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Youth Service Bureau Lighthouse (Baltimore County FY17 and Beyond - Annual)

Story Behind the Curve

FY23: The CAFAS or Child and Adolescent Functional Assessment Scale is a tool for assessing the day-to-day functioning level of the client and changes that occur over time. This performance measure tracks the treatment progress of children, youth, and young adults aged 5 – 18, when the total score on the initial pre-CAFAS assessment is 20 points or greater. A higher CAFAS score indicates a more significant behavioral health concern or number of concerns across such domains as home, school, community, and behavior toward others. Cases that demonstrate an improvement in the CAFAS total score of 20 points or greater represent a significant improvement for the client. During FY23, 83% or 20 of 24 Lighthouse clients with a CAFAS score of 20 points or greater on the initial CAFAS assessment demonstrated an improvement in CAFAS total score of 20 points or greater at the conclusion of formal counseling services.

Previous Narrative

Out-of-Home (OOH) placement describes the situation of children who are in the care and custody of the State for a variety of reasons, and is often used when less restrictive interventions have failed. Children and youth may enter OOH placements for a variety of reasons including the following:

  • Children who experience abuse or neglect may enter the child welfare system (e.g., kinship care, foster care). “Eighty percent of youth involved with the child welfare system require mental health intervention and services due to developmental, behavioral or emotional issues” (National Conference of State Legislatures).
  • Delinquent youth may enter the juvenile justice system. “Sixty-seven to seventy percent of youth in the juvenile justice system have a diagnosable mental health disorder” (National Center for Mental Health and Juvenile Justice).
  • Children and youth with behavioral health disorders may enter care for residential treatment, either through a Voluntary Placement Agreement (VPA) or though the public behavioral health system. “Children and youth in residential treatment centers, 69 percent of whom come from the juvenile justice and child welfare systems, have extremely high rates of mental and behavioral health disorders compared to the general population (National Center for Children in Poverty).

According to the FY2019 Out-of-Home Placement Report and Resource Guide, the County OOH placement rate for 2019 is 5.5. In actual numbers, the 2019 rate of 5.5 represents 661 County children and youth placed out-of-home.

The overarching Goal of the Lighthouse program is to reduce the out-of-home placements of children and youth by preventing entry or further penetration of the juvenile or adult justice system (e.g., detention), child welfare system (e.g., foster care or residential placement), and/or behavioral health system (e.g., psychiatric hospitalization or residential treatment). The Objective is to reduce the severity of or remedy the symptoms of the diagnosed behavioral health disorders of children and youth that may contribute to out-of-home placement.

Partners

  • Baltimore County Public Schools
  • Baltimore County Police Department
  • Baltimore County Department of Health / Bureau of Behavioral Health
  • Community Health Providers
  • Baltimore County Department of Housing and Community Development
  • United Way of Central MD (Delete this from the list of partners)

Program Summary

Lighthouse provides clinical counseling services for children, youth, and young adults that focus on addressing behaviors or symptoms which indicate a behavioral health condition.  Lighthouse counselors have training and experience in a wide variety of evidence-based treatment approaches, and practice from an integrative care model, designing treatment plans tailored to the needs of each child or adolescent and their family.  As a trauma-informed treatment provider, Lighthouse counselors regularly use Trauma Focused Cognitive Behavioral Therapy (TF-CBT), elements of Dialectical Behavior Therapy (DBT), yoga and mindfulness practice, and expressive modalities, all of which have documented success in the treatment of child and adolescent trauma.

Target Population

Children, youth, and transitional age young adults (age 24 and under), experiencing mental or emotional distress, effects of trauma or family dysfunction (current or past), or disturbances in behavior that have caused them to be referred by family, school or community agencies.

Governor's Strategic Goal

ACES

Local Highlight

FY23: HFY1: Lighthouse is transitioning back to "in person" treatment, but is still offering tele-health treatment when preferred by the client. The Lighthouse therapist staff now includes a Spanish-speaking therapist which is enabling the agency to serve Spanish-speaking clientele. Challenges: HFY1: Low insurance reimbursement rates for therapy continue to make it very difficult to financially sustain service delivery.

Measures

Time
Period
Current Actual Value
Current Target Value
Current
Trend
Baseline
% Change

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Scorecard Container Measure Action Actual Value Target Value Tag S A m/d/yy m/d/yyyy