Integrated Services Planning (formerly known as Interagency Review Process)/ Multi-system Rapid Response Team/RESPOND
DHS has a wide variety of services available for children and families to assist them to live safe and productive lives. Some children and young adults face serious barriers to well-being because their lives are complicated by multiple complex issues such as intellectual disability, severe emotional disturbances, violent behaviors and mental illness. DHS has developed three “whatever it takes” service delivery programs that pull together natural supports associated with the child and his or her family as well as representatives from all appropriate systems to determine the best solution for the child.
Integrated Services Planning
Integrated Services Planning provides a method to develop, implement and monitor a comprehensive plan that includes a full continuum of services and tangible assistance when needed to support a child or youth who is involved in more than one system when normal and customary service delivery falls significantly short of goals.
Potential participants may be referred to the process through the DHS Offices of Intellectual Disability; Children, Youth and Families; and/or Behavioral Health. They may also be referred directly by their family, school administrator or the Juvenile Justice system.
Each child and his/her family are joined in the planning process by members of the DHS Executive Office and representatives from all appropriate systems. Members of the Multi-system Rapid Response Team participate in the County Integrated Services Planning meetings.
Integrated Services Planning Referral Form
Integrated Services Planning Referral Form (Handwritten)
Multi-system Rapid Response Team (RRT)
The Multi-system Rapid Response Team (RRT) is the second most intensive level of involvement offered to families in Allegheny County to assist them in meeting the needs of their child or youth with complex needs who is involved in multiple systems.
The barrier-free, cross-systems RRT brings representatives from each child-serving system—the Executive Office of DHS, the DHS Offices of Behavioral Health, Intellectual Disability and Children, Youth and Families; the Children’s Cabinet; the managed care organization; and Juvenile Justice—together with a “What will it take?” approach. The team has regularly scheduled monthly meetings to identify trends and gaps in services and to carry out proactive planning and tracking. In addition, the RRT gathers for urgent meetings to review the circumstances and do “responsive planning” for a child or youth who is at imminent risk of losing his or her placement, for whom all viable options and appropriate resources have been explored but rejected by the County Integrated Services Planning Team or for whom special services are needed that do not currently exist in the system. Families are referred to the RRT process by the RRT representative of the lead DHS Program Office.
Individuals who become the focus of the RRT
The RRT is often convened to assist children and youth with complex needs who have not been successfully served within the existing array of mental health, intellectual disability, child welfare and juvenile justice systems due to a number of circumstances; a history of sex offenses; severe aggressive, assaultive or self-injurious behavior; limited cognitive functioning combined with severe behavioral disorders; and multiple disabilities, including fragile medical needs. Many young people served by the RRT exhibit a combination of these concerns.
When the well-being of a child or youth with complex needs is in jeopardy, the RRT is called upon to help. RRT members bring their creativity and expertise to the table to strategically develop viable (short- and long-term) plans that maximize the potential of each child or youth referred to them while minimizing barriers to service and treatment and enhancing resources available to service providers. In this way, the RRT ensures that supports and services are provided to individuals in the most integrated setting and in the most effective and efficient manner.
Current functions of the RRT include reviewing a child’s current placement, determining the appropriateness of that placement, ensuring that services are provided in a way that supports the cultural needs of the child and family, compiling information identifying and negotiating with potential service providers, discussing and determining funding options, and devising and implementing action plans.
RESPOND (Residential Enhancement Service Planning Opportunities for New Directions)
The RESPOND program was created in 2003 to help human services providers and families in Allegheny County better assist children and youth whose complex needs pose the most difficult challenges.
RESPOND is a highly selective, intensive residential program offered in three homes (licensed under 3800 regulations). Two of the residences are in rural settings in Westmoreland and Allegheny counties. The third residence is in an urban setting in Wilkinsburg. Capacity at each site is limited to two residents. Staff–to-child ratios range from 1:1 to 4:1, depending on the needs of the youth. RESPOND operates using a collaborative recovery model integrating effective clinical treatment with principles of psychiatric rehabilitation and community support programs. The residential staff in each home are highly skilled individuals with experience working with children and youth with complex needs. The group homes are also supported by a shared Mobile Treatment Team (MTT) comprised of a psychiatrist, psychiatric nurse, behavior specialist, behavior analyst and social worker who have a range of clinical expertise in intellectual disability, developmental disabilities and child psychopathology.
When RESPOND is utilized
When the Allegheny County Multi-System Rapid Response Team (RRT) identifies a child or youth with complex needs who has not been successfully served even when mental health, intellectual disability, child welfare and juvenile justice systems all work in concert, the child or youth is referred to RESPOND. Generally, these individuals have a history of one or more challenging behaviors— inappropriate sexual behaviors; severe aggressive, assaultive or self-injurious behavior; limited cognitive functioning combined with severe behavioral disorders—and multiple disabilities, including fragile medical needs. The needs of this small group of children and youth exceed the staffing ratios and behavioral intervention capacities of specialized Residential Treatment Facilities. Through RESPOND, referred individuals have an alternative to extended inpatient psychiatric care and/or repeated re-admissions by utilizing the program’s intensive behavioral and habilitation services in a safe, secure environment.
How it works
One result of an Integrated Services Planning meeting or RRT involvement might be a referral to the RESPOND program. The RESPOND team gets to know the child and his/her life history well by going to the child’s home, workplace and school and interviewing everyone involved. They also take an in-depth physical and mental health history. They wanted to know what drives the child, to identify his/her strengths and to determine existing barriers to living a full life. This evaluation is followed by integrated meetings to design a plan. All interested parties are brought to the table to discuss options, but decisions are made by the child and his/her family.
There are three options presented if residential care is required – urban, suburban and rural. The RESPOND process is far more than a relocation program. Each RESPOND home houses two children. The homes are staffed 24/7 by up to six professionals highly trained in behavioral intervention. The staffing patterns fluctuate based on the need and progress of the individual. Over time, staffing is reduced as the youth achieves success with less support, and preparation is made to transition to discharge. In addition, each home is supported by the MTT. The team travels from home to home on scheduled visits and in response to urgent needs. Their combined expertise integrates behavioral health supports with physical health supports to improve outcomes. The children and youth are provided with whatever it takes to attain a long-term quality life with the least supervision possible and minimal support.
Through the entire process the original integrated planning team supports the work of RESPOND and ensures that the family’s voice and choice are being honored. The team regularly reviews each child’s progress and ensures access to resources to facilitate transitions.
RESPOND was created by Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh Medical Center. This program is multi-system funded and regulated through the DHS Offices of Behavioral Health, Intellectual Disability and Children, Youth and Families and Community Care Behavioral Health Organization (CCBHO).
DHS Making an Impact: RESPOND
(Residential Enhancement Service Planning Opportunities for New Directions)