiction to the county in which the foster child or youth resides.  Presumptive transfer is intended to provide foster children and youth who are placed outside of their counties of original jurisdiction with timely access to specialty mental health services.

STRTP placements are intended to be short term.  Considering that placements are supposed to be short term and that there is an exception for placements of less than six months, it is often appropriate and in the best interest of the child to waive presumptive transfer.  For a waiver, the county mental health plan in the county of original jurisdiction must have an existing contract with a specialty mental health services provider, or the ability to enter into a contract within 30 days of the waiver decision and the ability to deliver timely specialty mental health services to the foster child or youth.

Counties should work together so that placement agencies have the information they need to make informed and appropriate waiver decisions.  County mental health plans should be able to enter into a contracts with an out-of-county STRTP when presumptive transfer is waived.  County mental health plans are required to ensure timely access to federally entitled EPSDT Specialty Mental Health Services for foster children and youth placed in STRTPs.   To facilitate this, county single points of contact are posted on the CDSS website.

Presumptive transfer can be waived if: 1) transfer would disrupt continuity of mental health care or delay access to services; 2) transfer would interfere with family reunification efforts; 3) placement in a county other than the county of original jurisdiction is expected to last more than 6 months or 4) the child or youth’s residence is within 30 minutes travel time to the established Specialty Mental Health Services provider in the county of original jurisdiction.

If presumptive transfer is waived, the placing county must work with the mental health plan in the placing county to address the child’s needs and the mental health plan in the placing county must ensure that the child receives Specialty Mental Health Services.

If a presumptive transfer waiver is denied, the placing county must notify the mental health plan in the receiving county and work to ensure coordination of care for Specialty Mental Health Services by immediately sending required paperwork to the mental health plan in the receiving county.  The mental health plan in the receiving county must ensure access to Specialty Mental Health Services.

In making a waiver decision, the placing county should consider: 1) The child’s service needs including family friends and close relationship, the Specialty Mental Health Services needs, Regional Center services, educational issues, physical health needs and transition or permanent planning and goals; 2) the provider’s STRTP profile.

When there is a discharge from STRTP who a child who has a presumptive transfer waiver, there must be a child and family team meeting, the placing county must identify a placement in which to step the child down, the placing county must provide transition services and the placing county notifies the mental health plan in the placing county if the child returns to the county of jurisdiction or moves to another county.  The discharge process is the same if a waiver is denied except that the mental health plan in the receiving county must work the with the mental health plan in the placing county for a smooth transition of Specialty Mental Health Services.  (ACL 19-94, September 18, 2019.)