Admissions

Residential Treatment Services 
The treatment model at Grandfather Home for Children is built upon our abiding belief in the inherent rights and dignity of individuals and families and the sanctity of all human life. As this belief is expressed through an equal emphasis on acceptance and accountability, children and families are able to respond with strength, integrity and hope.

The program at Grandfather Home for Children is focused on assisting residents in making a successful transition into the community support system that has been or is being established. Thus, we focus on individual and family treatment. Foremost, the treatment program at Grandfather Home for Children works to identify and build upon each child’s strengths. This starts with an understanding and appreciation of the strength that was necessary to endure and survive the traumatic backgrounds characteristic of nearly every child admitted to our program. We help children sense and build upon their strengths in a number of functional skill areas including academic, communication, social, self care, problem solving, etc. We also focus considerable attention on developing strengths in less measurable, but nonetheless critically important areas such as developing a positive self concept, a sense of safety and personal efficacy, and trust in the adult world.

boybearThe treatment program represents an amalgam of a variety of approaches and philosophies, but relies heavily on a group treatment model. There are a number of reasons for this. First, we build on the natural tendency of children to identify, care for, and learn from each other. Second, we recognize that the adult world has not been safe for the children served at Grandfather Home for Children and view the peer group as a natural point at which to begin the process of building trusting and caring relationships. Group-oriented treatment at Grandfather Home for Children is predicated on the expectation that children will experience the following:

  • Members of the group will develop and display caring for each other.

  • Members of the group will be able to understand and respond to the needs of individual members for personal acceptance and support as well as to confront inappropriate behavior.

  • Members of the group will learn to treat each other in a respectful manner.

The Positive Peer Culture model has heavily influenced Grandfather Home for Children’s group-oriented treatment practices. Additionally, Grandfather Home for Children uses the Sexual Abuse Cycle Intervention (SACI) program in treating those children who also have exhibited sexually abusive behaviors. Sexual Abuse Cycle Intervention (SACI) is a structured, group-oriented program with established approaches to assisting children in recognizing and controlling inappropriate sexual behavior. Sexual Abuse Cycle Intervention (SACI) has been adapted for use with children with solely victim experiences and is an effective victim education program, helping these children to identify family and other factors which led to their abuse as well as future high-risk circumstances.

The role of treatment staff at Grandfather Home for Children is influenced by the group-oriented model. Staff is responsible for ensuring physical and emotional safety and implementing treatment interventions and, to whatever extent possible, meeting these objectives by facilitating positive, productive peer group interactions. Thus, the role of treatment staff is less obviously dominant at Grandfather Home for Children than would be expected in a program with a points and levels system managed by staff. However, when the group process is not sufficient to ensure safety or when more directive interventions are required, the staff role is always to assertively implement whatever service plan strategies are required to ensure safety and meet the child’s treatment goals.

While we recognize a wide range of individual variance on this issue, Grandfather Home for Children subscribes to the traditionally-accepted view that behavioral problems among traumatized children are essentially "acted out", i.e., the external manifestation of internal emotional conflicts and turmoil which have not been acknowledged, understood, or accepted. In effect, we believe that, in most traumatized children, emotional conflicts, turmoil, and fears are "wired" directly to inappropriate behaviors. The Grandfather Home for Children treatment approach is best described by our understanding that children need to internalize the sense of interpersonal security that derives from being accepted and respected by others, especially by parents and others most significant to the children. Grandfather Home for Children believes that providing this acceptance and respect is critical when children are expressing their most troubling feelings or engaged in their most concerning behaviors. Thus, treatment interventions are directed toward containing aggressive, dangerous or destructive behavior while remaining open to and accepting of the feelings that may underlie these actions. Both through the peer group and staff, there is a continual focus on providing interpersonal support and acceptance of emotions while inappropriate behaviors are being contained and more acceptable alternatives are being identified and taught.
 
Referral and Admission Process to Residential Treatment Program 
Referrals / Application: Referrals for the residential treatment program may be accepted from parents, relatives, pastors, Departments of Social Services, Area Mental Health Offices, Court Counselors, or from any other person or agency having reason to be actively involved in the placement of a child. To become an active application, the legal custodian of the child must become actively supportive and must sign the formal application for admission. Referrals can be accepted by mail, FAX or phone. It is recommended that a telephone call be the first step in the referral process so that we are able to respond to any questions you might have, to determine whether the child is likely to be appropriate for placement in this program, and to provide you with some idea of when actual placement might be possible. Phone calls should be directed to
the Director of Admissions and Planning (828) 898-5465.
 
The application form used by Grandfather Home is the form provided by the North Carolina Association of Residential Child Care and Family Services. The form should be dated and signed by the legal custodian. If the form is faxed, please mail the original application. The form is available on this site. Please click here to see a list of needed forms.

We request that the application be accompanied by a social history of the child in order to provide us with additional information and help us understand the child's needs. Documentation beyond the application and a social history are not needed at this time. Applications received without a preliminary phone call will be acknowledged in writing or by phone call as soon as possible. If it is determined that the referral is not appropriate or that the program is unable to serve the family or the child for some other reason, this will be discussed and we will make an effort to refer the family or the child to other services or agencies which may be able to meet their needs.

If it is determined that the referral is appropriate and a formal application has been received, we will proceed with the admission process. In most circumstances, if there is an available bed or one is anticipated in the near future, an assessment interview will be scheduled at this point. If there is no bed available, we will report this to the referring party and, with their agreement, place the child on our waiting list.
 
Referral for services include 1) planned admissions with comprehensive assessment and admission processes conducted prior to the child's admission, and 2) unplanned admissions with admission screening and basic assessment processes conducted prior to the child's admission to a service assessment and functional evaluation unit within the Residential Treatment Center.
Residential Treatment Emphases 
IIIa. Family Clarification

Family clarification, as a treatment intervention or emphasis, provides care and planning for families with children who must live away from home due to a breakdown of parent/child relationships or other family dysfunction. The family clarification goal is reunification of children with their families. Since the completion of the Keener Family Center in 1996, Grandfather Home for Children has been able to invite entire family units onto the campus and therapeutically engage all family members around the needs addressed in the resident child’s service plan. This facility provides a comfortable and pleasant place for families to stay on campus, with motel-type rooms as well as apartments available at no cost to the family. Working with Qualified Mental Health Professionals (QMHPs), families work on identifying and implementing the changes that need to occur to ensure a child’s successful return to the family unit. Additionally, multi-family group meetings occur at least monthly for each peer group, insuring common needs for support and family change are processed.

IIIb. Preparation for Adoption

Preparation for adoption interventions are designed to enable residents to prepare, emotionally and behaviorally, to enter and become part of a new family. This emphasis is founded upon two important premises:

All children deserve the opportunity to be part of, and live with, a family committed to them for life.

Children who have been labeled unadoptable need an opportunity to confront the issues preventing them from accepting a new family.

Residents appropriate for emphasis on preparation for adoption usually are: (a) released for adoption; (b) unable to succeed as part of a family due to unresolved emotional and behavioral issues; (c) exhibiting behavioral problems stemming from adoption-related issues to an extent warranting out-of-home placement. Preparation for adoption allows residents to assess their situations, despite difficulty and pain. Daily living experiences provide opportunities to become aware of behaviors that interfered with successful functioning in a family. Preparation for adoption interventions also help prospective or new adoptive families prepare for adoption as a permanent family commitment through monthly multi-family group meetings and other relationship-building opportunities.

IIIc. Sexual Abuse Cycle Intervention (SACI)

While an increasing number of children in out-of-home placements are victims of sexual abuse, there is an additional and significant risk of sexual abuse victims developing sexual behavior problems. At times, this results in sexually reactive or sexually abusive acts toward other children. Therefore, early effective treatment for both the victimized children as well as sexually abusive children must be available to break the cycle of sexual abuse. The peer group model proves to be significantly effective and the treatment of choice for child victims of sexual abuse as well as for children with sexual behavior problems. Sexual Abuse Cycle Intervention (SACI) is a cognitive behavioral relapse prevention model providing a structured opportunity for children to understand and alter established patterns of sexually abusive and other destructive behavior.

The focus of Sexual Abuse Cycle Intervention (SACI) is disruption of the abuse cycle. The process objectives of this intervention are to:

  • repair emotional damage inflicted on residents as abuse victims and, through subsequent reenactments, as abusers,
  • repair emotional damage inflicted upon the involved family, siblings, and/or other children subjected to the resident’s sexually abusive behavior,
  • return the residents to normal, socially responsible lives in their communities as soon as they are able to manage future risk and avoid future abuse.

In reaching these objectives, residents resolve individual sexual behavior management issues through this six-stage process: 1) Overcoming Your Denial, 2) Thoughts, Emotions, and Sensations, 3) Your Sexual Development, 4) Factors That Contributed to Your Sexually Abusive Behaviors, 5) Empathy for the Person(s) You Hurt, and 6) Reducing Your Risk of Relapse. While the SACI component focuses on disruption of the abuse cycle, it is equally effective in helping children and adolescents address other problem cycles, including
victimization and anger management.
Formation of a "Corrective Relationship" Between Child and Adult Caretaker
Children who are seriously abused typically lack trust in adult caretakers and harbor deep shame and confusion.  We believe the quality of the relationships established here, both in peer groups and with adult staff, have the potential to restore and build trust and self-acceptance.  We place a strong emphasis on accepting children, even with they are "at their worse".  We understand that a child in the midst of acting out is expecting to be rejected or re-abused.  We clearly draw boundaries around and reject inappropriate behavior, but just as clearly convey understanding and acceptance of the underlying emotions and needs.
 
Sibling Intervention
 
Our sibling intervention provides opportunity for victims of sibling incest or other mutual sexual abuse to work together to overcome the effects of their shared experience.  The breakdown of normal, healthy familial boundaries and mutual sense of shame and guilt about their shared abuse-identity creates a significant relational conflict.  Siblings are assisted in coping with special dynamics of their past abuse prior to family placement.
Children Served 
The mission of Grandfather Home for Children is to serve families and children in need. The geographical area served is primarily North Carolina.  However, applications for admission of out-of-state areas are welcomed.  It is our policy and practice to serve any family and child who meets our admission criteria.
Admissions Criteria
 Va. The following is a statement of criteria used for the selection of children admitted to this program.

  • The child or adolescent is between the ages of 5 and 18.
  • The child or adolescent has experienced significant trauma, the nature and effects of which may or may not be significantly understood at the time of admission.
  • The child or adolescent has demonstrated significant impairment in social, family, or school functioning due to the intensity and severity of unresolved emotional issues. In most cases, these issues would include at least a suspected history of sexual and other abuse.
  • The child or adolescent’s goals for admission include resolution of emotional, social, family, and/or school issues and the child or adolescent is able to benefit from a peer-oriented social relationship model using an active peer group process as the primary course of treatment in meeting these goals. The child or adolescent may need the additional support of psychoactive medication, individual psychotherapy, or counseling as adjuncts to this primary course of treatment. The child or adolescent’s range of needs will be assessed on an ongoing basis to insure continuing benefit from the multi-modal program of treatment intervention and specific adjunctive therapies.
  • Prior less restrictive interventions have not been successful.
  • The child or adolescent has demonstrated a significant deterioration in behavior which makes it impossible to maintain his or her present placement or to maintain placement in other less restrictive settings.
  • The child or adolescent may be of potential danger to self, family, or others but should not be actively suicidal or homicidal.
  • The child or adolescent may be currently in or recently discharged from an inpatient psychiatric unit but sufficiently stable to participate and benefit from residential treatment services.
  • The child or adolescent may have been classified as Willie M.
  • The child or adolescent may be adjudicated as in need of supervision or delinquent.
  • The child or adolescent has the mental capacity to participate actively in the peer group process and to use abstract thought processes.
  • The child or adolescent is physically able to negotiate the environment of the cottage setting with no more than reasonable adjustments to meet special needs.
  • The child or adolescent’s parent(s) or legal guardian/custodian is willing to enter into a contractual agreement with Grandfather Home for Children and to collaborate with treatment planning and interventions. Grandfather Home for Children does not serve children or adolescents without active parental or legal guardian/custodian consent, support, and participation.
  • If the goal at the time of admission is reunification with family member(s), that individual or those individuals are willing to participate in family treatment, including participation in the admission process and monthly multi-family group meetings.
  • The child or adolescent who has a history of repeating the pattern of his or her own sexual abuse on other younger, smaller, or weaker children or adolescents may be considered for admission to our Sexual Abuse Cycle Intervention (SACI) program if a) the child or adolescent has undergone a risk assessment with a practitioner qualified in sex offense specific evaluation or screening prior to admission and b) the child or adolescent has been evaluated to be at a moderate-to-high risk to repeat sexually abusive or offending behavior. This would not be suitable treatment for a child or adolescent assessed to be a high-risk offender who needs a secure (locked) setting. The child or adolescent has no ongoing medical problems for which treatment would restrict full participation in the normal group process, or which would place the child or adolescent at risk in a residential treatment setting.

Vb. EXCLUSION CRITERIA

We are unable to serve children with the following characteristics:

  • The child or adolescent is actively suicidal or homicidal.
  • The child or adolescent is diagnosed as having continuing psychotic episodes.
  • The child or adolescent is diagnosed as having mental illness that is life threatening, indicates severe personality disorganization or deterioration, or may seriously affect the treatment or rehabilitation process.
  • The child or adolescent is a serious threat to himself or herself or others and is need of a locked or secured setting.
  • The child or adolescent is drug or alcohol dependent.
  • The child or adolescent who has ongoing medical needs which would restrict full participation in the normal group process or who would be at risk in a residential treatment setting.
  • The child or adolescent does not have the mental capacity to participate actively in the peer group process or to use abstract thought processes.

Traditionally, Grandfather Home for Children had been defined as a agency working with children who, for a wide variety of reasons, were unable to live with their families for a short or long period of time.  More recently, this agency has been licensed through the North Carolina Department of Health and Human Services, Division of Facility Services, to provide residential treatment for children in need of moderate to high behavior management and treatment.  The typical child we now work with is one who comes from a severe history of neglect and sexual abuse and may now present sexually abusive behaviors.  Because of an overriding concern for the safety of each resident, consideration of risk factors plays an important part in the admission decision for each child assessed.
Aggregate Behavioral Characteristics and Severity of Behavioral Characteristics

The typical child or adolescent served demonstrates behavior consistent with moderate to severe impairment of role performance in school, community, and/or home environments.

He or she may demonstrate self-harmful moods or emotions, self-harmful behavior, or thinking. The child or adolescent may demonstrate risk behaviors including: self-harmful behavior, aggressive behavior, sexual behavior, and fire setting. Additionally, there may be moderate to severe impairment in caregiver resources, including material needs or family-social support, which interferes with successful treatment while the child is living in the home. The child or adolescent's functioning and severity of behaviors is assessed through use of the Child and Adolescent Functional Assessment Scale with a pre-admission overall CAFAS score of 80 or higher.
Treatment Needs of the Population Served

The child or adolescent has treatment needs which include his or her functioning level in the following areas: social skills, recreational skills, communication skills, self-control or coping skills, special education services, clinical consultation, medication therapy, psychotherapy, and/or psychiatric consultation. Additionally, the child or adolescent with sexual behavior problems has needs which include: developing victim empathy, recognizing triggers for inappropriate sexual behavior and high risk situations, developing ways of expressing feelings that are safe and respectful to self and others, clarifying individual and family issues necessary to return to family and/or community living, and demonstrated ability to utilize a relapse prevention or safety plan to ensure appropriate relationships and functioning within a family or community.

Most frequent diagnoses for children admitted include Posttraumatic Stress Disorder, Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, Conduct Disorder, Reactive Attachment Disorder, Impulse-Control Disorder NOS, Encopresis, Enuresis and Adjustment Disorder.
Assessment Interview and On-campus Visit

If the available information indicates that a child on the waiting list is appropriate for admission to this program, based on the previously listed criteria, an assessment interview will be scheduled on the campus of Grandfather Home for Children when an opening is anticipated. This interview must include the child, the legal custodian and involved family. It is strongly recommended that a worker from the local area mental health program participate, if applicable. Guardians ad litem, court counselors and other active members of the child's larger "ecosystem" are strongly encouraged to participate in this process as well.

VIIIa. Information which must be received at least 24 hours prior to the interview, in order to permit review by team members:
  • Application form, signed by legal custodian
  • Social History
  • Sexual Offender Specific Evaluation (S.O.S.E.) if child has been adjudicated as sexually abusive
  • Sexual Offender Specific Screening if child has a history of sexually abusive behavior, has not been adjudicated, and screening has been completed. If this has not been completed, Grandfather Home reserves the right to request this be done prior to an admission decision.
  • Probation status, if applicable, and documentation of probation orders and conditions
VIIIb. Typical course of Admission Assessment Interview
  • Brief description of our treatment program:
  • Discussion (legal custodian and other adults should be prepared to discuss these issues):
    • reason for admission
    • previous treatment responses and outcome - why does this child now require additional treatment and out of home placement?
    • sexual abuse/victimization issues
    • sexually abusive or offending issues, including risk factors for this individual child
    • family involvement and/or family reunification/clarification plan/goals (what family members will be involved during treatment and when?)
    • what family members (sometimes regardless of TPR) might be utilized in the treatment process as necessary for the child's resolution of issues/treatment needs?
    • discharge plans and discharge criteria
    • willingness of custodian to adjudicate for sexual offenses surfacing during treatment
    • capacity/willingness to respond in concert with GHC staff on offending, running during placement
    • willingness to respond to probation violations during placement, if applicable
  • Response from Grandfather Home staff on all above applicable issues
  • Interview of child by treatment team members
We request that the legal custodian be willing to sign consents for release of information and names and provide names and telephone numbers of contact persons at the child's last three placements, if applicable.
 
The child and team members meet with potential peer group of children (This is an opportunity for the peer group members to share their experience at Grandfather Home and their reasons for being here with the visiting child. The child is not expected to share with the members of the peer group at this time, unless he or she chooses to do so).

If the child does not meet with the peer group in the cottage, they will be given an opportunity to tour the building they may be living in.

Grandfather Home staff will share their initial impressions regarding the child's appropriateness for placement with the adults accompanying the child and identify any additional questions or needs for information. The parents, legal custodian and others will be given an opportunity to ask further questions or seek clarification of any issues addressed. The parents, legal custodian, and others will have an opportunity to tour the campus, if desired.

The purpose of this interview and visit is to acquaint the applicant(s) with our program, to give them an opportunity to see the facility and to better determine if the needs of the child can be met by our program. Parents of children are a vital part of the assessment process and are given an opportunity to ask questions about the program and better understand our expectations for their active participation while their child is in placement. In cases where reunification is the goal of placement, regular parental involvement is critical to the child's success. This is also an additional opportunity to look at the possibility of the placement of the child in a less-restrictive, less-institutional environment.

Also at the time of the assessment interview, the Assistant Director of Admissions and Planning will go over a list of all documents and other items still required prior to the time of admission with the legal custodian. It would be very helpful to have as many of these documents as possible provided at the time of the assessment interview:

Requirements for Admission
  1. Grandfather Home's application form, fully filled out and signed by the legal custodian (or parent(s), if applicable).
  2. Documents substantiating legal custody of child, other than the child's biological parents.
  3. Copies of any court orders which show the child to be on probation or parole, if applicable.
  4. Birth Certificate. Does not need to be an "official" copy.
  5. Any psychological testing reports or evaluations generated during the past two years. Discharge summaries from any psychiatric hospitalizations during the past two years.
  6. A Social History of the child and his/her family situation. This should list all previous placements when at all possible.
  7. A Person Centered Plan indicating the need and implementaion of Residential Services at Grandfather Home for Children.
  8. Documentation of a recent physical examination and medical assessment, completed within 30 days prior to the date of admission. This must include completion of Grandfather Home's Supplementary Medical Examination form.
  9. Documentation of recent dental visits, within 1 year prior to admission. This should include any orthodontic records, if applicable.
  10. Medical/Dental Insurance. The child without medical and dental insurance coverage cannot be considered for admission.. If the child is covered by Medicaid, we will need the current month's card at the time of admission.
  11. Current Immunization Record. All immunizations should be up to date at the time of admission.
  12. Adequate clothing upon admission (see separate listing).
  13. Educational (school) information:
    1. last report card
    2. current Individual Educational Plan if special status (BEH, EMH, LD, etc.)
    3. most recent testing (CAT, WISC-R, etc.)
    4. assigned school grade
  14. Service Order and financial authorization for HRI services (if applicable).
  15. Prescription for current medications or 30 day supply of medications.
Finally, the assessment visit is an opportunity to discuss with the legal custodian and involved family members the specific goals of treatment expected for the child, the present discharge plan for the child, details of family involvement during treatment, expectations of visits for review conferences by social workers and families and various other issues which will be specifically spelled out in the Admission Agreement.
Team Recommendation and Final Decision 
 
A final decision is made following the assessment for planned admission, involving as many members of the appropriate Service Team as possible after the assessment interview and other information has been gathered.  Involved in the admission decision are the following:  Director of Admission and Planning, Service Team Directors, consulting psychologist, Director of Residential Treatment and consulting psychiatrist (if indicated).  If the decision is to accept the child for planned admission, admission generally occurs soon after the decision is made.
 
The time frame for notifying the legal custodian and/or parents of our decision on the admission of a child will be discussed at the time of the admission assessment and will normally occur within three days though we will make every effort to expedite the decision process when needed.
 
If it is determined that Grandfather Home for Children cannot meet the needs of a child and family, recommendations will be made, whenever possible, for alternative placement and planning.
 
If it is determined that Grandfather Home for Children can meet the needs of a child and family, the Director of Admissions and Planning will schedule a mutually convenient admission date and talk with the legal custodian to review additional documentation needed prior to admission. 
Financial Issues and Cost of Care

The monthly cost of treatment at Grandfather Home for Children is $5942.00, effective July 1, 2001.

Historically, a very significant portion of the cost of caring for children in this program has been borne by private contributors. Private donors continue to sustain a significant portion of the cost of this program and we anticipate that this will continue to be the case in years to come, but there are limits to the funding available from this source.

As a result, we believe it is imperative that we make a very clear statement regarding financial expectations for each child being admitted to the program at Grandfather Home for Children.

XIIa. Children in Department of Social Services custody

Although there may be a number of different sources available for funding, such as IV-E, foster care payments, state board rates, Willie M, SSI, AFDC and Medicaid funding, ultimately it is the responsibility of the legal custodian to make sure that payment is made for treatment.

Please be aware that as of October 1, 1998, it has not been possible to access Medicaid funding for children who are IV-E eligible.

Grandfather Home for Children will work as closely as possible with individual Mental Health Area Programs to expedite and provide the documentation necessary to secure authorization and payment for eligible children. If we are to bill an area mental health program for Residential Treatment services, we will need both a written Authorization for Services and a Residential Treatment Service Order, signed by a physician or a Ph.D. psychologist, presented by the time of admission. Should this authorization be denied or discontinued during the child's stay, however, it is the financial responsibility of the legal custodian to ensure full payment of the per diem rate.

Because of our strong commitment to serving the needs of children and families in spite of limited financial resources, there will continue to be limited funds available for scholarship assistance in cases where supplementary funding disappears. These funds, however, can be allocated only in response to specific written request. Each such request will be individually considered and funds allocated based on demonstrated need and availability.

XIIb. Private (Family) Placement

Grandfather Home for Children is dedicated to helping children and families in need of our services, but if we are to consistently deliver high quality services to the children we serve, we must be good stewards of the limited private resources available to us at any given time. Because of this, we must ask that families actively work to identify and seek out funding sources which might not be ordinarily available to the child who is not in Department of Social Services custody. Such sources include but are not limited to:

Area Mental Health Programs: Grandfather Home has been licensed by the North Carolina Department of Health and Human Resources to provide Residential Treatment Services. If your child is eligible for Medicaid, this program can make it possible to access Medicaid funds for treatment provided at Grandfather Home. Even if your child is not currently Medicaid eligible, he or she becomes eligible immediately upon out-of-home placement. Your local mental health department and the Assistant Director for Admissions and Planning can provide additional information on accessing these funds.

County Department of Social Services: Even if your child is not in DSS custody, county departments of social services are sometimes willing to enter into a Voluntary Placement Agreement with the family, which allows them to assume a degree of financial responsibility for placement without going to court to gain legal custody. By signing this agreement, a family partially gives up legal control of the child for a limited period of time (6 months at a time, subject to voluntary extension) in order to receive this financial support for out-of-home placement. The incentive for the Department of Social Services is to avoid the long term custody which may become necessary if needed services are not provided. Either your local Department of Social Services or the Assistant Director for Admissions and Planning can answer most questions you might have about this option.

As a last resort, Scholarship Funds may be awarded on a limited basis to cover the difference between funds available from all other sources and the $5942.00 monthly rate. These funds, however, may be allocated only in response to specific written request. Each request received will be considered on an individual basis and funds allocated based on demonstrated need and availability.

Regardless of custody status, agreement must be reached prior to admission on financial responsibility for the placement and the legal custodian or parent will be asked to sign a financial agreement at the time of admission, based on this agreement.

Admission and Admission Agreement

An admission date and time is normally determined by agreement between the child's legal custodian and the Assistant Director of Admissions and Planning, who would coordinate with the treatment team receiving the child.

Admission would also be dependent on the gathering and completion of all required information and documents by the legal custodian, as discussed at the time of the assessment interview.

When the child, legal custodian and any involved family arrive on campus for admission, the child is normally escorted to the cottage by a member of their treatment team, in order to avoid the added anxiety of sitting in a waiting area while necessary paperwork is completed. The involved adults are asked to remain with the Assistant Director of Admissions and Planning until the clerical aspects of the admission have been completed.

During the admission process, the legal custodian and involved parents are asked to sign an Admission Agreement, which is a contract between the legal custodian and Grandfather Home for Children, spelling out a number of issues which would already have been discussed at the time of the assessment visit and in conversations since that time. Among other items this would include:

  • The reason for the child's placement
  • Designation of responsibilities for Grandfather Home, the legal custodian, the child and (if appropriate) the family.
  • Long range goals for the child and family (if family clarification)
  • Tentative time periods for length of stay, evaluation of progress, discharge and aftercare
  • Visit and contact agreement
  • Permission for placement and treatment

Also at the time of admission, the legal custodian is asked to sign the following consent forms:

  • Consent for treatment
  • Consent to act on custodian's behalf with educational entities
  • Consent for photographs (child not identified)
  • Consent for out of state travel
  • Consent to authorize routine/emergency medical or dental treatment
  • Financial Agreement

As part of the admission process, the legal custodian and family (if applicable) each receive a Statement of Client Rights and a copy of the agency's Grievance Process. The child would receive a Child's Handbook and the parent(s) would receive a Parent Handbook, if applicable. The handbooks discuss the treatment program at Grandfather Home, the group process and further discuss both child and family rights and the grievance process.

Upon arrival in their cottage, the child would be reintroduced to his or her new peer group. In accordance with normal practice in a strength-based treatment milieu, group members would share information with the child about cottage routines and expectations, safety issues and other cottage life issues. Typically, group members would share memories of their own fears, uneasiness or anger on the day they first arrived at Grandfather Home, and would invite the child to discuss whatever feelings they might be having, if they feel comfortable doing so. The group would also explain that no group member is expected to share feelings, at any time, unless they feel comfortable and safe doing so.

Unplanned Conditional Admission

Unplanned conditional placement may be made for individual treatment needs assessment in the service assessment and functional evaluation (SAFE) residential unit within the Residential Treatment Center under the following conditions:

  1. There is a valid Service Order for Level III Residential Treatment.
  2. There is authorization for Level III Residential Treatment.
  3. The child is Medicaid-eligible.
  4. The child’s needs and risks may be appropriately mediated during emergency assessment, insuring the safety of other residents from aggression or otherwise dangerous behavior.
  5. The custodian is able to provide the following information upon referral and placement:
    1. Identifying information (name, date of birth, Social Security Number)
    2. Current diagnoses and presenting problems
    3. History of sexually aggressive or other dangerous behavior
    4. Most recent placement
    5. Emergency Health Needs, including:
      1. a listing of all current medication
      2. 5-day supply for all medication and written orders for 30-day supply of prescribed medication
      3. immunization records
      4. medical risks, including allergies and other ongoing health problems
    6. Imminent danger or risk of future harm, as appropriate for the service being provided
    7. Court orders indicating custody or guardianship
    8. Reason for service, placement need
  6. The custodian is willing and able to supply all documentation and information required for planned admission within 72 hours of placement to insure completion of emergency assessment within 5 days of placement.
  7. The custodian agrees to remove child immediately, should his or her demonstrated treatment needs endanger her or himself, other children within the unit, or assigned staff.

Intake screening and basic assessment activities will occur during the first five days of placement, including:

  • Assessment of need for residential treatment and appropriate level of restrictiveness
  • All elements of assessment required for planned admissions
  • Preliminary determination of appropriateness for admission to Level III residential treatment unit or referral for other appropriate resources
  • Development of a treatment plan to meet child’s assessed needs with immediate implementation of appropriate temporary treatment services
  • Projected time on waiting list for admission to residential treatment service.
Children placed for assessment and evaluation will receive supportive, therapeutic services during assessment and evaluation along with educational services. Should it be determined that the child is appropriate for residential treatment services at Grandfather Home, the child will be admitted.  In most cases, the child will remain in the cottage unit and peer group he/she was assigned to during the assessment, though at times information gained during assessment will result in assignment of the child to a cottage unit and peer group more appropriate for the needs of the child.
Admission Application
Required Medical Forms
 
 
 
 
 
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