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					      Mental Health Services Available to
         Children and Their Families:
A Resource Guide for Family Court Practitioners




                              Spring 2005
                                  Created by
                    The Mental Health Work Group of the
Child Welfare Subcommittee of the New York City Family Court Advisory Council
                             TABLE OF CONTENTS

Introduction
      Acknowledgments ………………………………………………………………………..                       1
      Purpose of Manual ……………………………………………………………………….                      2
      How to Use this Manual……………………..……………………………………………                   2

                   PART I: PROGRAM DESCRIPTIONS

Introduction to Part I ………………………………………………………………………….                       4
Emergency/Crisis Services
       Mobile Crisis Team ……………………………………………………………………..                     5
       Home Based Crisis Intervention ………………………………………………………..              5
Outpatient Services
       Clinic Treatment ………………………………………………………………………..                      6
       Day Treatment …………………………………………………………………………..                        6
Community Support Services
       Family Support Services ………………………………………………………………...                7
       Intensive, Supportive and Blended Case Management ………………………………….   8
       Home and Community Based Services Waiver………………………………………….          9
Community Residential Services
      Family Based Treatment …………………………………………………………………                    10
      Community Residence …………………………………………………………………...                    10
Inpatient Services
      Inpatient Services ………………………………………………………………………...                   11
      Residential Treatment Facility …………………………………………………………..             11
Mental Health Decision Tree …………………………………………………………………                     12

                     PART II: ACCESS TO SERVICES

Introduction to Part II …………………………………………………………………………                      14
Criteria for Serious Emotional Disturbance …………………………………………………            16
SPOA Description ……………………………………………………………………………..                          18
LifeNet Description …………………………………………………………………………….                        18
Emergency/Crisis Services
       Mobile Crisis Team ……………………………………………………………………..                    19
       Home Based Crisis Intervention ………………………………………………………..             19
Outpatient Services
       Clinic Treatment …………………………………………………………………………                      20
       Day Treatment …………………………………………………………………………..                       20
Community Support Services
       Family Support Services ………………………………………………………………..                 21
       Intensive, Supportive and Blended Case Management ………………………………….   22
       Home and Community Based Services Waiver ………………………………………...        23
Community Residential Services
       Family Based Treatment ……………………………………………………………...                  24
       Children’s Community Residence …………………………………………………..…..            24
Inpatient Services
      Inpatient Psychiatric Facility …………….…………………………………………….…                  25
      Residential Treatment Facility …………………………………………………………..                   25

                   PART III: MULTI-AGENCY PROJECTS

Coordinated Children’s Services Initiative/The Family Network ……...…………………...   28
Adolescent Sex Abuser/Offender Project ……………………………………………………                     30

                         PART IV: ATTACHEMENTS

Attachment A – Universal Referral Form ……………………………………………………….                   32
Attachment B – Release of Information Form …………………….…………………………….                41
Attachment C – List of Mobile Crisis Teams ……………………..…………………………….               44
Attachment D – List of School Bases Mental Health Clinics …………..……………………….      48
Attachment E – List of Day Treatment Programs ……………………………………………….               56
Attachment F – Family Network Referral Form ………………………..……………………….               61
Attachment G – List of Family Support Services ……………………………………………….              63
Attachment H – Vacancy Lists ………………………………………………………...………...                     80
Attachment I – List of Residential Treatment Facilities ………………...………………………      93
Attachment J – Helpful Resources ………………………………………….…………………...                    95
Attachment K – Acronym List …………………………………………………………………..                         96
                                              INTRODUCTION

Acknowledgments

This manual is the product of the Mental Health Work Group, an outgrowth of the Child Welfare
Subcommittee of the New York City Family Court Advisory Council. The work group was
originally formed at the suggestion of the Honorable Susan Knipps, in recognition of the important
role that improved familiarity with and access to mental health services can play in promoting more
efficient permanency planning for court-involved children. The members of the work group, which
include diverse representatives from the mental health, legal and child-advocacy communities, are
listed below. The Mental Health Work Group wishes to express its profound appreciation to Anita
Appel and Amanda Heller, who were the primary drafters of this document.

Anita Appel, Deputy Director, Children’s Services, New York City Field Office, New York
              State Office of Mental Health

Denise Arieli, Staff Analyst, New York City Department of Health and Mental Hygiene

Danielle Barry, L.M.S.W., Forensic Social Worker, Juvenile Rights Division of the Legal Aid
                            Society

Michael Bigley, Senior Program Specialist, Division of Children and Family Services, New York State Office
                 of Mental Health

Stephanie Davis, Esq., Juvenile Rights Division of the Legal Aid Society

Carol Fisler, Project Director, Brooklyn Mental Health Court, Center for Court Innovation

Amanda Heller, L.M.S.W., Manhattan Coordinator, Court Appointed Special Advocates

Louis Josephson, PhD, Former Assistant Commissioner, New York City Department of Health and Mental Hygiene

Cheryl Larrier, Director of Adoption, New York State Office of Children and Family Services

Glenn R. Metsch-Ampel, Esq., Deputy Executive Director, Lawyers For Children
                             Chair, OMH Work Group

Michael Murtagh, L.M.S.W., co-Director of Social Work, Lawyers For Children

Joan Siegel, Esq., Assistant Director, Legal Counsel Unit, Administration for Children’s Services

Susan Thaler, Field Coordinator, New York City Field Office, New York State Office of Mental Health

Xuan Tran-Walsh L.M.S.W., Manhattan Supervisor, Court Appointed Special Advocates

Marcia Werchol, M.D., Senior Director, Family Court Mental Health Services, New York City Health
                        and Hospitals Corporation




                                                                                                             1
                                        INTRODUCTION

Purpose of Manual

The manual is designed to serve as a concise, up-to-date reference for family court practitioners,
judges and other court-based or court-affiliated professionals participating in planning for youths
who may require and be eligible for services licensed by or in contract with the New York State
Office of Mental Hygiene (OMH) and the New York City Department of Health and Mental
Hygiene (DOHMH). OMH licensed programs include clinics, day treatment, family based
treatment, community residences, inpatient facilities and residential treatment facilities. In other
categories of programs, OMH or DOHMH contracts with providers for these services. For questions
regarding licensing or oversight of programs, please contact Anita Appel, Deputy Director,
Children’s Services, New York City Field Office, New York State Office of Mental Health, at 212-
330-1670.


How to Use this Manual

Part I contains program descriptions. As when selecting any specialty service, it is important to
know what is available in order to meet a specific child or family’s needs. The programs are listed
in a continuum progressing according to increasing intensity of services provided.

Part II describes eligibility requirements, how to access services, and who to contact for help in
obtaining these services. Part I and II have been separated so that someone who is already familiar
with the service types can go directly to the referral information contained in Part II.

Part III contains information regarding multi-agency initiatives.

Part IV contains other relevant attachments, including referral forms, program locations, and contact
information. Also included is a vacancy list for which electronic updates are available on a regular
basis. In order to obtain an up-to-date vacancy list, please contact Renee McMillan at the Division
of Mental Hygiene’s Office of Child & Adolescent Mental Hygiene, at (212) 219-5203.




                                                                                                   2
PART I: Program Descriptions
                                INTRODUCTION TO PART I

Overview of “Mental Health Services”

The system of care for children and adolescents encompasses a broad array of services, ranging
from community based treatment interventions to inpatient care. These treatments are organized
within five major categories: emergency, outpatient, community supports, community based
residential and inpatient. Youngsters with a Serious Emotional Disturbance (SED - See p.16) are
eligible for any appropriate level of treatment. A SED diagnosis is required for all levels of care
except clinic treatment, where children with any designated mental illness diagnosis are eligible.
 All treatment should be provided in the most integrated and normative setting that is clinically
appropriate. Families should be full participants in all aspects of the planning, delivery and
evaluation of services and need to be represented and treated as full partners. Mental health
services are voluntary and parents/caregivers do not have to relinquish custody in order to obtain
residential treatment for their child. Providing community based options embodies the
philosophy that the family, defined in its broadest sense, is the best place to raise children with
SED so that they can remain at home and in school. Services should be integrated with all other
child-serving programs, agencies and systems.

Children’s mental health services are provided by both public and private agencies. In order to
provide these services, agencies are licensed by the New York State Office of Mental Health
(OMH) and may also be in contract with the New York City Department of Health and Mental
Hygiene (NYCDH&MH).

Part I provides a program description for each type of mental health service available. In most
circumstances, it is the intensity and duration of the psychiatric symptoms that determine what
type of clinical intervention would be most beneficial to a youngster and his/her family. See
flowchart on page 12 for decision-making options.




                                                                                                  4
                             EMERGENCY/CRISIS SERVICES

Mobile Crisis Teams

Mobile Crisis Teams are designed to respond to an immediate need for mental health services
within 24 hours of a call. Mobile Crisis Teams visit a client who is experiencing a psychiatric
crisis wherever they are located. Teams are comprised of mental health professionals and
include nurses, social workers, psychologists, psychiatrists, and addiction specialists. They
provide a range of services including crisis intervention, assessments, linkage to community
programs, and where appropriate, transport and admission to psychiatric hospitals. For
application, referral and eligibility criteria, please see page 19. For a list of Mobile Crisis
Teams, see Attachment C (p. 44).


Home Based Crisis Intervention (HBCI)

Home Based Crisis Intervention programs are designed to provide in-home crisis services to
families where a child is at imminent risk of psychiatric hospitalization. Linked to emergency
rooms, these programs provide intensive in-home interventions for 4 to 6 weeks with the goals of
diverting hospitalization, teaching problem solving skills to the family, providing counseling and
linking the child and family with community-based resources and supports. Caseloads are small
with each counselor working with only two families at any one time. A counselor is available
seven days a week, 24 hours a day to work with the child and family. For application, referral
and eligibility criteria, please see page 19. For a list of Home Based Crisis Intervention
programs, see Attachment H (p. 80).




                                                                                                  5
                                  OUTPATIENT SERVICES

Clinic Treatment

Clinic Treatment programs offer traditional outpatient mental health services such as assessment,
individual, family and group therapies, case management and medication management. In
general, these services are offered from a fixed site but there may be satellite locations, such as
in schools and/or via mobile outreach. Youngsters are referred to clinic treatment for a variety
of reasons, including the reduction of their symptoms and improvement of their functioning in
school and/or at home. For application, referral and eligibility criteria, please see page 20. For a
list of School Based Services programs, see Attachment D (p. 48).


Day Treatment

Children’s Day Treatment programs are highly structured, intensive, non-residential mental
health programs that offer a blend of clinical intervention and special education to children and
adolescents, as well as social and clinical support to their families. A Day Treatment program
provides services designed to stabilize children’s adjustment to educational settings and to
prepare children to return to regular school-based educational settings. Typically, these
programs include special education in small classes with an emphasis on individualized
instruction, individual and group counseling, family services such as family counseling, crisis
intervention, interpersonal skill development and behavior modification. Children and
adolescents receiving day treatment services live at home or in the community but are identified
by their school district as seriously emotionally disturbed and cannot be maintained in regular
classrooms. Day Treatment programs occur in a variety of venues including hospitals and
community based organizations. For application, referral and eligibility criteria, please see page
20. For a list of Day Treatment programs, see Attachment E (p. 56).




                                                                                                   6
                                  COMMUNITY SUPPORTS

Family Support Services

Family Support Services provide an array of support services designed to empower families of
children and adolescents with Serious Emotional Disturbance (SED). Family Support Services
help to reduce family stress and enhance the family’s ability to care for their child(ren). To
accomplish this, family support programs operate on the principles of non-judgmental,
individualized care, and recognize that every child and family is unique in its strengths and
needs. Services include but are not limited to education and information distribution, individual
advocacy (accompaniment to court hearings, committee meetings, etc), family support groups,
respite, family recreation events and peer services for youth. In addition to the family support
service programs, each borough has a Parent Resource Center (PRC). The Parent Resource
Centers are staffed with trained parent advocates and are family run, culturally and linguistically
competent and community-based. The Centers offer an array of peer support services as well as
linkages to other borough support services. For application, referral and eligibility criteria,
please see page 21. For a list of Family Support Services, see Attachment G (p. 63).




                                                                                                  7
                                 COMMUNITY SUPPORTS

Case Management Services (SCM, ICM, BCM)

Case Management is designed to assist children and adolescents with Serious Emotional
Disturbance (SED) and their families to increase self-sufficiency, to support youngsters
remaining at home and in the community and to increase the appropriate utilization of
community-based services. Case Management services are community-based and individually
tailored to the youngster and his/her family with a psychosocial rehabilitation approach. Case
Managers facilitate mental health, medical, education and vocational service delivery by helping
clients and their families make and keep appointments (escorting if necessary), and advocate and
assist with access to entitlements and health care services. All Case Management programs are
available to clients and parents to address psychiatric emergencies and crisis 24 hours a day, 7
days per week. Three levels of Case Management are available, based on the current clinical
needs of the child and family being referred. For application, referral and eligibility criteria
please see page 22. For a list of Case Management programs, see Attachment H (p. 80).

Three levels of case management services are available:

        Supportive Case Management (SCM)            Supportive Case Management is the least
intensive level of mental health case management support available to youngsters and families.
The frequency of contacts between the SCM and the youngster is twice per month, at a
minimum, or as frequently as needed. This level of case management would be appropriate for
youngsters who are already achieving a noticeable level of success in their overall functioning.

       Intensive Case Management (ICM)              Intensive Case Management is designed for
those youngsters and families who need the most intense level of case management services. The
frequency of contacts between the ICM and the youngster and family is four times per month at a
minimum and can be as frequently as needed. This level of case management would be most
appropriate for those children and families who need weekly support minimally by one case
manager.

        Blended Case Management (BCM)                 Blended Case Management is a team
approach to the delivery of case management services, that combines the caseload and expertise
of an Intensive Case Manager (ICM) and a Supportive Case Manager (SCM). The frequency of
contacts between the BCM team members and the youngster can fluctuate between a minimum
of 2 contacts per month to as many contacts as needed. This level of case management would be
appropriate for youngsters and families who have experienced some levels of functional success
in the community, are somewhat connected to services but past history and/or prognosis shows
that their need for additional support may fluctuate from month to month. Youngsters can
fluctuate between “intensive” and “supportive” levels of service without severing ties with
familiar case managers.




                                                                                                   8
                                  COMMUNITY SUPPORTS

Home and Community Based Services Waiver (HCBS Waiver)

The Home and Community Based Services Waiver (HCBS) is designed to provide children and
adolescents with Serious Emotional Disturbance (SED) with the level of support necessary to
avoid residential placement or psychiatric hospitalization. Each child is provided with an
individualized care coordinator who develops a service plan which accesses six waiver services
including care coordination, crisis response, intensive in-home counseling, skill building, respite
care and family support as well as traditional mental health services. The care coordinator
maintains regular contact with the child to ensure that the service plan is implemented. The
Waiver provides the most intensive home based intervention available. For application, referral
and eligibility criteria, please see page 23. For a list of Home and Community Based Services
Waiver programs, see Attachment H (p. 80).




                                                                                                  9
                         COMMUNITY RESIDENTIAL SERVICES

Family Based Treatment (FBT)

Family Based Treatment is designed to offer a normative, non-restrictive residential option for
children and adolescents with Serious Emotional Disturbance (SED) who can live in the
community and who can function in a family setting with the support of trained professional
parents. Professional parents are trained in behavior management and other related aspects of
caring for youth with SED. Additional supports, including clinical services, are arranged
through community mental health programs and other community agencies. Since all services
are provided in the community (school, recreation, health and mental health), a child must be
able to travel for services. The child’s natural family, foster family and/or legal guardian are
expected to be active partners in the treatment and are provided with counseling and support.
For application, referral and eligibility criteria, please see page 24. For a list of Family Based
Treatment programs, see Attachment H (p. 80).


Children’s Community Residence (CCR)

A Children’s Community Residence is designed to provide a small therapeutic residential
program for 8 children or adolescents with Serious Emotional Disturbance (SED). Services
include structured daily living activities, problem solving skills training, a behavioral
management system, and caring consistent adult relationships. Because CCR’s are located in
the community, they offer a neighborhood-based, less restrictive residential option. CCR’s are
linked to local day treatment programs and outpatient clinics and youngsters must be able to
travel to services. The child’s natural family and/or legal guardian are expected to be active
partners in their child’s treatment. Families are supported in their efforts to continue and/or
resume primary care for their child by the provision of education/information, skill development,
and emotional support. For application, referral and eligibility criteria, please see page 24. For a
list of Community Residences, see Attachment H (p. 80).




                                                                                                     10
                                          INPATIENT SERVICES

Inpatient Psychiatric Hospital

Inpatient Services are hospital-based programs that offer a full range of treatment and support
services in an intensively supervised, locked, structured setting. Based on the clinical needs of
the youngster, inpatient care is available on an acute or intermediate basis. For application,
referral and eligibility criteria, please see page 25.


Residential Treatment Facility (RTF)

Residential Treatment Facilities (a subclass of inpatient psychiatric hospitals) provide services to
children and adolescents with Serious Emotional Disturbance (SED) who are in need of longer-
term inpatient treatment in a residential setting. RTFs provide comprehensive mental and
primary health care services including case coordination, verbal therapies, medication-
management, and vocational and recreational services. RTFs also provide education in on site
schools. For application, referral and eligibility criteria, please see page 25. For a list of
Residential Treatment Facilities, see Attachment I (p. 93).

Note: RTFs are separate and distinct from Residential Treatment Centers (licensed by the Administration for
Children’s Services and the Office of Children and Families) and Residential Schools (contracted by the State
Education Department).




                                                                                                                11
12
PART II: Access to Services
                                 INTRODUCTION TO PART II

Part II describes the eligibility requirements for each of the services described in Part I as well as
how to access them. As you move through the continuum of care, the intensity of the services
increases. For all intensive mental health services (Case Management, Waiver, Family Based
Treatment, Community Residence, and Residential Treatment Facility), youngsters must meet
the criteria for Serious Emotional Disturbance (see pp. 16-17). Additional eligibility criteria are
listed for each of the service components.

For clinic treatment, intensity/duration (crisis, short-term, long-term, intermittent, maintenance),
modality of treatment (individual, family, group, milieu), or type (counseling, psychotherapy,
medication) should be based on the needs expressed in the child(ren) and family’s treatment
plan. The type of staffing in clinics with respect to professional discipline and accreditation may
vary. Given local variations, it is important for anyone making referrals on a regular basis to
understand the current practice standards in the programs and agencies to which they are
referring. Some clinics may have every child seen by a child psychiatrist; in others the
psychiatrist may review the treatment plans and course of treatment and treat only those children
needing medication or having limited treatment success. The following three resources are
available to help improve access to appropriate mental health services.

       LifeNet

LifeNet is a toll-free, confidential mental health help line for all New York City residents. The
help line is a partnership between The Mental Health Association of New York City, which
operates the service, and the New York City Department of Heath and Mental Hygiene. LifeNet
referral specialists have access to a broad database of private and public community resources to
meet the particular needs of a client. The referral specialist will need to know the age,
neighborhood and the type of problem the client is experiencing in order to make a successful
match. LifeNet’s referral specialists are trained in assessing the severity of the problem based on
the caller’s report. If it is determined that a high level of risk is present, the referral specialist
will contact either 911 or a mobile crisis team to provide appropriate intervention. LifeNet will
then follow up with the responding agency to check on the status of the person in crisis. See
page 18 for more information.

       SPOA

The New York City Department of Health and Mental Hygiene (DOHMH) and The Office of
Mental Health (OMH) have begun to develop a citywide centralized referral system (Single
Point of Access-SPOA) in order to streamline and improve access to care. SPOA centralizes
access to the intensive mental health services listed above with the exception of RTFs. The RTF
referral process is currently centralized through the New York City PACC (Pre-admission
Certification Committee) process. The SPOA works closely with the NYC PACC as well as the
CCSI Family Networks. To date, SPOA is operational in the Bronx with plans for citywide
expansion. A
single universal referral form (see Attachment A, p. 32) can be used for all intensive mental
health services (Case Management, Waiver, Family Based Treatment and Community
Residence).

                                                                                                    14
                                 INTRODUCTION TO PART II (cont.)


Based on the level of need identified, the SPOA makes referrals to the appropriate programs.
The goal is to develop this process citywide within the next two years. For the remaining four
boroughs, referrals can be made directly to specific programs. Referral agencies may use the
universal referral form to refer clients to any of these services. See page 18 for more
information.

        CCSI/Family Networks

Family Networks are available in each borough to assist youngsters with complex needs and
multi-agency involvement. Networks are a mechanism to bring together the child, family and
service providers. They are intended for high need youngsters who are at risk of out-of-home
placement and where there is evidence of fragmentation, duplication and/or lack of coordination
of services. Networks are family driven and strength based. The plan developed through the
network meeting makes use of available community resources and offers a support circle
responsible for carrying out specific objectives to meet the family’s goals. See page 28 for more
information.


Note: Parents/Guardians/Caregivers do not need to relinquish custody in order to receive mental health treatment.




                                                                                                                    15
                          Criteria for Serious Emotional Disturbance Among
                                       Children and Adolescents

       Youngsters with a Serious Emotional Disturbance are eligible for any appropriate level of
treatment. A SED diagnosis is required for all levels of care except clinic treatment, where
children with any designated mental illness diagnosis are eligible. To be considered a child or
adolescent with serious emotional disturbance criteria A and criteria B or C must be met.

A.       Designated Emotional Disturbance Diagnosis

         The youngster is younger than 18 years of age and currently meets the criteria for a
         DSM-IV psychiatric diagnosis other than alcohol or drug disorders (291.xx-292.xx,
         303.xx-305.xx); delirium, dementia, and amnesia and other cognitive disorders (290.xx,
         293.0x, 294.xx, 780.09, 780.9x); developmental disabilities (299.xx, 315.xx, 317.xx-
         319.xx); or other conditions that may be a focus of clinical attention (313.82, 316.xx,
         332.xx-333.xx, 995.xx, Vxx.xx). 1 International Classification of Diseases (ICD-9-CM
         and ICD-10) categories and codes that do not have an equivalent in Diagnostic and
         Statistical Manual 4th Edition (DSM-IV) or Diagnostic and Statistical Manual Treatment
         Edition (DSM-TR) are also not included as designated mental illness diagnoses.

                                                         AND

B.       Extended Impairment in Functioning due to Emotional Disturbance
         The youngster must meet 1 and 2 below:

1.       The youngster has experienced functional limitations due to emotional disturbance over
         the past 12 months on a continuous or intermittent basis. The functional problems must
         be at least moderate in at least two of the following areas or severe in at least one of the
         following areas. 2

         a.       Self-care (personal hygiene; obtaining and eating food; dressing avoiding
                  injuries).
         b.       Family life (capacity to live in a family or family-like environment; relationships
                  with parents or substitute parents, siblings, and other relatives; behavior in family
                  setting).
         c.       Social relationships (establishing and maintaining friendships; interpersonal
                  interactions with peers, neighbors, and other adults; social skills; compliance with
                  social norms; play and appropriate use of leisure time).


         1
         Inclusion of mental disorders due to a general medical condition (293.8x-293.,xx, 310.xxc, 316.xx,
607.xx-625.xx, 78x.xx) in the definition of designated mental illness is currently being reviewed by OMH.

         2
           It is intended that the clinician assess the youngster’s functioning in at least these five domains in
consideration of assigning a single numerical rating on the Children’s Global Assessment Scale (CGAS).

                                                                                                                    16
        d.       Self-direction/self-control (ability to sustain focused attention for long enough
                 periods of time to permit completion of age-appropriate tasks; behavioral self-
                 control; appropriate judgment and value systems; decision- making ability).
        e.       Learning ability (school achievement and attendance, receptive and expressive
                 language; relationships with teachers; behavior in school).

2.      The youngster has met criteria for rating of 50 or less on the Children’s Global
        Assessment Scale (CGAS) due to emotional disturbance for the past 12 months on a
        continuous or intermittent basis. 3
                                                OR

C.      The youngster must have experienced at least one of the following within the past 30
        days:

        1.       Serious suicidal symptoms or other life-threatening self-destructive behaviors.
        2.       Significant psychotic symptoms (hallucinations, delusions, bizarre behavior).
        3.       Behavior caused by emotional disturbances that placed the youngster at risk of
                 causing personal injury or significant property damage.




        3
          While the CGAS is recommended, ratings of 50 or less on the Global Assessment of Functioning Scale
(Axis V of DSM-IV) may be substituted. The CGAS is described in Shaffer, D. et al. (1983) “A Children’s Global
Assessment Scale (CGAS)” Archives of General Psychiatry 40:1228-1231.




                                                                                                             17
                                 Single Point of Access (SPOA)

This pilot centralized referral process (SPOA) in the Bronx is responsible for screening,
assessing and monitoring access for referrals to the following programs:
    !" Home and Community Based Waiver
    !" Case Management
    !" Family Based Treatment
    !" Community Residence

A uniform referral form for all these services is included in the Attachment A (p. 33).

Referrals should be sent to: Elyse Hart, Program Director
                             Mental Health Association of NYC, Inc.
                             400 East Fordham Road-6th Floor
                             Bronx, NY 10458
                             (718) 220-0456


                                              LifeNet

LifeNet is a free, confidential, professional, 24-hour telephone referral line for mental health and
substance abuse services and access to mobile crisis teams:

English: (800) 543-3638
TTY Hard of Hearing (212) 982-5284
Spanish: (877) 298-3373
Cantonese/Mandarin: (877) 990-8585




                                                                                                  18
                             EMERGENCY/CRISIS SERVICES

Mobile Crisis Team

Referrals are made directly to the Mobile Crisis Team. Attachment C (p. 44) contains agency
specific information, including agency address, contact person and vacancies. In addition to
contacting the crisis team directly, referrals can be made by calling LifeNet at 1-800-543-3638.


Home Based Crisis Intervention

Referrals are made directly to the HBCI teams. Attachment G (p. 63) contains agency-specific
information, including agency address, contact person and vacancies. While this intervention
has been established as diversion for emergency rooms, community referrals are also accepted.

Eligibility for access to an HBCI team is the following:
* The target population for the HCBI program is youth 5 to 17 years of age,
* Child is living at home within their natural, foster, or adoptive family,
* Child is experiencing a psychiatric crisis that would require hospitalization without immediate
  intensive intervention,
* Child and their parents must be willing to receive in-home crisis services.




                                                                                                19
                   OUTPATIENT SERVICES

Clinic Treatment




                                         20
                                  COMMUNITY SUPPORTS

Family Support Services

See Attachment G (p. 63) for a list of Family Support programs. Although families can call the
Family Support programs directly, it is advised that they seek referrals through their local Parent
Resource Center. The following is a citywide listing of the Parent Resource Centers. Referrals
for families are made directly to the borough specific resource center.

          Manhattan                           Bronx                            Brooklyn
     157 Chambers Street           400 East Fordham Road, 6th fl      2581 Atlantic Avenue - 3rd fl
     New York, NY 10007                  Bronx, NY 10458                  Brooklyn, NY 11207
    Ms. RueZalia Watkins               Ms. Shirley Vasquez                 Ms. Melinda Vega
       Program Director                  Program Director                  Program Director
   (212) 964-5253, ext. 352               (718) 220-0456                (718) 298-6047, ext. 223
     Fax: (212) 964-7302               Fax: (718)-364-3357                Fax: (718) 526-3180
           Queens                          Staten Island
 163-18 Jamaica Avenue - 4th fl        2795 Richmond Road
      Jamaica, NY 11432              Staten Island, NY 10314
  Ms. Cecile-McIntosh-Green               Deborah Miller
       Program Director                  Program Director
   (718) 298-6047, ext. 223               (718) 698-5307
     Fax: (718) 526-3180               Fax: (718) 370-1142




                                                                                                      21
                                  COMMUNITY SUPPORTS

Case Management

Referrals to Case Management are made to individual programs, except in the Bronx, where
referrals are made to the Pilot SPOA (Single Point of Access - p. 18; Referral Form - Attachment
A, p. 32).

A subsequent determination is made for the appropriate level of care (ICM, BCM or SCM). This
determination is based on an evaluation of the referral documentation submitted. Once a Level
of Care determination is made, an assignment to the appropriate Case Management program is
made.

Case Management program directors should be called initially to discuss the referral and to
determine if there is a vacancy. Based on the youngster’s & family’s needs and program
availability, referral packets should be forwarded to the appropriate provider. With the
exception of three Intensive Case Management Programs (Brooklyn Children’s Center, Queens
Children’s Psychiatric Center, Lexington Center) - all providers offer the full range of case
management levels of care (ICM, BCM, SCM). Case Management programs are noted in
Attachment G (p. 65).

Eligibility Criteria for Case Management:

* Child has Serious Emotional Disturbance as evidenced by an Axis I DSM-IV Diagnosis,
* Child is between the ages of 5 - 17 (prior to 18th birthday for enrollment),
* Child demonstrates complex health and mental health needs,
* Child either required, or is at imminent risk of needing psychiatric inpatient care,
* Child requires support services that cannot be met by one agency or child-serving system,
* Child is capable of being cared for in the home and/or in the community.

In addition:

* There is evidence of “risk behaviors” in the youngster’s past. “Risk behaviors” are defined as:
  danger to self, danger to others, history of running away, sexually acting out behavior, socially
  aggressive and inappropriate behavior, crime/delinquency.

* The caregiver(s) and child are in need of concrete services, linkages to community supports
  (social services, schools, and entitlements) and assistance in the development of a structure
  within the home that provides for safety for the family and treatment compliance for the
  youngster being referred.




                                                                                                  22
                                   COMMUNITY SUPPORTS

Home and Community Based Services Waiver

Referrals to Home and Community Based Services are made to individual programs, except in
the Bronx, where referrals are made to the SPOA (Single Point of Access - p. 18; Referral Form
- Attachment A, p. 32). Attachment G (p. 63) contains agency specific information, including
agency address, contact person and vacancies.

Eligibility Criteria for Home and Community Based Waiver:
* Child has serious emotional disturbance as evidenced by an Axis I DSM-IV Diagnosis,
* Child is between the ages 5 - 17 years (prior to 18th birthday enrollment),
* Child demonstrates complex health and mental health needs,
* Child either requires or is at imminent risk of psychiatric inpatient or institutional care,
* Child requires support services that cannot be met by one agency/system,
* Child is capable of being cared for in the home and/or community.

In addition;

* There is evidence of on going and current "risk behaviors" by the youngster. "Risk behaviors"
  are defined as: danger to self, danger to others, history of running away, sexually acting out
  behavior, socially aggressive and inappropriate behavior, crime/delinquency.

* The care giver(s) and child are in need of concrete services, linkages to community supports
  (social services, schools, and entitlements), and assistance in the development of a structure
  within the home that provides for safety for the family and treatment compliance for youngster.

* It is determined that if Waiver services are not delivered within the home setting the youngster
  is at imminent risk of psychiatric hospitalization and/or out-of-home placement.




                                                                                                 23
                         COMMUNITY RESIDENTIAL SERVICES


Family Based Treatment

Referrals are made to individual programs, except in the Bronx, where a referral is made to the
SPOA (Single Point of Access). Attachment G (p. 63) contains agency specific information,
including agency address, contact person and vacancies.

Children and adolescents admitted to FBT program are those who have the potential of
functioning in the community and do not need the restrictiveness of a hospital or residential
treatment facility. They are able to accept the responsibilities of being integrated into a family
unit and capable of sustaining the type of close one on one relationship seen in a family
environment.

Eligibility Criteria for Family Based Treatment:
* Attainment of least 5th birthday, but not the 18th;
* Child has Serious Emotional Disturbance as evidenced by an Axis I DSM-IV Diagnosis;
* Must have a minimum full-scale IQ score of 70 (IQ’s between 50 and 70 will be
 evaluated on a case by case basis).


Children’s Community Residence

While the clinical profiles for youngsters eligible for Children’s Community Residences (CCR)
and Family Based Treatment (FBT) are similar, a CCR may be more appropriate for a child who
has difficulty adjusting to a family setting. CCR’s might also benefit older adolescents to help
develop the skills needed to live independently.

Referrals are made to individual programs, except in the Bronx, where a referral is made to the
SPOA (Single Point of Access). Attachment G (p.65) contains agency specific information,
including agency address, contact person and vacancies.

Eligibility Criteria for Community Residence:
* Attainment of at least the 5th birthday but not the 18th;
* Child has Serious Emotional Disturbance as evidenced by an Axis I DSM-IV Diagnosis;
* Must have a minimum full-scale IQ score of 70 (IQ’s between 50 and 70 will be
   evaluated on a case by case basis).




                                                                                                     24
                                   INPATIENT SERVICES

Inpatient Psychiatric Facilities
Admission criteria to inpatient psychiatric facilities are contained in Article 9 of the Mental
Hygiene Law. Acute care hospitalizations are short term and are provided at municipal
voluntary or private hospitals. Youngsters are admitted directly from psychiatric emergency
rooms. If a youngster requires continued hospitalization, the Acute Care Facility makes a
referral for intermediate care to state operated Children’s Psychiatric Centers. Access to these
facilities is through a central intake process (718)-264-4546 except for Staten Island where
referrals are made directly to South Beach Psychiatric Center.

Residential Treatment Facility
RTFs are inpatient psychiatric facilities for longer-term (up to 9 months) psychiatric treatment.
All services are provided on site including therapy, education, recreation and vocational training.
A list of Residential Treatment Facilities is located in Attachment H (p.80).
Parents/guardians/care-givers do not have to relinquish custody in order for a child to gain
access to RTF services.
Eligibility for RTF is determined by the Pre-admission Certification Committee (PACC), which
reviews all referrals to RTFs. All RTF referrals are to be sent to:

                              Ms. Cathy Moran, PACC Coordinator
                              Mental Health Association
                              157 Chambers Street
                              New York, NY 10007
                              (212) 614-6306

Programmatic Eligibility Criteria for RTF:
* Attainment of 5th birthday but not 18th birthday;
* Primary diagnosis of mental disorder as specified in DSM IV or ICD 9-CM.
* Identification of a serious and persistent psychopathology as evidenced by:
        1.      Severe thought disorder;
        2.      Severe affective disorder;
        3.      Moderate thought disorder in conjunction with an impulse control disorder or a
                deficit in activities of daily living skills;
        4.      Moderate affective disorder in conjunction with an impulse control disorder or a
                deficit in activities of daily living skills;
        5.      Severe conduct disorder in conjunction with an impulse control or a deficit in
                activities of daily living skills;
        6.      Severe personality disorder in conjunction with an impulse control disorder or a
                deficit in activities of a daily living skills;
        7.      Any combination above.



                                                                                                   25
                                   INPATIENT SERVICES

* Evidence that less intense ambulatory care services and residential placements, other than the
  sub-class of inpatient services offered by an RTF, do not meet the treatment needs of the
  individual child.
* Psychiatric condition requires care and treatment in an RTF under the direction of a
  psychiatrist.
* Identification of the specific clinical outcomes that can reasonably be expected to be
  accomplished within an RTF facility.
* Identification of a liaison staff person to the local system of care who will be available to
  participate in treatment plan reviews and discharge planning.

*Exclusionary criteria:

1. NYCRR Part 583.4(c) - Likelihood of serious harm or a substantial risk of physical harm to
   others as manifested by recent homicidal or other violent behavior by which others are placed
   in reasonable fear of serious harm.
2. Manifest current and serious substance addiction that prevents an adequate psychiatric
   determination of RTF eligibility. Substance rehabilitative services are identified as the
   primary need.

Medicaid Eligibility

To receive services thorough the RTF a youngster must be Medicaid eligible (either a US citizen
or a lawfully admitted alien who meets the definition of a “qualified alien”).

Attachment G (p. 63) provides specific RTFs information including address, contact information,
gender and ages served.




                                                                                                   26
PART III: Multi-Agency Projects
             New York City Coordinated Children’s Services Initiative (CCSI)

What is the Coordinated Children’s Services Initiative (CCSI)?

CCSI is a multi-agency, cross system effort to enhance the system of care for children and youth
with serious emotional and or behavioral challenges. The initiative promotes a core set of values
and principles throughout the system of care that include cooperative inter-agency planning and
service delivery, individualized care planning and a strength based approach that includes
families as full partners in all aspects of service planning. Core values also include the
importance of culturally competent care, the belief that children are best served when they
remain in their home communities while undergoing treatment and an unconditional, never give
up, approach to care.

What is the Family Network?

The Family Network helps to coordinate services for families with children and youth who have
emotional and /or behavioral challenges and who are receiving or are in need of services from
two or more agencies or systems such as mental health, child welfare (ACS), juvenile justice or
educational systems. Through a series of meetings called the Family Network Conference
providers and family members come together to create and implement a plan for the child. The
meetings make it possible for all of the professionals involved to talk to each other and the
family at the same time.

Who attends the Family Network Conference?

Family members, service providers already working with the family, other service providers that
might help the child or family, and others that families believe would be helpful such as a
relative, friend, neighbor, religious leader or teacher are invited to attend the Family Network
Conference. Parent advocates who have had similar experiences with their children and who can
help guide family members through the process are also available to assist the family.

What happens at the Family Network Conference?

At the conference, everyone, the family, the providers, advocates and others, sit together around
the same table. The family is always at the center of the process. The discussion centers on the
child and family, their strengths and needs and how each professional can help meet the needs of
the child and family. Together all participants work to develop a detailed plan about how the
child and family will be served.




                                                                                               28
            What Constitutes An Appropriate Referral To The Family Network?

If you answer yes to the following five questions, then you have an appropriate referral:
   1. Is this child between birth and 21 years old?
                                              AND
   2. Does this child have serious emotional or behavior challenges that have resulted in a
      DSM-IV diagnosis or are negatively impacting his/her everyday life and the life of
      his/her family?
                                            AND
   3. Has this child received high-end services from more than one child and family serving
      system, such as the:
               -Education System             -Mental Health System
               -Child Welfare System         -Substance Abuse System
               -Juvenile Justice System       -Legal System
               -Primary Care System
                                              AND
   4. Is there clear evidence of the negative impact of fragmentation, lack of coordination,
      duplication, contradiction and inadequate service delivery?

                                              AND
   5. Have the various service providers, as well as the child’s family, tried everything to help
      this child and no longer know where to turn?

Attachment C (p. 44) contains a referral form for the network. Direct referrals for networks are
made by contacting the CCSI staff listed below:

Manhattan Family Network             Bronx Family Network           Brooklyn Family Network
   Stephanie Johnson                    Anabella Escobor                 Rasheema Rainy
 (212) 964-5253 ext. 971                 (212) 614-6350              (212) 964-5253, ext. 751
 Queens Family Network                Staten Island Family            CCSI/Family Network
    Rick Barinbaum                          Network                        Coordinator
 (212) 964-5253 ext. 793                 Andrea Moullin                Iren Valentine, Psy.d
                                     (212) 964-5253, ext 735              (212) 614-6320

For general information regarding Family Networks contact:
                Mental Health Association of New York City- (212) 624-6320
                                157 Chambers St. 9th Floor
                               New York, New York 10007




                                                                                            29
                        The Adolescent Sex Abuser/Offender Project

The Adolescent Sex Abuser/Offender (ASA/O) project aims to reduce sexual recidivism of
sexually abusing juvenile delinquents identified by the New York State Office of Children and
Family Services and New York State Division of Probation and Correctional Alternatives.
These children/adolescents are identified as needing services. The initiative also aims to protect
the public safety through increased community supervision. The project provides psychosexual
specific intervention (group and individual) to youth and families, case management, education,
advocacy, and wraparound services. This intensive intervention is provided on site at Bronx and
Brooklyn.

Bronx
Provider: Bronx Children’s Psychiatric Center
Clinicians: Clifton Ables, Psy.D
            Email: BCPGC,A@omh.state.ny.us
            Phone: (718) 590-3070; Fax: (718) 590-6289

            Lonnie Stafford, MSW
            Email: BCISLSS@omh.state.ny.us
            Phone: (718) 590-3038; Fax: (718) 590-6317

Address: Child & Adolescent Sex Offender Treatment Program
         Bronx Family Probation - Room 5F-21
         900 Sheridan Avenue
         Bronx, NY 10451

Brooklyn
Provider: Brooklyn Children’s Psychiatric Center
Clinicians: Vivian Thompson, Social Worker
            Email: BKSWVST@omh.state.ny.us
            Phone: (718) 722-2082

           Melissa Peaslee, MS, LPC
           Email: BLPGMAP@omh.state.ny.us
           Phone: (718) 722-2083

Address: NYS Office of Children and Family Services
         Aftercare
         55 Hanson Place
         Brooklyn, NY 11217




                                                                                                30
PART IV: Attachments
Attachment A- Universal Referral Form




                                   32
                                         Mental Health Association of New York City, Inc.

                                           Universal Referral Form: Bronx Pilot
     Bronx SPOA: Case Management, Home and Community Based Services Waiver, Family Based Treatment and
                                          Community Residence

Date of Referral ______ /______ /______

Client Information

Youngster’s Name (Last, First, MI) ______________________________________________________________________________________

DOB _____ / _____ / ______                                                           Gender                 Male                 Female

Current Address                                                                      City                               State             Zip

Phone #                                                                              Alternate #

Parent(s) name(s) and address (if different from youngster’s)




Referral Source

Type of Referral Source

    Family/Legal Guardian                   School/Education System                       ACS/Foster Care                 Family Based Treatment

    Community Residence                Residential Treatment Facility (OMH)            Residential Treatment Center (ACS)           Day Treatment

    HCBS Waiver                 Case Management          Home Based Crisis Intervention            Emergency Room           Juvenile Justice System

    Education Residential Placement (CSE)           Acute Psychiatric Inpatient    State Psychiatric Inpatient     Outpatient Mental Health Clinic

    Other, specify

Referral Source

Address                                                                              City                               State             Zip

Contact Person                                                                       Second Contact

Phone #                                                                              Fax #

Type of services referred for           Case Management           HCBS Waiver              Family Based Treatment         Community Residence



Signature of person completing the Universal Referral Form

Signature/Title                                                       Print Name                                                      Date




Demographic Information




                                                                                                                                                33
                                             Mental Health Association of New York City, Inc

Financial and Insurance Information

Type of health coverage:

If youngster has Regular Medicaid, provide Medicaid ID # _______________________

If youngster has Managed Care Medicaid, provide Name of HMO ___________________________ ID#_____________________________

Medicaid Status                                   Eligible                   Application Pending                Not Applied        Ineligible



    Private, third party coverage payor                                                                         None

    Other, specify

Does youngster receive personal income? (i.e. trust fund, survivors’ benefits, etc.)                     Yes           No          Unknown

    If yes, how much money does he/she receive on a monthly basis?                                              Over $642          Under $642



`Family Information

       Independent Living                                             Homeless Shelter

       Parent(s)                                                      Education Residential Placement (CSE)

       Relative’s Home                                                Residential Treatment Center (ACS)

       Foster Care                                                    Residential Treatment Facility (OMH)

       Community Residence                                            State Psychiatric Inpatient

       ACS Group Home                                                 Acute Psychiatric Inpatient

       Family Based Treatment                                         Jail

       Therapeutic Foster Boarding Home                               Homeless/Streets or Abandoned Bldg.

       Crisis Shelter                                                 Other (specify)



Legal Status

What is the youngster’s current legal status? (Select one response)

   None                    PINS                  PINS Diversion                  Juvenile delinquent             Juvenile delinquent – probation

   Juvenile delinquent – OCFS                      Juvenile offender                      Juvenile offender – parole                  Unknown

    Other, specify




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                   Mental Health Association of New York City, Inc




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                                  Mental Health Association of New York City, Inc
Please select one answer for the following questions


Youngster’s strengths
                                                                                    YES             NO   LIMITED
Youngster exhibits appropriate social skills with both peers and adults.

Youngster is able to maintain significant relationships wit family members
and other significant individuals.

Youngster exhibits the ability to adapt and maintain appropriate behavior in
different environments and situations in their life.

Youngster is in an appropriate educational setting that meets academic,
emotional, and cognitive needs.

Youngster and family are involved in spiritual or religious activities that offer
support.




Caregiver’s strengths
                                                                                    YES             NO   LIMITED
The caregiver has the capacity to provide appropriate guidance and discipline
for the youngster.

The caregiver actively participates in the planning and provision of the
youngster’s care.

The caregiver understands and accepts the youngster’s condition and the
reasons for treatment.

Caregiver exhibits the ability to manage the household to support the
youngster’s care and related activities.

Caregiver has the financial and social assets available to assist in the
youngster’s care.

The caregiver is able to provide a stable living environment for the
youngster, both presently and in the foreseeable future.

Caregiver is able to provide a stable living environment for the youngster as
free from harmful elements as possible, such as neglect, drugs, violence, etc.

Caregiver is able to assume care taking responsibilities without the following
challenges i.e., medical, physical, mental health and substance abuse.




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                    Mental Health Association of New York City, Inc


Please use the following scale for questions on the next page.



Scale


  0     Not Evident             Child does not display this symptom/behavior.


  1     Mild                    This symptom/behavior exists, but there is no impairment (loss of effectiveness) in carrying out daily
                                activities or in meeting major role requirements.


  2     Moderate                This symptom/behavior exists. This child maintains an appropriate level of functioning in daily
                                activities and major roles only with difficulty and increased effort and support.


  3     Marginally Severe       This symptom/behavior exists. There is definite impairment in carrying out daily activities and/or
                                performing major roles. Major roles are able to be performed at a minimal level.


  4     Severe                  This symptom/behavior exists. Definite impairment exists in daily activities. The child is unable to
                                perform one or more major roles at any level. The child may not be allowed to remain in one or more
                                major roles due to severity of symptom/behavior.




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                                  Mental Health Association of New York City, Inc


Symptoms and Behaviors

Level of Functioning: Indicate the degree to which each of the following interferes with the youngster’s performance of daily activities.
Scale:                         0-Not evident                    1-Mild             2-Moderate             3-Marginally Severe               4-Severe
                                                            0                  1                      2                      3                    4
Self-care
Social relationships
Cognitive/communication functioning
Self-direction
Fine motor skills


Select one response for each current and history. Indicate the degree to which each of the following interferes with the youngster’s performance of daily
activities.
Scale:                         0-Not evident                    1-Mild             2-Moderate             3-Marginally Severe               4-Severe
                                                                                              Current (last 3 months)                        History
                                                                                          0       1       2      3       4                  Yes       No
Suicidal ideation
Psychotic symptoms (i.e. hallucinations)
Depression
Anxiety
Phobias
Dangerous to self
Dangerous to others
Temper tantrums
Sleep disorders
Enuresis/encopresis
Physical complaints
Alcohol abuse
Drug abuse
Developmental delays
Sexually inappropriate (i.e. inability to maintain boundaries)
Sexually acting out (i.e. promiscuous behavior)
Sexually aggressive (i.e. perpetrator or at risk for potential perpetration)
Verbally aggressive
Physically aggressive
Animal cruelty
Eating disorder
Peer conflict
Hyperactivity
Impulsive
Self-injury
Runaway




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                             Mental Health Association of New York City, Inc


Service History

Please indicate which programs/services the youngster has been enrolled in, both prior to the referral and currently.
                                                                                                            Prior          Current
                                                                                                      Yes           No   Yes     No
Case Management
Name                                             Date
Name                                             Date
HCBS Waiver
Name                                             Date
Name                                             Date
Day Treatment
Name                                             Date
Name                                             Date
Home Based Crisis Intervention
Name                                             Date
Name                                             Date
Clinic treatment
Name                                             Date
Name                                             Date
Acute Psychiatric Inpatient
Name                                             Date
Name                                             Date
State Psychiatric Inpatient
Name                                             Date
Name                                             Date
Foster Care/Residential Treatment Center
Name                                             Date
Name                                             Date
Community Residence
Name                                             Date
Name                                             Date
Family Based Treatment
Name                                             Date
Name                                             Date
Residential Treatment Facility
Name                                             Date
Name                                             Date




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                            Mental Health Association of New York City, Inc



                                    Addendum for Youngster’s Known to ACS
                                 Must be completed if youngster/family has ACS involvement



ACS Case #_______________________________________

What is the youngster’s involvement with ACS?                            None                     Current Case        Past Case

Has an 853C been submitted, signed and approved regarding the change in plan for the youngster?       Yes        No

Please explain any past or present involvement with ACS or Preventive Services




If family is involved with ACS/foster care, provide the following information
Foster Care Planning Agency _________________________________________________________________________________________
Case Planner (Last, First) __________________________________________________ Unit # __________________________________
   Phone # (     )

Supervisor (Last, First) _____________________________________________________________________________________________
   Phone # (     )

Case Manager (Last, First) ___________________________________________________________________________________________
   Phone # (     )

CES Worker (if applicable) (Last, First) ________________________________________________________________________________
   Phone # (     )

Preventive Worker (Last, First) _______________________________________________________________________________________
   Phone # (      )




Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
Attachment B- Release of Information Form




                                     41
                                                  Mental Health Association of New York City, Inc


                                            AUTHORIZATION FOR RELEASE OF INFORMATION

   This authorization must be completed by the patient or his/her personal representative to use/disclose protected health information, in accordance with State and
   Federal laws and regulations. A separate authorization is required to use or disclose confidential HIV related information.

                                                    PART 1: Authorization to Release Information

   Description of information to be Used/Disclosed:
     Parent/Legal Guardian/ACS/Foster Care
        I, ____________________________________, consent to release clinical information to the Bronx Single Point of Access (SPOA). I understand that the Bronx
   SPOA will review and evaluate this information to determine eligibility for services in Home and Community Based Services Waiver, Case Management Services,
   Family Based Treatment or Community Residence


   Purpose or Need for information:                                         Name of Youngster
       1. This information is being requested:
                           by the individual or his/her personal representative; or
                           Other (please describe)________________________________________________________________________________
         2.   The purpose of the disclosure is (please describe) :




       It is understood that this information will be used to evaluate ______________________________ for possible placement with HCBS Waiver, Case
   Management, Family Based Treatment or Community Residence. Upon acceptance, my child will be receiving services from one of the above.


   To: Name, Address, & Title of Person/Organization/Facility Program to Which this Disclosure is to be Made
   NOTE: if the same information is to be disclosed to multiple parties for the same purpose, for the same period of time, this authorization will
   apply to all parties listed here.
                                                                             Bronx Children’s Psychiatric Center
                                                                             Saint Dominic’s Home
                                                                             Steinway Child and Family Services
                                                                             St. Christopher-Ottilie
                                                                             Berkshire Farms Center for Youth Services
                                                                             Cardinal McCloskey
                                                                             Jewish Board of Family and Children Services


   A.     I authorize the Bronx SPOA to release clinical information and make recommendations for the appropriate program for possible
        enrollment. I also understand that the Bronx SPOA may recommend other appropriate programs/services, such as Residential Treatment
        Facility, the Coordinated Children’s Services Initiative, or the Bronx Parent Resource Center. I hereby permit the use or disclosure of the
        above information to the Person/Organization/Facility/Program(s) identified above. I understand that:
          1. Only this information may be used and/or disclosed as a result of this authorization.
          2. This information is confidential and cannot legally be disclosed without my permission.
          3. If this information is disclosed to someone who is not required to comply with federal privacy protection regulations, then it may be
             redisclosed and would no longer be protected.
          4. I have the right to revoke (take back) this authorization at any time. My revocation must be in writing on the form provided to me
             by (insert name of facility/program) Bronx Intensive Mental Health Services. I am aware that revocation will not be effective if the
             persons I have authorized to use and/or disclose my protected health information have already taken action because of my earlier
             authorization.
          5. I do not have to sign this authorization and that my refusal to sign will not affect my abilities to obtain treatment from the New York
             State Office of Mental Health, nor will it affect my eligibility for benefits.
          6. I have a right to inspect and copy my own protected health information to be used and/or disclosed in accordance with the
             requirements of the federal privacy protection regulations found under 45 CFR§164.524).

                                                                                                                                          Continued on Next Page



Youngster’s Name (Last, First, MI) ________________________________________
Revised: June 24, 2004
                                                    Mental Health Association of New York City, Inc.

                                      AUTHORIZATION FOR RELEASE OF INFORMATION
Please select one choice from either B-1 or B-2
B-1. One-time Use/Disclosure: I hereby permit the one-time use or disclosure of the information described above to the
person/organization/facility/program identified above.
      My authorization will expire:               When acted upon;
                                                    90 Days from this Date;

B-2. Periodic Use/Disclosure: I hereby permit the periodic use/disclosure of the information described above to the
person/organization/facility/program identified above as often as necessary to fulfill the purpose identified above.
      My authorization will expire:          When I am no longer receiving services from one of the intensive high end mental health services;
                                               One year from this date;
                                                    Other


C.     Patient Signature: I certify that I authorize the use of my medical/mental health information as set forth in this document.

      Signature of Patient or Personal Representative                                                                         Date

      Patient’s Name (Printed)

      Personal Representative’s Name (Printed)

      Description of Personal Representative’s Authority to Act for the Patient (required if Personal Representative signs Authorization)


D.     Witness Statement/Signature: I have witnessed the execution of this authorization and state that a copy of the signed authorization was
     provided to the patient and/or the patient’s personal representative.
       WITNESSED BY
                                                  Staff person’s name and title
      Authorization Provided To                                                                                                      Date


To be Completed by Facility:

                                   Signature of Staff Person Using/Disclosing Information

                                   Title

                                  Date Released


                                            PART 2: Revocation of Authorization to Release Information

I hereby revoke my authorization to use/disclose information indicated in Part 1, to the Person/Organization/Facility/Program whose name and
address is:




I hereby refuse to authorize the use/disclosure indicated in Part 1, to the Person/Organization/Facility/Program whose name and address is:




Signature of Patient or Personal Representative                                                                               Date

Patient’s Name (Printed)

Personal Representative’s Name (Printed)

Description of Personal Representative’s Authority to Act for the Patient (Required if Personal Representative signs Authorization)




                                                                                                                                                 43
Attachment C- List of Mobile Crisis Teams




                                       44
                                                Mobile Crisis Teams

           Team                 Address             Hours of          Community               Telephone Number
                                                    Operation           Districts
                                                                    (CD's) in Service
                                                                          Area
BRONX
Bronx Lebanon Hospital      Psychiatric E.R.      Mon. - Fri.            Bronx CD's              (718) 901-8223
Center Comprehensive        1276 Fulton Ave.   8:00am - 7:00pm              3,5,6
Psychiatric Emergency       Bronx, NY 10451       Sat. - Sun.
Program (CPEP)                                 9:00am - 5:00pm
Lincoln Medical & Mental    234 East 149th St. Mon. - Fri. 9:00am        Bronx CD's              (718) 579-4627
Health Center                      B77             - 5:00pm              1,2,3,4,5,6
                             Bronx, NY 10451
Visiting Nurse               1601 Bronxdale       Mon. - Fri.           Bronx CD's               (718) 319-7330
Service/Homecare                   Ave.        8:30am - 4:30pm         7,8,9,10,11,12            (718) 319-7338
                             Bronx, NY 10462                                                       (Geriatrics)
BROOKLYN
Brookdale Medical Center     One Brookdale          Mon. - Fri.     Brooklyn CD's 5, 7, 8,       (718) 240-6249
Comprehensive Psychiatric    Plaza, Brooklyn,    9:00am - 9:00pm             18
Emergency Program (CPEP)        NY 11212              Sun.
                                                 9:00am - 9:00pm
Coney Island Hospital         2601 Ocean            Mon. - Fri.         Brooklyn CD's            (718) 616-4478
                            Parkway, Rm. 202     8:30am - 5:00pm    10, 11, Part of 12, 13,
                              Brooklyn, NY                                  15, 18
                                 11235
Interfaith Medical            1545 Atlantic     Mon. - Thurs.          Brooklyn CD's             (718) 613-6618
CenterMobile Crisis Team        Avenue        9:00am - 9:30pm       3,5,6,7,8,9,14,16, 17        (718) 613-6499
                              Brooklyn, NY           Fri.
                                 11213        9:00am - 5:00pm
                                                 Sat. & Sun.
                                              10:00am - 6:00pm
Kings County Hospital        606 Winthrop St.     Mon. - Fri.           Brooklyn CD's            (718) 245-2350
Comprehensive Psychiatric     7th floor, Room 9:00am - 10:00pm        5,8,9,14,16,17,18
Emergency Program (CPEP)            2302            Sat.
                               Brooklyn, NY   10:00am - 6:00pm
                                   11203            Sun.
                                              11:00am - 7:00pm
Woodhull Medical and Mental 760 Broadway, 5th     Mon. - Fri.           Brooklyn CD's            (718) 260-7725
Health Center                        floor    8:30am - 5:30pm             1,2,4,5,16
                               Brooklyn, NY         Sat.
                                   11206      8:30am - 4:30pm




                                                                                                            45
                                                 Mobile Crisis Teams

MANHATTAN
Association to Benefit      1841 Park Avenue           Mon. - Fri.       Manhattan CD's           (646) 459-6166
Children/Fastbreak             New York, NY         9:00am - 5:0pm         11 and 8             24-Hour Crisis Line
(children/adolescents only)        10035                                                          (212) 996-7734
Bellevue Hospital Center    First Ave. & E. 27th      Mon. - Sun.        Manhattan CD's           (212) 562-4330
Comprehensive Psychiatric            St.           10:00am - 6:00pm           5,6
Emergency Program (CPEP)       New York, NY
                                   10016
Columbia Presbyterian       513 West 166th St.        Mon. - Fri.        Manhattan CD's          (212) 342-5797
Medical Center                 New York, NY        8:00am - 7:00pm     12 (West 155th St. to
Comprehensive Psychiatric          10032              Sat. - Sun.      220th St. and Marble
Emergency Program (CPEP)                           9:00am - 5:00pm             Hill)
Gouverneur Hospital          227 Madison St.          Mon. - Fri.        Manhattan CD's          (212) 238-7529
                               New York, NY        9:00am - 5:00pm              1,3
                                   10002
Project H.E.L.P.             227 Madison St.           Mon - Fri.      Citywide Homeless         (212) 238-7777
Homeless Outreach Team         New York, NY           9:00am - 12
                                   10002                Midnight
                                                      Weekends/
                                                        holidays
                                                   12 Noon - 8:00pm
Harlem Hospital Center         506 Lenox Ave.          Mon. - Fri.      Manhattan CD's           (212) 939-3016
Comprehensive Psychiatric       New York, NY       8:00am - 6:00pm           9,10,11
Emergency Program                  10037                  Sat.      (96th St. River to River;
(CPEP)*                                            8:00am - 4:00pm     North to 155th St.)
St. Luke's - Roosevelt        1111 Amsterdam           Mon. - Fri       Manhattan CD's           (212) 523-6711
Medical Center                       Ave.          8:00am - 7:00pm       4,7,9,Part of 10
Comprehensive Psychiatric       (At 113th St.)         Sat. - Sun.   (34th-125th Sts., West
Emergency Program               New York, NY          10am - 7pm        of Central Park)
(CPEP)*                             10001
Visiting Nurse                 1250 Broadway           Mon. - Fri.       Manhattan CD's          (212) 609-7799
Service/Homecare                New York, NY       9:00am - 9:00pm          2,4,7,8
                                    10001                Sat.
                                                   9:00am - 5:00pm
                                                         Sun.
                                                   10:00am - 6:00pm




                                                                                                           46
                                                    Mobile Crisis Teams

QUEENS
Builders for Family and           13-29 Beach         (718) 337-6800 Rockaway Peninsula;          (718) 337-6800
Youth                             Channel Dr.        M-F 5-10pm; 230-  Broad Channel          M-F 5-10pm; 230-10p Sat
                               Far Rockaway, NY      10p Sat and Sun                                  and Sun
                                     11691
                                                       (718) 945-1937                             (718) 945-1937
                                                      M-F 530p-930p;                          M-F 530p-930p; 230-10p
                                                      230-10p Sat and                               Sat and Sun
                                                             Sun
                                                                                                  (718) 327-5267
                                                      (718) 327-5267                                M-F 9a-5p
                                                         M-F 9a-5p
Creedmoor Psychiatric           80-45 Winchester        Mon. - Sat.       Queens CD's             (718) 264-4025
Center Mobile Crisis Team             Blvd.          12:00pm - 8:30pm       7,11,13
                                    Bldg. 21,
                               Queens Village, NY
                                     11427
Elmhurst Hospital Center         79-01 Broadway      Mon. - Thurs.       Queens CD's              (718) 334-3443
Comprehensive Psychiatric      Elmhurst, NY 11373  9:00am - 9:00pm           1,2,3,4,5
Emergency Program                                      Fri. - Sat.
(CPEP)                                             9:00am - 5:00pm
MTA/Connections                    2 Broadway          Mon. - Fri.     All transit subway         (646) 252-1216
(Transit/Subway Outreach)          (mezzanine)       24 hours/day    lines; Grand Central
                                  NY, NY 10004           Sun.        Station, Long Island
                                                   7:00am - 3:00pm)          Railroad
Visiting Nurse Service         41-61 Kissena Blvd.     Mon. - Fri.  Borough wide (except          (718) 463-9660
                               Flushing, NY 11355 8:30am - 8:30pm       no Rockaways)
                                                       Sat. - Sun.
                                                   9:00am - 5:00pm
Queens Hospital Center          82-68 164 Street    Mon, Tue, Wed,       Queens CD's              (718) 883-3522
CPEP**                         Jamaica, NY 11432           Fri      6,7,8,9,10,12, parts of
                                                    9:00pm-4:30pm 13 - Flushing, North of
                                                   Thurs 11:00am -         Union Tpk.
                                                        7:00pm
STATEN ISLAND
St. Vincent's Medical Center     355 Bard Ave.           Mon. - Fri.      Borough wide            (718) 818-6900
Comprehensive Psychiatric       Staten Island, NY    8:00am - 8:00pm                              (718) 818-5339
Emergency Program                    10310                 Sat.
(CPEP)**                                             11:00am - 5:00pm
                                                           Sun.
                                                     10:00am - 6:00pm




                                                                                                           47
Attachment D- List of School Based Mental Health Clinics




                                                  48
                                 School Based Mental Health Clinics
           On Site programs – Licensed programs over which the Department has oversight.

 BOROUGH AND              PROVIDER                     SCHOOL (S)                        SERVICES
SCHOOL DISTRICT

  MANHATTAN
      1              Educational Alliance    P.S. 142, P.S. 20, P.S. 64  Individual, Family, group
                                                                         therapy, psychiatric consult,
                                                                         and Crisis Intervention
       3             Children’s Aid Society P.S. 144, P.S. 208, P.S. 185 Individual, Family, group
                                                                         therapy, and Crisis Intervention
       6             Columbia Presbyterian P.S. 128, P.S. 152, P.S.      Individual, Family, group
                     Hospital               173, P.S. 4                  therapy, Crisis Intervention and
                                                                         Consultation
                     Jewish Board of Family Martin Luther King High      Outpatient Services to
                     and Children Services/ School, Humanities High      Adolescents 16-21 years of Age
                     Youth Counseling       School
                     League Division
    BRONX
      8              South Bronx Mental      P.S. 48, P.S. 60, P.S. 75,        Individual, Family, Group and
                     Health Council          I.S. 74                           Crisis Intervention
      12             Bronx Lebanon           I.S. 158, I.S. 92, I.S. 67, I.S   Individual, Family, Group and
                     Hospital                44                                Crisis Intervention
       8             Soundviews Throgs       P.S. 93, J.H.S. 123, I.S.         Individual, Family, Group
                     Neck CMHC               152                               therapy and Crisis Intervention
      10             Fordham Tremont         P.S. 32, P.S. 59, P.S. 159        Individual, Family, Group
                     CMHC                                                      therapy and Crisis Intervention
  BROOKLYN
     14              Brooklyn Psychiatric    I.S. 49                           Individual, Family, Group
                     Centers                                                   therapy and Crisis Intervention
      15             Brooklyn Psychiatric    P.S. 32, P.S. 38, P.S. 261,       Individual, Family, Group
                     Centers                 P.S. 230, M.S. 293, M.S.          therapy and Crisis Intervention
                                             51, M.S. 88
      16             Bedford Stuyvesant      P.S. 308, P.S. 335, P.S.          Individual, Family, and Group
                     CMHC                    324, P.S. 35                      therapy
      17             Brooklyn Center for     P.S. 167, P.S. 91, P.S. 61,       Individual, Family, and Group
                     Psychotherapy           P.S. 391                          therapy
      18             Brooklyn Center for     P.S. 244, P.S. 219, P.S. 233      Individual, Family, and Group
                     Psychotherapy                                             therapy
      19             Institute for           P.S. 149, P.S. 159, P.S.          Individual, Family, and Group
                     Community Living        174, P.S. 213                     therapy and Crisis Intervention
      21             Coney Island Hospital   I.S. 96, P.S. 90, P.S. 288,       Individual, Family, and Group
                                             P.S. 225                          therapy, Crisis Intervention, and
                                                                               teacher/guidance consultations


                                                                                                    49
   QUEENS
     27         Long Island Jewish        P.S. 105, P.S. 197, J.H.S.   Individual, Family, and Group
                Hospital (Hillside        198                          therapy, Psychiatric
                Division)                                              Evaluations, teacher
                                                                       consultations
     28         Queens Hospital Child     P.S. 160, P.S. 117, P.S. 217 Individual, and Family therapy,
                and Adolescent Clinic                                  psychiatric Evaluation
     28         Queens Child guidance     P.S. 30, I.S. 72             Individual, Family, and Group
                center (Jamaica Clinic)                                therapy
     28         Queens Child guidance     P.S. 76, P.S. 150, P.S. 127 Individual, Family, and Group
                center (Kew Gardens                                    therapy
                Clinic)
     30         Steinway Child and        P.S. 150, P.S. 76, P.S. 127      Individual, Group and Family
                Family Services                                            therapy
     24         Glendale                  P.S. 91                          Individual, Group treatment,
                MHC/Catholic                                               Consultation
                Charities
STATEN ISLAND
     31         Staten Island Mental      I.S. 2, P.S. 11, P.S. 13, P.S.   Individual, Group, Family
                Health Society            14, P.S. 16, P.S. 16A, P.S.      therapy, Consultation, and
                                          22, I.S. 27, I.S. 61             Crisis Intervention




                                                                                                50
                              School Based Mental Health Clinics
        School based Mental Health Clinics (Satellites) not in contract with the Department.

 BOROUGH AND             PROVIDER                      SCHOOL (S)                      SERVICES
SCHOOL DISTRICT

  BROOKLYN
                    Brookdale Hospital      I.S. 275                             All licensed Clinical
                    Medical Center          985 Rockaway Avenue                  Services must offer
                                                                                 Individual, Group
                                                                                 and/or Family therapy
                                                                                 and Crisis Intervention
                                                                                 and/or any combination
                                                                                 listed above.
                                            I.S. 55
                                            2021 Bergen Street
                                            P.S. 150
                                            364 Sackman Street
                                            P.S. 155
                                            1355 Herkimer Street
                                            P.S. 156
                                            104 Sutter Avenue
                                            P.S. 165
                                            76 Lott Avenue
                                            P.S. 178
                                            2163 Dean Street
                                            P.S. 183
                                            76 Riverdale Avenue
                                            P.S. 263
                                            210 Chester Street
                                            P.S. 271
                                            1137 Herkimer Street
                                            P.S. 284
                                            220 Watkins Street
                                            P.S. 327
                                            111 Bristol Street
                                            P.S. 322
                                            51 Christopher Street
                                            P.S. 41
                                            411 Thatford Avenue
                                            P.S. 73
                                            241 Mac Dougal Street
                    Lutheran Medical        P.S. 1                               See above
                    Center                  309 47th Street
                                            P.S. 314
                                            33 59th Street
                                            P.S. 15
                                            71 Sullivan Street

                                                                                               51
  CONT.     Lutheran Medical         P.S. 94
BROOKLYN    Center                   5010 6th Avenue
                                     P.S. 172
                                     29th Street & 4th Avenue
                                     P.S. 169
                                     4305 7th Avenue
                                     I.S. 88
                                     544 7th Avenue
            Dyker Heights            P.S. 27                               See above
                                     Nelson & Hicks Street
                                     P.S. 32
                                     317 Hoyt Street
                                     P. 15
                                     71 Sullivan Street
MANHATTAN
            CIS Counseling Center  P.S. 38                                 See above
                                   232 E. 103rd Street
                                   P.S. 126
                                   80 Catherine Street
                                   P.S. 217
                                   Stellite 645 Man Street
                                   P.S. 144
                                   134 W. 122nd Street
            Jewish Board of Family H.S. of Art and Design                  See above
            and Children’s         2nd Avenue & E. 57th Street
            Services/Youth
            Counseling League Div
                                   The Beacon School
                                   227 W. 61st Street
                                   High School of Environmental
                                   Studies
                                   444 W. 56th Street
                                   Institute for collaborative Education
                                   Jacqueline Kennedy Onassis H.S.
                                   120 W. 46th Street
                                   Manhattan Comprehensive Night &
                                   Day School
                                   240 2nd Avenue, NYC
                                   Manhattan Village Academy
                                   43 W. 22nd Street
                                   Professional Performing Arts H.S.
                                   328 W. 48th Street
                                   Stuyvestant H.S.
                                   345 Chambers Street
                                   University Neighborhood H.S.
                                   2000 Monroe Street
                                   Young Women’s Leadership
                                   105 E. 106th Street

                                                                                       52
                                  School Based Mental Health Clinics
   School Support 3 – This is a joint funded program by NYS Office of Mental Health, NY State
   Education Department, and the NY State Department of Health. The Mental Health
   components are attached to the Health Clinics.


 BOROUGH AND                   PROVIDER                  SCHOOL (S)                SERVICES
SCHOOL DISTRICT

     BRONX
     CSD 10           Montefiore Elementary School   P.S. 8                 Individual, Group, Family
                      3010 Briggs Avenue                                    counseling, Teacher
                                                                            Consultation
      CSD             Bronx Lebanon Hospital         Taft High School       Individual, Group, Family
                      E. 240 Street & Sheridan                              counseling, Teacher
                      Avenue                                                Consultation
  BROOKLYN
    CSD 13            Woodhull Hospital              P.S. 307               Individual, Group, Family
                                                     Elementary School      counseling, Teacher
                                                     209 York Street        Consultation
     CSD 20           Guidance Center of Brooklyn    I.S. 220               Individual, Group, Family
                                                     4812 9th Avenue        counseling, Teacher
                                                                            Consultation
    QUEENS
     CSD 30           Elmhurst Hospital              I.S. 145               Individual, Group and
                                                     33-34 80th Street      Family counseling,
                                                                            Teacher Consultation
  MANHATTAN
    CSD 6             Children’s Aid Society         I.S. 218               Individual, Group and
                                                     4600 Broadway (196th   Family counseling,
                                                     Street) NYC            Teacher Consultation
                                                     I.S. 90
                                                     21 Jurnel Pl (168th
                                                     Street) NYC




                                                                                           53
                                 School Based Mental Health Clinics
    School Based Initiatives – These are non-certified programs whose primary focus is drop-out
            prevention. Programs are funded via Reinvestment or City Council dollars.


 BOROUGH AND                 PROVIDER                   SCHOOL (S)                 SERVICES
SCHOOL DISTRICT

  BROOKLYN
                    Brooklyn Psychiatric Centers    Erasmus H.S.           Individual, Group
                                                    911 Flatbush Avenue    Counseling, Case
                                                    Brooklyn, NY           Management, Classroom
                                                                           presentations, Consultations,
                                                                           with school staff linkages
                                                                           with Community resources.
                    Brooklyn Psychiatric Centers    Wingate H.S.           See above
                                                    600 Kinston Avenue
                                                    Brooklyn, NY
    BRONX
                    Astor Child Guidance Center     CES 104                Individual, Counseling,
                                                    1449 Shakespeare Ave   Group Evaluations, Crisis
                                                    Bronx, NY              Intervention, Family
                                                                           Support Services, Linkages
                                                                           with Community Services
                                                                           including health and Mental
                                                                           Health Clinics.




                                                                                            54
                                 School Based Mental Health Clinics
     School Based Initiatives – These are non-certified programs whose primary focus is Violence
                     Prevention. Programs are funded via City Council dollars.

 BOROUGH AND                PROVIDER                     SCHOOL (S)                   SERVICES
SCHOOL DISTRICT

  MANHATTAN
                    The Valley                    Park West High School        Individual, Group
                                                  525 W. 50th Street           Counseling, Violence
                                                                               Prevention Workshops,
                                                                               Leadership Training
                                                                               Workshops Peace Jam
                                                                               Activity
    BRONX
                    Woodycrest Center for         William Howard Taft High     Individual, Family
                    Human Development             School                       Counseling Mediation and
                                                  240 E. 172nd Street          Conflict Resolutions
                                                  Bronx, NY                    Training, Peer
                                                                               Counseling,
                                                                               Empowerment Training
  BROOKLYN
                    Youth Dares                   John Jay High School         Peer Mediation Project,
                                                  237 7thAvenue                Anti-Violence Groups,
                                                  Brooklyn, NY                 Substance Abuse
                                                                               Education, Prevention and
                                                                               Intervention Project,
                                                                               Youth Leadership
    QUEENS
                    Police Athletic League        Beach Channel High School    Individual, Group
                    (P.A.L.)                      100-00 Beach Channel Drive   Counseling, Peer
                                                  Rockaway, NY                 Mediation Training,
                                                                               Conflict Resolution
                                                                               Training, Educational
                                                                               Seminars, Collaborative
                                                                               Advisory Group,
                                                                               Recreational Activities
 STATEN ISLAND
  (RICHMOND)
                    Camelot of Staten Island      Concord High School          Individual, Group
                                                  109 Rhine Avenue             Counseling, Classroom
                                                  Staten Island, NY            Presentations, Crisis
                                                                               Intervention and referral,
                                                                               Family Support Groups,
                                                                               Workshops/Seminars,
                                                                               Linkage with Community
                                                                               Resources.




                                                                                              55
Attachment E- List of Day Treatment Programs




                                          56
                        New York City Day Treatment Programs

Manhattan

1.   The Children’s House
     Association in Manhattan for Autistic Children, Inc.
     25 West 17th Street
     New York, NY 10011
     Phone No. (212) 645-5000

2.   Bellevue Hospital Center
     Day Treatment Programs
     First Avenue & 27th Street
     New York, NY 10016
     Phone No. (212) 562-8959
     Contact Person: Dr. Sherri Krigsmam

3.   Children’s Day Treatment & School
     255 West 71st Street
     New York, NY 10023
     Phone No. (212) 873-2280

4.   HHC Metropolitan Hospital Adolescent Day Treatment Program (ADTP)
     1900 Second Avenue
     New York, NY 10029
     Phone No. (212) 423-7310
     Contact Person: Jill Winnis, CSW

5.   Harlem Center for Child Study/PS 162M
     34 West 118th Street
     New York, NY 10026

6.   Puerto Rican Family Institute Adolescent Day Treatment
     145 West 15th Street - 6th Floor
     New York, NY 10011
     Phone No. (212) 229-6960
     Contact Person: Ms. Grace Velasquez

7.   Queens Children’s Psychiatric Center PS 94 @ PS 188
     422 East Houston Street
     New York, NY 10002
     Phone No. (718) 995-2045
     Contact Person: Ms. Hannah Stefanyshyn

8.   Queens Children’s Psychiatric Center Adolescent ’s Day Treatment @ Kennedy School PS
     169
     110 East 88th Street
     New York, NY 10128
     Phone No. (212) 987-2513, (212) 987-2010
     Contact Person: Ms. Hannah Stefanyshyn

                                                                                            57
                        New York City Day Treatment Programs

Bronx

1.      Bronx Children’s Psychiatric Center Community Day Treatment Program
        4215 Third Avenue
        Bronx, NY 10457
        Phone No. (718) 299-2304

2.      Bronx Children’s Psychiatric Center Acute Adol. Day Treatment Program
        1000 Waters Place
        Bronx, NY 10461
        Phone No. (718) 430-7202

3.      Bronx Lebanon Adolescent Day Treatment Program
        406 East 176th Street
        Bronx, NY 10457
        Phone No. (718) 590-1800

4.      JBFCS Ittleson Center for Child Research
        5050 Iselin Avenue
        Bronx, NY 10471
        Phone No. (718) 549-6700

5.      JBFCS Ittleson Westside School of New York City
        1925 Grand Concourse
        Bronx, NY 10453
        Phone No. (718) 731-8880

6.      The Astor Home for Children/Astor Child Guidance Center Day Treatment Prog.
        750 Tilden Street
        Bronx, NY 10467
        Phone No. (718) 231-3400

7.      The Astor Home for Children/Astor Child Guidance Center Day Treatment Prog.
        4330 Byron Avenue
        Bronx, NY 10466
        Phone No. (718) 324-7526




                                                                                      58
                      New York City Day Treatment Programs

Brooklyn

1.   Brookdale Hospital CMHC Child Day Treatment
     Linden Blvd. & Brookdale Plaza
     Brooklyn, NY 11236
     Phone No. (718) 240-5641

2.   Brooklyn Children’s Psychiatric Center
     1819 Bergen Street - 2nd Floor
     Brooklyn, NY 11233
     Phone No. (718) 221-4500

3.   HHC Kings County Hospital Prog. For Adolescent Development Day Treatment
     451 Clarkson Avenue
     Brooklyn, NY 11203
     Phone No. (718) 245-2709

4.   JBFCS Montague Day Treatment Program
     57 Willoughby Street
     Brooklyn, NY 11201
     Phone No. (718) 858-0886

5.   JBFCH Infants Home of Brooklyn
     87 Bay 49th Street - 5th Floor
     Brooklyn, NY 11214
     Phone No. (718) 266-5050

6.   League School
     567 Kingston Avenue
     Brooklyn, NY 11203
     Phone No. (718) 498-2500

7.   South Beach Children and Youth Day Program
     25 Flatbush Avenue
     Brooklyn, NY 11217
     Phone No. (718) 858-4002

8.   Steinway Child & Family Services, Inc./Steinway Day Treatment Program
     335 37th Street
     Brooklyn, NY 11232
     Phone No. (718) 956-0796




                                                                                59
                        New York City Day Treatment Programs

Queens

1.    Lifeline Center for Child Development, Inc.
      80-09 Winchester Blvd.
      Queens Village, NY 11427
      Phone No. (718) 740-4300

2.    Long Island Jewish Zucker Hillside Hosp. Child & Adolescent Day Hospital
      75-59 263rd Street
      Glen Oaks, NY 11004
      Phone No. (718) 470-8002

3.    Queens Children’s Psychiatric Center Arlene Wolf Day Treatment Program
      74-03 Commonwealth Blvd.
      Bellerose, NY 11426
      Phone No. (718) 264-2900


4.    Queens Hospital Center Day Treatment Program
      82-68 164th Street
      Jamaica, NY 11432
      Phone No. (718) 883-2900

5.    Addabo Day Treatment Program
      360 Beach 53rd Street
      Arverne, NY 11692
      Phone No. (718) 318-0032

Staten Island

1.    South Beach Adolescent Day Treatment Program
      777 Seaview Avenue
      Staten Island, NY 10305
      Phone No. (718) 667-2457

2.    Staten Island Mental Health Society, Inc./S.I. Children’s CMHC Day Treatment
      669 Castleton Avenue
      Staten Island, NY 10301
      Phone No. (718) 442-2225

3.    Staten Island Mental Health Society, Inc. Day Treatment Program/South Shore
      PS 25 Annex
      6581 Hylan Blvd.
      Staten Island, NY 10309
      Phone No. (718) 966-1296




                                                                                     60
Attachment F- Family Network Referral Form




                                        61
62
Attachment G-List of Family Support Services




                                          63
                       Family Support Services

BOROUGH     FACILITY/LOCATION                         DESCRIPTION
            CONTACT PERSON(S)
MANHATTAN   Manhattan Resource Center            Special Population: Parent run service
            157 Chambers Street                  for Manhattan parents of SED, at risk, or
            New York, NY 10007                   children in SIE VII classes.
            Phone No. (212) 964-5253
            Fax No. (212) 964-7302               Program Components: Warm line,
                                                 advocacy, information and referral,
            Program Coordinator                  workshops, support groups, and respite
            Rue Zalia Watkins, ext. 352          activities.

            Clinical Social Worker
            Rachael Krammer, ext. 311

            Parent Advocates
            Gina Delgado ext. 343
            Janet Rosa, ext. 353
            Vionette Morales, ext. 322
            KkemSang Fong, ext. 388
            Myra Cabot, ext. 312
            Ruth Cabrera, ext. 316

            Youth Advocate
            Matilda Amezquita, ext. 315
            Steven Hernandez, ext. 316
            Mental Health Association/NYC        Special Population: Families of SED
            Inc. Gouveneur Hospital              children attending the outpatient
            227 Madison Street                   psychiatry clinic. Also offers services in
            New York, NY 10002                   Spanish, Chinese and Mental Health
                                                 treatment services.
            Family Support Liaison
            Janet Rosa                           Program Components: Case assistance,
                                                 respite, training and support groups.
            Graham Windham Family                Special Population: SED, at-risk, or
            Services                             homeless families residing or relocated
            274 West 145th Street - 2nd Fl New   to the Harlem community. Community
            York, NY 10030                       Planning Board 9 and 10.
            Phone No. (212) 368-4100 x31
            Fax Nos. (212) 281-5041              Program Components: Bi-linqual
                     (212) 481-5796              services including case assistance and
                                                 referrals, support groups, education,
            Program Coordinator                  respite and recreation. Program operates
            Robyn Davis                          Monday - Friday 9AM - 6PM and
            Clinical Social Worker               Thursday 8AM -4PM.
            Delores Blackwell

                                                                                  64
MANHATTAN Cont’d.   Nitchen, Inc.                        Special Population: Native American
                    Operates out of:                     families who have Seriously Emotionally
                    Lutheran Church                      Disturbed (SED) or are at risk children.
                    164 West 100th Street                Program accepts referrals citywide.
                    New York, NY 10025
                    Phone No. (212) 749-9494
                    Fax No. (212) 749-9075               Program Components: Family education
                    Email: Nitchen02@aol.com             and support, Indian community resource
                                                         library, workshops and retreats. Case
                    Program Director                     assistance/advocacy five days per week.
                    Irma LaGuerre                        Saturday programs for families. In a
                                                         holistic environment.
                    Consultant
                    Yvonne Beamer/Martinez

                    Parent Advocate
                    Deborah Mulllins

                    Chinese-American Planning            Special Population: Asian-American
                    Council/Asian Family Services        families who have Seriously Emotionally
                    365 Broadway                         Disturbed (SED) or are at risk children.
                    Ground Floor                         Program accepts referrals citywide.
                    New York, NY 10013
                    Phone No. (212) 941-0030
                    Fax No. (212) 226-5351               Program Components: Parent support
                                                         group parenting workshops counseling,
                    Program Director                     newsletter, information and referral,
                    Judy Ah-Yune                         respite programs, recreation activities,
                                                         community education and outreach.
                    Program Coordinator                  Program operates 5 days per week.
                    Benny Hui
                    NAMI-NYC Metro                       Special Population: Parents of SED or at
                    National Alliance for the Mentally   risk children and adolescents. The
                    Ill of NYC, Inc.                     agency also provides services to mentally
                    432 Park Avenue South                ill adults and their families.
                    Suite 710
                    New York, NY 10016
                    Phone No. (212) 684-3365             Program Components: Public education,
                    Help line No. (212) 684-3264         Help line (12PM to 7PM, Monday -
                    Fax No. (212) 684-3364               Thursday);
                                                         (12PM to 6PM, Fridays), advocacy,
                    Executive Director                   coping skills (9 week) workshop for
                    Evelyn Roberts, Ph.D                 consumers, support groups, monthly
                                                         meetings newsletter, website, library.
                    Director of Services
                    Susan Saler


                                                                                         65
MANHATTAN Cont’d.   Metropolitan Hospital Center       Special Population: Children and
                    1901 First Avenue- Room 7M31       adolescents ages 10-16 who are enrolled
                    New York, NY 10029                 in Metropolitan Hospital’s Adolescent
                    Phone No. (212) 423-6017           Day Treatment Program or Psychiatric
                    Fax No. (212) 423-7321             Outpatient Clinic.

                    Director                           Program Components: After-school
                    Leonard Davidman, Ph.D.            therapeutic recreation program operates
                    (212) 423-7309                     Monday, Wednesday, Thursday and
                                                       Saturday. Weekly day time parent
                    Program Coordinator                support group and consultation to
                    Meredith Rosenberg, Psy.D.         Adolescents Day Treatment Program and
                    (212) 423-6017                     Psychiatric Outpatient Clinic.
                    Harlem YMCA                        Special Population: Children ages 9-14
                    180 West 135th Street              who are SED and attend the Community
                    New York, NY 10030                 Day Treatment Program and their
                    Phone No. (212) 281-4100, x 14     families. In addition, the program is
                    Fax No. (212) 281-2195             open to those families residing in the
                                                       Harlem area who have an SED or
                    Program Coordinator                behaviorally disordered child.
                    Conrad Johnson
                                                       Program Components: After-school:
                    Parent Advocate                    Saturday activities for both parents and
                    Betty Bethea                       children, between 11AM and 4PM.
                                                       Parent support meeting held on 3rd
                                                       Saturday of the month.
                    Greenwich Village Youth            Special Population: Parents of youth who
                    Council, Inc. (J.O.Y.) Center      attend The Joy Center Program and other
                    12 East 33rd Street - 10th Floor   GVYC programs. Provide services to
                    New York, NY 10016                 young persons ages 7-22 on the lower
                    Phone No. (646) 935-1812           Eastside.
                    Fax No. (646) 935-1829
                    Email: GVYCNET@aol.com             Program Components: Art, Education,
                    Web Site: GVYCWORLD.ORG            Careers, Sports individual and Group
                                                       Counseling Referrals to Housing, Health
                    Program Site - J.O.Y. Center       Care, Educational programs, and Mental
                    213-15 Eldridge Street             Health Services.
                    New York, NY 10002
                    (212) 979-2442                     Mission Statement: “We Empower and
                                                       Encourage young people to be Dynamic,
                    Site Director
                                                       strong and independent.
                    Rosa Vargas
                    Parent Advocate
                    Janet Guzman
                    Director of Development
                    David Kaplan, Esquire

                                                                                      66
MANHATTAN Cont’d.   Columbia Presbyterian Medical       Special Population: Children and families
                    Center, Venderbilt Clinic           affected by HIV disease and substance
                    622 West 168th Street - 4th Floor   abuse.
                    New York, NY 10032
                    Phone No(s) (212) 305-9099,5000     Program Components: Parent support
                                                        groups, behavior training workshops,
                    Program Director                    creative arts and recreation programs.
                    Virginia Robles, Ph.D.              Program accepts those children attending the
                                                        Special Needs Clinic. Group meets Monday
                    Program Coordinator
                                                        and Tuesday 4:30PM to 6:30 PM.
                    Cherie Gerstadt, Ph.D.
                    Harlem Dowling/Westside Ctr         Special Population: Serves children (and
                    2090 Adam Clayton Powell Blvd.      their families) age
                    New York, NY 10027                  0-18 diagnosed as SED and/or learning
                    Phone No. (212) 749-3656 x330       disabled.

                    Director                            Program Components: Bi-weekly and
                    Rosa Manzano                        therapy group Tuesday 3PM to 5PM.
                                                        Empowerment circle (Thursday 6PM - 7:30
                    Parent Advocate
                                                        PM) for parents of learning disabled and
                    Denise L. Pitt, ext. 332
                                                        SED children.
                    All Children’s House (ABC)
                    Association to Benefit Children
                    1841 Park Avenue - 3rd Floor
                    New York, NY 10035

                    Program Director
                    Sara Lichtenberg
                    1-646-459-6155

                    Clinical Director
                    Adam Lecz8 05cki




                                                                                          67
MANHATTAN Cont’d.   Northside Center for Child       Special Population: Families of children
                    Development Central Harlem       classified as SED, homeless or formerly
                    Services                         homeless families and families affected
                    247-249 West 135th Street        by HIV/AIDS.
                    New York, NY 10030
                    Phone No. (646) 259-2000         Program Components: Advocacy, psycho
                    Fax No. (212) 694-4477           education, short-term counseling, parent
                                                     support groups, family recreation and
                    Program Director                 referrals to on site mental health services.
                    L. Zakiya Jones
                                                     Program Hours:
                    Parent Advocates                 Monday - 9AM - 6PM
                    Andrea Morant                    Tuesday - 10AM - 6PM
                    Antoinette Davis                 Wed./Thurs. - 9AM - 7PM
                                                     Friday - 9AM - 2PM
                                                     Saturday 10AM - 2PM
                    The Upper Manhattan Mental       Special Population: Formerly homeless
                    Health Center, Inc.              families, with at-risk children residing in
                    The Oasis Program for Families   West Harlem.
                    and Children
                    1727 Amsterdam Avenue            Program Components: Recreational
                    New York, NY 10031               activities, case assistance, tutoring,
                    Phone No. (212) 281-1120         vocational skills, individual and Family
                    Fax No. (212) 281-1312           Mental (counseling by referral).

                    Program Director
                    Ruth McIntosh

                    Case Manager
                    Elaine Frank

                    Case Manager
                    Neris Guerrero
                    Mental Health Association/NYC    Special Population: Families of SED
                    Inc./Gouveneur Hospital          children attending the outpatient
                    227 Madison Street               psychiatry clinic. Also offers services in
                    New York, NY 10002               Spanish, Chinese and Mental Health
                                                     treatment services.
                    Family Support Liaison           Program Components; Case assistance,
                    Janet Rosa                       respite, training and support groups.




                                                                                       68
BRONX   Bronx Parent Resource Center      Special Population: Parents of SED, or at
        Parent Resource Center/Hub Site   risk children who reside in the Bronx
        400 East Fordham Road - 6th Fl.   community.
        Bronx, NY 10458
        Phone No. (718) 220-0456

        Program Director                  Program Components:
        Shirley Vasquez

        Parent Advocates
        Yvette Pena
        Maria Santos

        Peer Advocate
        Vacant

        Clinical Consultant
        Adam Stein, Ph.D
        Mental Health Association/New     Special Population: Parents of SED, or at
        York & Bronx Parent Resource      risk children residing in the South Bronx
        Center/South Bronx                community.
        1503-05 Walton Avenue, Apt. B
        Bronx, NY 10452                   Program Components: Parent runs
        Phone No. (718) 583-2447          services including warm-line, advocacy,
        Fax No. (718) 583-2452            information and referral, workshops and
                                          training, support groups and respite
        Coordinator/Parent Advocate       activities.
        Wanda Greene

        Parent Advocates
        Milagros Roja
        Geraldine Burton
        M.H.A./New York & Bronx
        Parent Resource Center/ West
        Bronx
        38 West 182nd Street
        Bronx, NY 10453
        Phone No. (718) 329-3854
        Fax No. (718) 329-3861

        Coordinator/Parent Advocate
        Wanda Greene

        Parent Advocates
        Sonya Omosanya
        Clara Augusta


                                                                          69
BRONX Cont’d.   Fordham-Tremont Community        Special Population: Families of SED
                Mental Health Center             children who attend the outpatient
                2021 Grand Concourse             program or the therapeutic nursery.
                Bronx, NY 10453
                Phone No. (718) 960-0347         Program Components
                          (718) 933-2502         Case assistance, parenting groups and
                                                 support groups.
                Program Site
                817 East 180th Street
                Bronx, NY 10460

                Program Director
                Barbara Becker Bruno, CSW

                Program Coordinator
                Angela Quintana
                Bronx Children’s Psychiatric     Special Population: Families of SED
                Center                           children who attend our inpatient and
                1000 Waters Place                outpatient, Day Treatment programs.
                Bronx, NY 10461
                Phone No. (718) 239-3660         Program Components: Case assistance
                Fax No. (718) 239-3669           parenting groups and Support groups.

                Program Director
                Lillie Hall

                Parent Advocates
                Deborah Lowman, FDC
                Enid Lugo FDC
                Visiting Nurse Services of New   Special Population: SED children and
                York                             their families either from the HBCI
                120 Waters Place                 program or the Bronx community.
                Bronx, NY 10461
                Phone No. (718) 536-3214         Program Components: Psycho-
                Fax No. (718) 319-7301           educational and support groups, Family
                                                 Fun Night, in-home respite services and
                Administrative Assistant         family activities.
                Rona Bender
                (718) 536-3200

                Program Coordinator
                Benjamin Elliot
                (718) 678-8555

                Outreach Worker
                Aisha Jones

                                                                                70
BRONX Cont’d.   Astor Home for Children          Special Population: Families whose
                750 Tilden Street                children are enrolled in the Day
                Bronx, NY 10466                  Treatment Program.
                Phone No. (718) 324-7526
                Fax No. (718) 994-8465           Program Components:
                                                 Parent support groups, education, respite
                Program Site                     and recreational activities.
                4330 Byron Avenue
                Bronx, NY 10466

                Program Director
                Joan DiBlasi

                Parent Coordinator
                Brunilda Torres
                F.R.I.E.N.D.S, Inc.              Special Population: Family that have
                Families Reaching In Every New   children with Emotional Problems.
                Direction
                489-493 East 153rd Street
                Bronx, NY 10455
                Phone No. (718) 402-3900

                Program Director
                Vacant

                Parent Consultants
                Santiago Ventura
                Michele Wingfield
                Tasha Murrdy
                Elizabeth Olorarria




                                                                                 71
BROOKLYN   Brooklyn Parent Resource
           Center/ICL
           2581 Atlantic Avenue - 3rd Floor
           Brooklyn, NY 11207
           Phone No. (718) 290-8110 x141
           Fax No. (718) 290-8100

           Program Director
           Vacant

           Clinical Consultant
           Renie Rondon-Jackson




                                              72
BROOKLYN Cont’d.   The Children Act Team           Special Population: Serving Children 5-
                   2150 Beverly Road               18 with @ least one psychiatric
                   Brooklyn, NY 11226              emergency visit with an Axis I
                   Phone No. (718) 693-7899        Diagnosis. Parents are taken to King’s
                   Fax No. (718) 693-7729          County Hospital Parent Support meeting
                                                   on Thursdays.
                   Clinic Director
                   Marcia Prescott, R.N.           Program Components: In home services
                                                   respite care services recreational
                   Client Advocate                 activities for clients. Hours: Monday,
                   Magalis Jaquez                  Thursday and Friday 9AM to 5PM,
                                                   Tuesday and Wednesday 9AM to 8PM.
                   Maimonides Medical Center       Special Population: Clients of the
                   (CMHC), Laughing Tiger          hospital’s Child & Adolescent Outpatient
                   920 48th Street                 Services ages 7-15 and their parents.
                   Brooklyn, NY 11219
                   Phone No. (718) 283-8128        Program Components: After-school
                   Fax No. (718) 283-6161          tutoring program and Summer recreation
                                                   program. Laughing Tiger operates
                   Program Director                Saturdays only.
                   Dr. Alan Hilfer

                   Laughing Tiger
                   Louis Infante
                   Flatbush YMCA                   Special Population: Children ages 7-15
                   1401 Flatbush Avenue            who attend Brooklyn Children’s Day
                   Brooklyn, NY 11210              Treatment Program or the local mental
                   Phone No. (718) 469-8100        health clinics. Referrals accepted from
                   Fax No. (718) 284-5537          the Flatbush community.
                   *Recreation site at The Dutch
                   Reform Church

                   Program Director                Program Components: After-school
                   Vacant                          program operates Tuesday, Thursday
                                                   from 4PM to 6PM and Saturday from
                   Program Coordinator             11AM to 1PM. Program offers
                   Vacant                          recreation, homework assistance, and a
                                                   parent support group.
                   Parent Advocate
                   Ms. Sandra Staggers




                                                                                   73
BROOKLYN Cont’d.   Lakeside Family Services           Special Population: ED and SED
                   Program site: John Dewey Middle    children ages 5-18 attending John Dewey
                   School                             Middle School and residing in Sunset
                   4004 Fourth Avenue - Room 108      Park, Williamsburg, Gowanus, Red
                   Sunset Park, NY 11232              Hook.

                   Program Director                   Program Components: Homework
                   Kevin Roberts                      assistance, parent support, children’s
                   (718) 671-7300                     groups and inter-generational groups.
                                                      Programs operates 3:30 PM to 7:30 PM.
                   Program Coordinator                Monday to Thursday and 12PM to 3PM
                   Ana Carbello                       Saturday
                   Jewish Association for Attention   Special Population: Parents of children
                   Deficit Disorder (J.A.D.D.)        diagnosed with Attention Deficit
                   1801 Avenue M - Suite 10           Disorder (ADD) and Attention Deficit
                   Brooklyn, NY 11230                 Disorder with Hyperactivity (ADHD).
                   Phone No. (718) 421-4200           Primarily serves the Orthodox Jewish
                   Fax No. (718) 258-6428             community of Brooklyn, but will accept
                                                      citywide referrals.
                   Program Director
                   Ann Levi Julian                    Program Components: Case assistance,
                                                      advocacy, home visits, homework help,
                                                      support groups and respite.
                   Kings County Hosp./Downstate       Special Population: Parents of children
                   Medical Center                     diagnosed with Attention Deficit
                   Division of Child & Adolescents    Disorder (ADD) and Attention Deficit
                   451 Clarkson Avenue                Disorder with Hyperactivity (ADHD).
                   “J” Building - Room 110            Primarily serves the Orthodox Jewish
                   Brooklyn, NY 11203                 community of Brooklyn, but will accept
                   Phone No. (718) 270-1430           citywide referrals.
                   Fax No. (718) 245-2517

                   Program Director                   Program Components: Case assistance,
                   Kalman Flomenhaft, M.D.            advocacy, home visits, homework help,
                                                      support groups and respite.
                   Program Coordinator
                   Delia Pollard

                   Parent Advocate
                   Luisa Jimenez




                                                                                     74
BROOKLYN Cont’d.   Jewish Child Care Association   Special Population: Formerly homeless
                   Brooklyn Families First         families with at-risk children who are
                   3003 Avenue H                   classified as SED, living in Northern
                   Brooklyn, NY 11210              Brooklyn and residing in Community
                   Phone No. (718) 859-4500        Boards 1, 2, 3, and 4.
                   Fax No. (718) 859-5708

                   Program Coordinator             Program Components: Parent support
                   Ellen Pemstein                  groups, recreation activities, case
                                                   assistance and advocacy program.
                   Parent Advocate                 Hours: Wednesday 9AM to 5PM.
                   Priscilla McMillan              Family trips and home visits also
                                                   provided. Family group meet Fridays
                                                   from 10AM to 6PM.




                                                                                  75
QUEENS   Safe Space                         Special Population: Queens parents who
         Parent Resource Center             have children ages 5-18 with emotional
         163-18 Jamaica Ave. - 6th Floor    or behavioral difficulties are at risk, or
         Jamaica, NY 11432                  were formerly homeless.
         Phone No. (718) 206-3440
         Fax No. (718) 206-3638
         Program Director                   Program Components: Parent run
         Ceceile Green                      service, which provides a warm line,
                                            advocacy, referral, workshop support
         Parent Advocates                   groups and parenting education training.
         Yolanda Mercado
         Evelyn Santana
         Annette Okoko
         Deborah Khan
         Coordinator Respite Program
         Yondel Hodges
         Queens Children’s Psychiatric      Special Population: Queens parents who
         Center                             have children ages 5-18 with emotional
         74-03 Commonwealth Blvd.           or behavioral difficulties are at risk, or
         Bellerose, NY 11426                were formerly homeless.
         Phone No. (718) 264-4578
         Director                           Program Components: Parent-run service
         Tony Liotta                        which provides a warm-line, advocacy,
                                            referral, workshops and support groups.
         Parent Advocate
         Carol Russo
         The Korean-American Family         Special Population: Korean-American
         Service Center (in collaboration   SED children and their families living in
         with the Flushing YMCA)            the five boroughs are eligible for
         39 West 32nd Street - Room 1403    counseling. Recreation program occurs
         New York, NY 10001                 in the afternoon are open to those
         Phone No. (212) 275-6550           children residing in Flushing and
         Fax No. (212) 279-6650             attending the Beacon School Program.
         Program Site                       Program Components: After-school
         JHS 189                            respite and parent support group operates
         32-15 149th Street                 Tuesdays and Thursday 3PM - 6PM.
         Flushing, NY 11354                 Counseling services available at the
         Phone No. (718) 460-3800           Manhattan location Monday through
         Fax No. (718) 460-3960             Friday.
         Executive Director
         Hye-Seak Chong
         Program Director
         Seung-Leon Lee

                                                                             76
QUEENS Cont.   The Joseph P. Addabbo Family       Special Population: SED children 5-18
               Health Center, Inc.                and their families who live on the
               1288 Central Avenue                Rockaway peninsula and attend the
               Arverne, Queens, NY 11692          Joseph Addabbo CMHC.
               Phone No. (718) 327-8306           *Program Meets in Edgemere
               Fax No. (718) 327-8336             Community Center
               Family Support Coordinator         Program Components: Evening
               Laura Craft - ext. 212             therapeutic recreation program and
                                                  parent support group. Family Support
               Parent Advocates                   group meets every Thursday from
               Joyce Mohondhis                    5:30PM to 8:00PM.
               Violeta Keney - ext. 205
               Steinway Child and Family          Special Population: 6-13 year old SED
               Services, Inc.                     children and their families.
               Home & Community Base Waiver
               24-15 Bridge Plaza                 Program Components: After-school and
               Long Island, NY 11105              summer recreation program, Monday to
               Phone No. (718) 752-1262           Friday 2PM - 6PM, which serves
               Fax No. (718) 752-1270             children 6-13. Services also include:
                                                  advocacy and parent support activities (at
               Parents & Kids Forever & Kids on   main office).
               the Move @Boys & Girls Club (2
               programs)
               Phone No. (718) 728-0946
               Fax No. (718) 728-4001
               Program Coordinator
               Patricia Hines
               Recreational Counselor
               Julian Rawlins
               Corranne Haynes
               Parent Advocate
               Michelle Going-Butler
               Neighborhood Care Team             Special Population: SED children and
               111-54 Merrick Boulevard           their parents living in St. Albans, Queens
               St. Albans, NY 11434
               Phone No. (718) 739-3000/3470
               Fax No. (718) 739-3000
               Program Directors                  Program Components: After-school
               Carrie Johnson                     recreational and vocational activities,
               Anita Johnson                      tutoring and parent support group and
                                                  workshops. Referrals, crisis
               Program Coordinator                intervention, parenting skills groups,
               Barbara Barker                     community outreach and social skills
               Parent Advocate Lisa Revell        group.

                                                                                   77
QUEENS Cont.   Puerto Rican Family Institute    Special Population: Spanish-speaking
               Queens Mental Health Clinic      parents of SED and at risk children living
               97-45 Queens Blvd. - Suite 503   in Western Queens and families enrolled
               Rego Park, NY 11374              in the mental health clinic
               Phone No. (718) 275-0983         psychotherapeutic services for
               Fax No. (7128) 275-7973          individuals and families.

               Program Director                 Program Components: Time-limited in-
               Dr. Andriana Silva               home services, psych-educational
                                                support groups and case management.
               Program Coordinator              Program operates on a 12 week cycle.
               Maria Delatorre                  Parent education, home and office visits.

               Parent Education/Caseworker
               Dalma Torres
               St. John’s Episcopal Hospital:   Special Population: SED children and
               Home Based Crisis Intervention   families who have participated in the St.
               (HBCI) Program                   John’s HBCI program, who live in Far
               115-04 Rockaway Beach Blvd.      Rockaway, Queens.
               Rockaway Park, NY 11694
               Phone No. (718) 474-2070         Program Components: Parent Support
               Fax No. (718) 318-2711           Recreational for activities, teen and pre-
                                                teen groups, psycho education, linkages
               Program Director                 with supportive services city wide.
               Anne Knight

               Parent Advocates
               Alexandria Jones
               Dalisa Espinol




                                                                                 78
STATEN ISLAND   Staten Island Parent Resource       Special Population: Parents of SED or at-
                Center in partnership with Jewish   risk children ages 5 - 18 years, who
                Board of Family and Children’s      reside in Staten Island.
                Services
                2795 Richmond Road                  Program Components: Parent run service
                Staten Island, NY 10314             which includes a warm-line, advocacy,
                                                    referrals, respite, educational workshops
                Phone No. (718) 698-5307            and support groups.
                Fax No. (718) 370-1142              Program hours: Monday to Friday 9AM
                Program Director                    to 5PM; parenting skills program.
                Deborah Miller, M.S.                Evening hours available upon request of
                                                    family.
                Parent Advocate(s)
                Debbie Sullivan
                Nadya Alisco
                Clinical Consultant
                Linda Dezio, CSW
                Staten Island Mental Health         Special Population: Families at risk or
                Society Family Support &            SED children and adolescents who are
                Program                             receiving services within the community.
                14 Slosson Terrace
                Staten Island, NY 10301
                                                    Program Components: Recreation, case
                Phone No. (718) 720-6727            management, parent education training
                Fax No. (718) 720-0326              and support groups. Respite provided
                *Program Sites:                     on-site during parent support group
                North Shore&South Shore             meeting.
                locations
                Program Coordinator
                Sharmayne Chavis, CSW, MPA
                Parent Advocate
                Kemba Williams
                Project Hospitality/Hospitality     Special Population: Residents of Project
                House                               Hospitality’s Tier II Shelter and their
                100 Central Avenue                  children.
                Staten Island, NY 10301
                                                    Program Components: Self-help and
                Phone No. (718) 720-2109            psycho-educational groups, training, case
                Director                            management, therapeutic recreation and
                Vacant                              respite services.

                Coordinator
                Vanessa Harmon


                                                                                    79
           Attachment H- Vacancy Lists:
           Home Based Crisis Intervention
Home and Community Based Service Waiver
                      Case Management
                Family Based Treatment
                  Community Residence




                                       80
                                  Division of Mental Hygiene
                              Office of Child & Adolescent Mental Hygiene
                                   93 Worth Street Room 200
                                     New York, NY 10013


TO:                    DISTRIBUTION

FROM:                  Natalie Basiuk, Health Service Manager
                       Bureau of Child and Adolescent Services

DATE:                  February 8, 2005

SUBJECT:          MONTHLY VACANCY REPORT
_______________________________________________________________________


Attached are the program vacancies as of January 31, 2005.
This report serves as a guide to aid programs where there is availability for them to refer
children to the most appropriate services within the community.

If I can be of assistance please contact me, my direct line is 212-219-5437.
For changes in address, capacity or contact person, please leave this information with Renee
McMillan at 212-219-5203 or fax it to her attention at 212-219-5466.

* All referrals to the Bronx Case Management, Family Based Treatment, Community
Residence and Waiver Programs should be made to:

             Elyse Hart, Program Director
             Single Point of Access
             400 East Fordham Road, 6th floor
             Bronx, New York 10458
             718-220-0456, ext. 232
             Fax: 718-364-3357

IF YOU HAVE EMAIL, PLEASE FAX RENEE YOUR EMAIL ADDRESS OR CALL
IT IN TO HER AT THE ABOVE TELEPHONE NUMBER AS SOON AS POSSIBLE.
WE WILL BE SENDING THIS REPORT VIA EMAIL




                                                                                               81
Page 2                                                     February 8, 2005




                                            Distribution

Joyce Wale, HHC
William Bell, ACS
Directors of OMH Psychiatric Centers
Chief of Service, Children & Youth Units
RTF Directors
Parent Resource Centers
Citywide Parent Consultants
Cathy Moran, PACC
St. Vincent's Medical Center of Richmond (S.I.)
Greater NY Hospital Association
Director of Juvenile Services/Legal Aid Society
Thomas R. Frieden, M.D., M.P.H.
Lloyd I. Sederer, M.D.
Myla Harrison, M.D.
Dimitria Risueno, Ph.D.
Oscar Serrano
Michael Zuber
Anita Appel
Susan Thaler
Mitchell Dorfman
Bette Levy
Children's Chairpersons
City-wide Oversight Body
Program Directors, Family Based Treatment
Program Directors, Community Residence
Program Directors, Children=s Intensive Case Management
Coordinators, Crisis Respite
Program Administrators, Home Based Crisis Intervention
Agency Executive Directors




Citywide Programs: RTFs
                                                                              82
                   RTFs                        Ages Served/Sex          Capacity       Vacancy         Contact Person

 I.      Henry Ittleson Center for                   5-12                   32               0         Kathy Forte, Director
         Child Research                          male & female                                         (718) 549-6700
         JBFCS                                                                                         Admissions:
         5050 Iselin Avenue                                                                            Barbara Weinberg, CSW
         Bronx, NY 10471                                                                               ext 217

 II.     St. Christopher-Ottilie                     14-21                  61          Immediate      Pam Lenon, PhD, Director
         85-70 148th Street                     dual diagnosed                          availability   (718) 658-4101
         Jamaica, NY 11433                           M/MR                               no wait list   Admissions:
                                                male & female                                          Mr. Steve Brenner, CSW

 III.    August Aichhorn Center                   Admission                 32               0         Dr. Michael Pawel,
         23 West 106th Street                  age range: 12-16                                        Director
         New York, NY 10025                     male & female                                          (212) 873-9170
                                                                                                       Admissions:
                                                                                                       Ms. Laura Pawel

 IV.    *Children's Village                           6-12                  14               0         Ms. Sarah Borlo, CSW
         Echo Hills                                   males                                            Director
         Dobbs Ferry, NY 10522                                                                         (914) 693-0600


 V.     *Astor Home for Children                      5-11                  20               0         Suzanne Button, PhD,
         6339 Mill Street                             males                                            Director
         PO Box 5005                                                                                   (914) 876-4081
         Rhinebeck, NY 12572-5005                                                                      Admissions:
                                                                                                       Mr. Brendan Sullivan

 VI.    *Green Chimneys Children's                Admission                 14               0         Ms. Jo Ann Burns, RN
            Services                           age range: 13-17                                        RTF Director
         400 Doansburg Road                          males                                             (845) 279-2995 Ext. 125
         Caller Box 719                                                                                 Admissions:
         Brewster, NY 10509 - 0719                                                                     Jennifer Tinker, CSW,
                                                                                                       Supervising Social
                                                                                                       Worker Ext. 232

 VII. *Goldsmith Center                           Admission                 49               0         Shari Silverstein, CSW
       JBFCS                                   age range: 13-17                                        Director
       226 Linda Avenue                              males                                             (914) 773-7440
       Hawthorne, NY 10532                                                                             Admissions:
                                                                                                       Deborah Mondello,
                                                                                                       ATR-BC
                                                                                                       (914) 773-7434

 VIII. *Linden Hill                               Admission                 55               0         Karen Malmet, CSW
        JBFCS                                  age range: 12-18                                        Director
        500 Linda Avenue                        male & female                                          (914) 773-7507
        Hawthorne, NY 10532                                                                            Admissions:
                                                                                                       Ms. Deborah Lavin, PhD.
                                                                                                       914-773-7683
* NYC youngsters share access to beds in these programs with youngsters from upstate and Long Island counties.

Admission to Residential Treatment Facilities is by eligibility determination through the New York City PACC Committee. Contact
agencies directly regarding waiting lists. Questions and referrals should be directed:
                                                       Ms Cathy Moran @ 212-614-6306
            Mental Health Association of NY                                             As of January 31, 2005
                                th
            157 Chambers St, 9 floor
            New York, NY 10007



                                                                                                                                  83
                                            Vacancy List
                                      MANHATTAN- September 2004

     Home Based Crisis
                                     Ages/Sex    Capacity     Vacancy        Contact Person
       Intervention
   Northside Center for Child
                                                 2 programs
         Development                                                      Adrienne Williams-Myers
                                       5-18           8
      1301 Fifth Avenue                                                        (212) 426-3419
                                     Males and                      2
    New York, NY 10029                                                      Fax (212) 410-7561
                                     Females         6
       CD's 9, 10, & 12
     University Settlement                                                     Robbie Holden
                                       5-18
        184 Eldridge St                                                     Program Coordinator
                                     Males and      11              2
    New York, NY 10002                                                        (212) 453-4593
                                     Females
           CD's 1-7                                                         Fax (212) 387-9186
  Family Based Treatment             Ages/Sex    Capacity     Vacancy        Contact Person
       Harlem Dowling/
                                                                              Peter Woodbine
Westside Center for Children and       5-18
                                                                             Admin. Supervisor
        Family Services              Males and      10              8
                                                                            (212) 749-3656 x351
2090 Adam Clayton Powell Blvd        Females
                                                                             Fax (212) 749-4720
     New York, NY 10027
   Community Counseling &                                                   Augustina Melekwe
                                       5-18
          Mediation                                                               Director
                                     Males and      20             15
      115 West 31st Street                                                    (212) 564-6006
                                     Females
     New York, NY 10001                                                     Fax (212) 564-3440
Home and Community Based
                                     Ages/Sex    Capacity     Vacancy        Contact Person
     Service Waiver
 St. Luke’s Roosevelt Hospital                                              Catherine Passman
                                       5-18
     HCBS Waiver Program                                                     Program Director
                                     Males and      48              2
      411 W. 114th Street                                                     (212) 523-2876
                                     Females
     New York, NY 10025                                                     Fax (212) 523-5766
Blended Case Management              Ages/Sex    Capacity     Vacancy        Contact Person
 Postgraduate Center for Mental                                              Mary McGovern
                                       5-18
              Health                                                         Program Director
                                     Males and      44              0
  138 East 26th Street – 5th Floor                                            (212) 576-4166
                                     Females
      New York, NY 10010                                                    Fax (212) 576-4187
  St. Luke’s/Roosevelt Hospital                                             Catherine Passman
                                       5-18
              Center                                                         Program Director
                                     Males and      44              3
 411 W. 114th Street – Suite #4B                                              (212) 523-2876
                                     Females
      New York, NY 10025                                                    Fax (212) 523-5766
    Union Settlement/Johnson
        Counseling Center                                                      Betsy Cordero
                                       5-18
         2089 3rd Avenue                                          3 ICM         Coordinator
                                     Males and      88
      New York, NY 10029                                          2 SCM       (212) 828-6160
                                     Females
(covers Zip Codes 10017, 10021,                                             Fax (212) 828-6145
  10022, 10028, 10035, 10128)
   University Settlement Oberia                                                Elissa Ramos
         Dempsey Center                5-18                                  Program Director
 127 West 127th Street, Rm #428      Males and      220            18         (212) 864-2007
      New York, NY 10027             Females                                  (212) 387-0557
(covers all Manhattan Zip Codes)                                            Fax (212) 864-2350




                                                                                              84
                                            Vacancy List
                                        BRONX September 2004

       Home Based Crisis
                                   Ages/Sex     Capacity       Vacancy    Contact Person
            Intervention
     Visiting Nurse Services
     1601 Bronxdale Avenue                                                Katherine Levine
                                               2 programs
        Bronx, NY 10462                                           1        Acting Director
                                     5-18           8
(referrals from psych ER's Bronx                                           (718) 536-3200
                                   Males and
  Municipal and Bronx Lebanon                                     2      Fax (718) 678-8558
                                   Females         6
  Hospital, Mobile MH Teams,                                              A.A. Rona Bender
  Physicians on duty @ BCPC)
          Jewish Board of
  Family and Children Services       5-18                                  Owen Mazon
    4049 Henry Hudson Pkwy         Males and       8              2      Admin. Supervisor
(referrals from MCT's, CCT's and   Females                                (718) 796-4582
 ER's in No. West Bronx ONLY)




                                                                                           85
                                          Vacancy List
                              BRONX SPOA PROGRAMS- September 2004

   Community Residence            Ages/Sex   Capacity      Vacancy        Contact Person
   Ittleson Center (JBFCS)                                                George McCray
    Community Residence            10-14                                  Program Director
                                                8             0
    2215 Holland Avenue            Males                                   (718) 655-8916
   Bronx, New York 10468                                                 Fax (718) 655-8940
  Family Based Treatment          Ages/Sex   Capacity      Vacancy        Contact Person
                                                                           Joanne Murphy
    St. Christopher-Ottilie        5-18
                                                                          Program Director
 30-36 East Tremont Avenue       Males and      25            3
                                                                        (718) 658-4101 x174
  Bronx, New York 10461          Females
                                                                         Fax (718) 523-2582
                                                              0
 Berkshire Farm Center and                                                 Jodi Saitowitz
                                   5-18                     Until
    Services for Youth                                                   Program Director
                                 Males and      20       Professional
      406 East 176 St                                                     (718) 901-6816
                                 Females                 Parents are
  Bronx, New York 10457                                                 Fax (718) 901-6880
                                                           Trained
                                                              0
                                                                           Elise Elbrecht
Cardinal McCloskey Services        5-18                     Until
                                                                          Program Director
   349 East 149th Street         Males and      20       Professional
                                                                        (718) 993-7700 x754
 Bronx, New York 10451           Females                 Parents are
                                                                         Fax (718) 993-7946
                                                           Trained
Intensive Case Management         Ages/Sex   Capacity     Vacancy        Contact Person
 Bronx Children's Psychiatric                                             Lillie Hall, RN
                                   5-18
           Center                                                       CICM Coordinator
                                 Males and      84            8
     1000 Waters Place                                                    (718) 239-3646
                                 Females
  Bronx, New York 10461                                                 Fax (718) 239-3654
Home and Community Based
                                  Ages/Sex   Capacity      Vacancy        Contact Person
      Service Waiver
                                                                          Annette Thomas
 St. Dominic's Families First      5-18
                                                                          Program Director
 1 Fordham Plaza, Room 226       Males and      60            6
                                                                           (718) 295-9112
      Bronx, NY 10458            Females
                                                                         Fax (718) 295-2104
 Blended Case Management          Ages/Sex   Capacity      Vacancy        Contact Person
                                                                            Jennifer Rojas
 St. Dominic's Families First     May-04
                                                           2 ICM         Admin. Supervisor
 1 Fordham Plaza, Room 226       Males and      44
                                                           1 SCM        (718) 295-9112 x106
      Bronx, NY 10458            Females
                                                                         Fax (718) 295-2104
 Steinway Child and Family                                                 Rosalie Wilson
                                   5-18
       Services, Inc.                                                     Program Director
                                 Males and     308           58
     206 E. 163rd Street                                                   (718) 537-5435
                                 Females
  Bronx, New York 10451                                                  Fax (718) 537-5909




                                                                                           86
                                           Vacancy List
                                       QUEENS- September 2004

    Community Residence           Ages/Sex       Capacity       Vacancy       Contact Person
                                                                               Joanne Murphy
                                                                              Program Director
   St. Christopher-Ottilie         10-14
                                                                            (718) 658-4101 x174
    218-41 99th Avenue             Males            8              0
                                                                            Colette Garcia, MSW
  Queens Village, NY 11429         Only
                                                                                 Supervisor
                                                                               (718) 468-2772
  Steinway Child and Family                                                     Robert Jorlett
                                    5-18            8
        Services, Inc.                                                             Director
                                  Males and                        1
       11-40 31st. Ave                                                         (718) 726-5588
                                  Females                          2
      Astoria, NY 11116                                                      Fax (718) 728-8882
  Family Based Treatment          Ages/Sex       Capacity       Vacancy       Contact Person
                                                                               Joanne Murphy
                                                                              Program Director
    St. Christopher-Ottilie         5-18
                                                                            (718) 658-4101 x174
      85-70 148th Street          Males and         25             3
                                                                              Rene Minter-Carr
    Briarwood, NY 11435           Females
                                                                                Asst. Director
                                                                               (718) 297-5074
                                                                               Jeanette Burgos
Coalition for Hispanic Families     5-18                                  Director of Mental Health
                                                     20
    315 Wyckoff Avenue            Males and                       16               Services
                                              Covering Queens
 Brooklyn, New York 11237         Females                                      (718) 497-1955
                                                                             Fax (718) 497-6262
 Intensive Case Management        Ages/Sex       Capacity       Vacancy       Contact Person
 Queens Children's Psychiatric
                                                                            Ina Gottlieb, CSW
             Center                 5-18
                                                                             ICM Coordinator
  74-03 Commonwealth Blvd         Males and         84             2
                                                                              (718) 264-4626
      Bellerose, NY 11426         Females
                                                                            Fax (718) 264-4954
        (718) 264-4666
  Lexington Center for Mental
        Health Services
                                                                                Adele Agin
    30th Ave and 75th Street        5-18
                                                                            Executive Director
  Jackson Heights, NY 11370       Males and         36             2
                                                                              (718) 350-3110
* Citywide CICM Program for       Females
                                                                            Fax (718) 899-9846
   deaf and hard of hearing
   children and adolescents
      Case Management             Ages/Sex       Capacity       Vacancy        Contact Person
 Queens Child Guidance Center       5-18                                  Shirley Lambacker-Brown
     80-20 Broadway, # 1D         Males and         60            16         (718) 457-1211 x12
      Elmhurst, NY 11373          Females                                    Fax (718) 457-1353




                                                                                               87
                                           Vacancy List
                                       QUEENS- September 2004

Home Based Crisis Intervention    Ages/Sex      Capacity        Vacancy       Contact Person
  St. John's Hospital Community
   Mental Health Center 115-04                                                Ms. Anne Knight
                                    5-18
      Rockaway Beach Blvd.                                                Director/Clinical Manager
                                  Males and        8               6
    Rockaway Park, NY 11694                                                    (718) 474-2070
                                  Females
 (serves Rockaway Peninsula St.                                              Fax (718) 318-2711
            John's E.R.)
                                                                             Elizabeth Traverso
 Queens Child Guidance Center       5-18
                                                                                Coordinator
    80-20 Broadway, # 1D          Males and        8               2
                                                                            (718) 457-1211 x11
     Elmhurst, NY 11373           Females
                                                                            Fax (718) 457-1353
                                                                              Bettina Beckford
      Elmhurst Hospital             5-17
                                                                           Coordinating Manager
79-01 Broadway, Section H3-38     Males and        8               0
                                                                              (718) 334-2321
     Elmhurst, NY 11373           Females
                                                                            Fax (718)334-2522
 Home and Community Based
                                  Ages/Sex      Capacity        Vacancy       Contact Person
      Service Waiver
                                                                                 Karen Clark
  Steinway Child and Family                                                   Program Director
                                    5-18
         Services, Inc                                                      (718) 389-5100 x124
                                  Males and        56             16
      24-15 Bridge Plaza                                                       Emanuel Odigie
                                  Females
  Long Island City, NY 11101                                                     Supervisor
                                                                             (718) 752-1262 x23
  Blended Case Management         Ages/Sex      Capacity        Vacancy        Contact Person
        Western Queens                                                           John Lavin
                                    5-18
       Case Management                                          3 ICM         Program Director
                                  Males and        44
    44-01 Queens Boulevard                                      0 SCM          (718)392-3516
                                  Females
 Sunnyside, New York 11104                                                   Fax (718) 392-4089
 Queens Child Guidance Center                                                Ruthine Codrington
                                    5-18
     87-08 Justice Avenue                                       4 ICM       Program Coordinator
                                  Males and        88
         Room # X-A                                             1 SCM       (718) 334-0143 x218
                                  Females
      Elmhurst, NY 11373                                                     Fax (718)334-0810
                                                                          Anaya Chunn-McCombs
  St. John's Episcopal Hospital
                                    5-18                                    Program Coordinator
    2-30 Beach 102nd Street                                      9 ICM
                                  Males and        88                          (718) 474-2169
             Suite 2A                                           13 SCM
                                  Females                                  Fax (718) 474-2372 or
   Rockaway Park, NY 11694
                                                                               (718)318-2711
  Steinway Child and Family                                                   Emmanuel Odigie
                                    5-18
         Services, Inc                                                        Program Director
                                  Males and        44              2
      24-15 Bridge Plaza                                                    (718) 752-1262 xt23
                                  Females
  Long Island City, NY 11101                                                 Fax (718) 752-1270




                                                                                               88
                                               Vacancy List
                                      STATEN ISLAND- September 2004

    Blended Case Management           Ages/Sex     Capacity         Vacancy           Contact Person
           Jewish Board of                                                             Kathy Bland
                                        5-18
   Family and Children Services                     ICM 96           0 ICM           ICM Coordinator
                                      Males and
       2795 Richmond Avenue                         SCM 80           3 SCM         (718) 982-6982 x245
                                      Females
      Staten Island, NY 10314                                                       Fax (718) 982-6916
 Home Based Crisis Intervention       Ages/Sex     Capacity         Vacancy           Contact Person
           Jewish Board of                                                             Kathy Bland
                                        5-18                      1 (always call
   Family and Children Services                                                        Coordinator
                                      Males and        8             frequent
       2795 Richmond Avenue                                                        (718) 982-6982 x245
                                      Females                       turnover)
      Staten Island, NY 10314                                                       Fax (718) 982-6916
     Family Based Treatment           Ages/Sex     Capacity         Vacancy           Contact Person
           Jewish Board of
                                                                                     Valerie Mitchell
   Family and Children Services         5-18
                                                                                     Program Director
  Caring Families of Staten Island    Males and        20               0
                                                                                   (718) 982-9633 x262
         1267 Forest Avenue           Females
                                                                                    Fax (718) 370-1142
      Staten Island, NY 10302
   St. Vincent's Catholic Medical
                                                                                      Judith Sherman
    Center Bailey Seton Hospital        5-18      20 Covering
                                                                                     Program Director
        75 Vanderbilt Avenue          Males and   Brooklyn and         19
                                                                                      (718) 876-1636
             Quarters 11              Females     Staten Island
                                                                                    Fax (718)876-3300
      Staten Island, NY 10304
       Community Residence            Ages/Sex     Capacity         Vacancy          Contact Person
           Jewish Board of                                                         Sheila Santiago, CSW
   Family and Children Services                                                       (718) 370-2975
                                                                   Accepting
Staten Island Community Residence       8-13           8                           Beryl Kende, ACSW
                                                                   Referrals
          19 Vedder Avenue                                                            (718) 720-0762
      Staten Island, NY 10314                                                       Fax (718) 720-0762
  Home and Community Based
                                      Ages/Sex     Capacity         Vacancy          Contact Person
           Service Waiver
           Jewish Board of
 Family and Children Services, Inc.     5-18                                           Kathy Bland
    Madeline Borg Comm. Svcs.         Males and        16               2          (718) 982-6982 x245
       2795 Richmond Avenue           Females                                       Fax (718) 982-6916
  Staten Island, New York 10314




                                                                                                   89
                                            Vacancy List
                                       BROOKLYN- September 2004

    Community Residence              Ages/Sex     Capacity        Vacancy      Contact Person
      Brooklyn Children's                                                    Dr. Michael Harrigan
     Community Residence              Dec-04                                   Program Director
                                                     8               1
       451 Ralph Avenue               Males                                     (718) 221-2320
     Brooklyn, NY 11233                                                       Fax (718) 221-2461
    Concord Family Services                                                     Robert Butcher
                                      12-17
      260 East 92nd Street                           8               0         Program Director
                                      Males
     Brooklyn, NY 11212                                                     (718) 398-3499 x3090
   Family Based Treatment            Ages/Sex     Capacity        Vacancy      Contact Person
  Coalition for Hispanic Family                                                 Jeanette Burgos
                                       5-18
          Services Corp.                         20 Covering                        Director
                                     Males and                      16
      315 Wycoff Avenue                           Brooklyn                      (718) 497-1955
                                     Females
      Brooklyn, NY 11237                                                      Fax (718) 497-6262
    Community Counseling                                                     Augustina Melekwe
                                       5-18
          and Mediation                                                             Director
                                     Males and       25              5
      115 West 31st Street                                                      (212) 564-6006
                                     Females
     New York, NY 10001                                                       Fax (212) 564-3440
                                                                                Robert Butcher
    Concord Family Services
                                                                               Program Director
      1221 Bedford Avenue              5-17          20              1
                                                                            (718) 398-3499 x 3090
   Brooklyn, New York 11216
                                                                              Fax (718) 638-3016
  Intensive Case Management          Ages/Sex     Capacity        Vacancy      Contact Person
                                                                               David Ortiz, CM
  Puerto Rican Family Institute                                                     Director
  175 Remsen Street, 11th floor        5-18                                     (212) 229-6970
      Brooklyn, NY 11201             Males and      132              3             Jill Green
   (covers all other Brooklyn        Females                                 Program Coordinator
          Zip Codes)                                                            (718) 596-1320
                                                                              Fax (718) 596-1250
    Brooklyn Children's Center
                                                                             Mark Bibby, CSW
        1819 Bergen Street             5-18
                                                                              ICM Coordinator
       Brooklyn, NY 11233            Males and       36              7
                                                                            (718) 221-4500 x266
 (covers Zip Codes 11212, 11213,     Females
                                                                             Fax (718) 221-4851
          11221, 11233)
North Brooklyn Children's Services
  Jewish Child Care Association
                                                                            Charyn Wilson, CSW
        870 E. 29th Street             5-18
                                                                              SCM Coordinator
       Brooklyn, NY 11210            Males and       96              0
                                                                               (718) 758-7869
 (covers Zip Codes 11201, 11205,     Females
                                                                             Fax (718) 258-2800
   11206, 11207, 11208, 11211,
   11217, 11222,11227, 11237)




                                                                                             90
                                               Vacancy List
                                          BROOKLYN- September 2004

Children’s Assertive Community
                                        Ages/Sex    Capacity         Vacancy       Contact Person
       Treatment (ACT)
                                                                               Marcia Titus-Prescott, RN
   Brooklyn Psychiatric Center
                                          5-18                                        Supervisor
       2150 Beverly Road
                                        Males and      40               3         Ms. Taylor, Sec'y
      Brooklyn, NY 11226
                                        Females                                    (718) 693-7899
    (covers CD's 8, 9, 14, 17)
                                                                                 Fax (718) 693-7729
 Home Based Crisis Intervention         Ages/Sex    Capacity         Vacancy       Contact Person
    Puerto Rican Family Institute                                                    Tania Rivera
       217 Havemeyer Street                                                     Program Coordinator
                                          5-18
        Brooklyn, NY 11206                                                          718-388-8934
                                        Males and      10               4
       (covers CD's 1,2,3,4,6)                                                        Ann Diaz
                                        Females
 referrals: SEP-Woodhull Hospital                                               (718) 963-4430 x497
  KCH Chn's walk-in Svc./J Bldg.                                                 Fax (718)963-0814
    Visiting Nurse Service of NY
                                                                                    Foluse Otyelo
               (HBCI 2)
                                                                                 Program Coordinator
          241 37th St, 6th fl             5-18
                                                                                   (718) 840-4058
        Brooklyn, NY 11232              Males and      8                1
                                                                                 Debra Thomas, A.A.
       (covers CD's 5, 16, 18)          Females
                                                                                   (718) 840-4064
      referrals: Psych ER's and
                                                                                 Fax (718) 840-4062
    Mobile Crisis Teams ONLY
    Visiting Nurse Service of NY
               (HBCI 1)
                                                                                    Foluse Otyelo
          241 37th St, 6th fl
                                                                                 Program Coordinator
        Brooklyn, NY 11232                5-18
                                                                                   (718) 840-4058
(covers CD's 7, 8, 9, 10, 11, 12, 13,   Males and      8                1
                                                                                 Debra Thomas, A.A.
              14, 15, 17)               Females
                                                                                   (718) 840-4064
 referrals: KCH walk-in/ J building
                                                                                 Fax (718) 840-4062
      CICM - PRFI and JCCA
   Psych ER, Mobile Crisis Team
    Blended Case Management             Ages/Sex    Capacity         Vacancy       Contact Person
                                                                                    Caroline Weiner
   Institute for Community Living         5-18
                                                                                    Program Director
    2384 Atlantic Avenue, 2nd fl        Males and      44               0
                                                                                  (718) 272-6025 x134
         Brooklyn NY 11207              Females
                                                                                      Annette White
      St. Christopher-Ottilie             5-18
                                                                     0 ICM         Program Supervisor
  1420 Bushwick Ave. - 2nd floor        Males and      44
                                                                     0 SCM         (718) 452-3338 x28
       Brooklyn, NY 11202               Females
                                                                                   Fax (718) 452-6218
   Jewish Child Care Association                                                  Charyn Wilson, CSW
                                          5-18
  Central Brooklyn Family Services                                                Program Coordinator
                                        Males and      88               0
          870 E. 29th Street                                                         (718) 758-7869
                                        Females
        Brooklyn, NY 11210                                                         Fax (718) 258-2800




                                                                                                   91
                                           Vacancy List
                                      BROOKLYN- September 2004

  Home and Community Based
                                     Ages/Sex    Capacity        Vacancy        Contact Person
       Service Waiver
                                                                                  Annette White
      St. Christopher-Ottilie          5-18
                                                                                   Supervisor
  1420 Bushwick Ave. - 2nd floor     Males and     24               0
                                                                               (718) 452-3338 x28
       Brooklyn, NY 11207            Females
                                                                               Fax (718) 452-6218
                                                                                 Richard Nelson
  Jewish Child Care Association        5-18
                                                                                Program Director
         3003 Avenue H               Males and     24               0
                                                                              (718) 859-4500 x158
      Brooklyn, NY 11210             Females
                                                                               Fax (718) 421-7438
          Crisis Respite             Ages/Sex    Capacity     Vacancy            Contact Person
                                                              Vacancies          Joanne Murphy
*new address
                                                              generally         Program Director
       St. Christopher-Ottilie         5-18
                                                              available.      (718) 658-4101 x174
       1420 Bushwick Ave.            Males and     11
                                                            Please call for     Alan Kahn, Asst.
       Brooklyn, NY 11207            Females
                                                               specific         Program Director
  (covering Brooklyn and Queens)
                                                              openings         (718) 452-3338 x15
  Supportive Case Management         Ages/Sex    Capacity     Vacancy            Contact Person
   Jewish Child Care Association
       Child TFC/Transitions
                                                                              Charyn Wilson, CSW
         870 E. 29th Street            5-18
                                                                                  SCM Director
        Brooklyn, NY 11210           Males and     50               1
                                                                                 (718) 758-7869
 (covers Zip Codes: 11201,11205,     Females
                                                                               Fax (718) 258-2800
11206, 11207, 11208, 11211, 11217,
       11222, 11227, 11237)
    Puerto Rican Family Institute
          Adolescent SCM                                                           Jill Green
                                      18-21
   175 Remsen Street, 11th floor                                              Program Coordinator
                                     Males and     80               4
        Brooklyn, NY 11201                                                      (718) 596-1320
                                     Females
     (Covers all other Brooklyn                                               Fax (718) 596-1250
            Zip Codes)




                                                                                              92
Attachment I- List of Residential Treatment Facilities




                                                    93
                                       List of Residential Treatment Facilities

                 RTFs                    Ages Served/Sex        Capacity      Vacancy        Contact Person

 I.      Henry Ittleson Center for              5-12                32             0         Kathy Forte, Director
         Child Research                     male & female                                    (718) 549-6700
         JBFCS                                                                               Admissions:
         5050 Iselin Avenue                                                                  Barbara Weinberg, CSW
         Bronx, NY 10471                                                                     ext 217

 II.     St. Christopher-Ottilie                14-21               61        Immediate      Pam Lenon, PhD, Director
         85-70 148th Street                dual diagnosed                     availability   (718) 658-4101
         Jamaica, NY 11433                      M/MR                          no wait list   Admissions:
                                           male & female                                     Mr. Steve Brenner, CSW

 III.    August Aichhorn Center              Admission              32             0         Dr. Michael Pawel,
         23 West 106th Street             age range: 12-16                                   Director
         New York, NY 10025                male & female                                     (212) 316-9353
                                                                                             Admissions:
                                                                                             Ms. Laura Pawel

 IV.    *Children's Village                     6-12                14             0         Ms. Sarah Borlo, CSW
         Echo Hills                             males                                        Director
         Dobbs Ferry, NY 10522                                                               (914) 693-0600


 V.     *Astor Home for Children                5-11                20             0         Suzanne Button, PhD,
         6339 Mill Street                       males                                        Director
         PO Box 5005                                                                         (914) 876-4081
         Rhinebeck, NY 12572-5005                                                            Admissions:
                                                                                             Mr. Brendan Sullivan

 VI.    *Green Chimneys                      Admission              14             0         Ms. Jo Ann Burns, RN
         Children's Services              age range: 13-17                                   RTF Director
         400 Doansburg Road                     males                                        (845) 279-2995 Ext. 125
         Caller Box 719                                                                       Admissions:
         Brewster, NY 10509 - 0719                                                           Jennifer Tinker, CSW,
                                                                                             Supervising Social
                                                                                             Worker Ext. 232

 VII. *Goldsmith Center                      Admission              49             0         Shari Silverstein, CSW
       JBFCS                              age range: 13-17                                   Director
       226 Linda Avenue                         males                                        (914) 773-7440
       Hawthorne, NY 10532                                                                   Admissions:
                                                                                             Deborah Mondello,
                                                                                             ATR-BC
                                                                                             (914) 773-7434

 VIII. *Linden Hill                          Admission              55             0         Karen Malmet, CSW
        JBFCS                             age range: 12-18                                   Director
        500 Linda Avenue                   male & female                                     (914) 773-7507
        Hawthorne, NY 10532                                                                  Admissions:
                                                                                             Ms. Deborah Lavin, PhD.
                                                                                             914-773-7683
* NYC youngsters share access to beds in these programs with youngsters from upstate and Long Island counties.
Admission to Residential Treatment Facilities is by eligibility determination through the New York City PACC Committee.
Contact agencies directly regarding waiting lists.



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                                                                                 Attachment J- Helpful Resources
New York State Office of Mental Health
New York City Field Office
330 Fifth Avenue - 9th Floor
New York, NY 10001
Telephone No. (212)-330-1650      Fax No. (212)-330-6359

New York City Department of Health & Mental Hygiene
Bureau of Child and Adolescent Services
93 Worth Street - Room 715
New York, NY 10013
Telephone No. (212)-219-5430       Fax No. (212)-226-8436

Information and Advocacy-
Advocates for Children (educational issues): (212) 947-9779
Early Intervention Hotline (for children under 3): (800) 577-BABY
New York City Youth Hotline (after school recreation programs): (800) 246-4646
New York Parent Connection (Office of Children and Family Services) (800) 345-5437
Resources for Children with Special Needs: (212) 677-4650

Useful Websites-
Annie E. Casey Foundation!http://www.aecf.org/

Bazelon Center!http://www.bazelon.org/

Center for Mental Health!http://www.mentalhealth.org/child/

Families Together of NYS!http://www.ftnys.org/

Federation of Families for Children's Mental Health!http://www.ffcmh.org/

NYS Department of Health!http://www.health.state.ny.us/

NYS Office of Mental Health!http://www.omh.state.ny.us/

NYS Office of Mental Retardation and Developmental Disabilities!http://www.omr.state.ny.us/

Partners For Children!http://www.nyspartnersforchildren.org/

State Communities Aid Association!http://www.scaany.org/

New York State Council On Children and Families!http://www.ccf.state.ny.us/

New York State Education Department!http://www.nysed.gov/

New York State Department of Family Assistance NYSOCFS and NYSDSS




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                                                                      Attachment K– Acronym List

ACS-Administration Children’s Services (NYC’s Child Welfare Agency)
BCM-Blended Case Management
CCSI- Coordinated Children’s Service Initiative
CR- Community Residence
CSE- Committee Special Education
DOHMH- Department of Health and Mental Hygiene
DSM IV- Diagnostic and Statistical Manual, Volume IV
FBTP- Family Based Treatment Program
HBCI- Home Based Crisis Intervention
HCBS- Home and Community Based Services
ICM- Intensive Case Management
OCFS- Office of Children and Family Services (New York State)
OMH- Office of Mental Health
OMRDD- Office of Mental Retardation and Developmental Disabilities
PACC- Pre-Authorization Certification Committee
RTF- Residential Treatment Facility
SCM- Supportive Case Management
SED- Serious Emotional Disturbance
SPOA- Single Point of Access




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