Promesa Main Office 7120 N. Marks Ave, Ste 110 Fresno, CA 93711 559.439.5437 Monday - Friday 8:00am-6:00pm After hours: Call Assigned Program Your assigned program phone number is:
tHealth Promesa Behavioral WELCOME This handbook has been designed to provide you and your parents/family with an overview of the rules and guidelines during your stay at Promesa Behavioral Health. Please take the time to read through this information. If you have any questions, please ask a staff member for help. Right away, you will be given an Orientation to the facility that includes a tour of the home, program rules and expectations and information regarding emergency situations. This handbook includes all of the documents that you will sign at the time of intake. We recognize that it can be difficult for you to be away from your family. If you have been referred here it is because someone believes you have the ability to change behaviors and thoughts that have caused significant issues in your life. It is our hope that you make an attempt to open your heart and mind to gain some new ways to cope, you can reduce stress and hurt that has been following you. Our goal is to help you learn the skills to cope with your life more successfully. Our primary goal is to return you to a healthy, productive lifestyle. We will help you learn how to exit the Promesa program successfully, with the tools to grow in all major areas of your life. We believe this handbook will provide many answers to questions you may have. We hope that you will use this change to put your life back on a positive track.
01 Program Therapy Goals 02 03 Daily Operation ADL'S Stage Program 04 05 Program Info Youth Forum Resident Council 06 Allowance Savings Policy Telephone Use Loss of Privleges Off Program 07 08 09 10 11 Medical / Dental Care Activities Education / I L S Rights Legal Issues On Site Visitation Off Site Visitation 12 Shut Down Status Emergency Intervention Removal / Discharge 13 14 Emergency Evacuation Infection Control No Smoking Policy Complaint Procedure Grievance Procedure
The purpose of the program is to provide each youth with an individualized treatment plan which will address and successfully remedy their presenting problems, needs and situation. The means by which a youth’s treatment goals are achieved is through the development of a treatment plan based on well defined objectives and methods. In general, these objectives involve assessing a youth’s problems and needs; implementing interventions to change or resolve these problems and needs and determining whether the interventions have the desired outcome. T HERAPY You will be assigned a personal therapist to meet with weekly. The focus of individual is to help you learn to understand yourself and gain skills to change old patterns of behavior and thinking that have led to STRTP placement. Therapy begins with an assessment of your history, behaviors, symptoms and experiences that brought you to Promesa. A treatment plan will be devised to establish goals for therapy while in placement. In some cases, the therapist will refer you to a Psychiatrist for a medication evaluation, or a psychologists for additional testing/assessments. Each session with your therapist are typically 50 minutes in length, and will occur one to two times during the week. Therapy may include opportunities to complete therapeutic worksheets, activity books, communicate thoughts and feelings, and understand the use of the Thinking Errors Chart. The Thinking Errors Chart will be posted in the house and you will have access to it in session with your therapist. Other Mental Health Services offered include: 9-12 week anger management classes, Mental Health Driven Substance Abuse Prevention and Education group, Dialectical Behavioral Therapy Group, Self-Care and Coping Skills group, Healthy Relationships, Gang Redirection Education, Emotional Intelligence, Challenging Negative Thinking, as well as other mental health services that are specific to your needs. Specialty Mental Health Services will also include rehabilitation services, in which you will meet with one to two Mental Health Rehabilitation Specialist for individual or group activities. The focus of this is to increase ability to demonstrate skills that will assist with making progress towards treatment and transition goals. You and your caregivers are strongly encouraged to participate in Family Therapy Services, unless your placement worker has determined otherwise. Family therapy is scheduled accordingly to the participating parties’ availability. Therapy sessions may occur onsite or at sites convenient to all parties. Sessions can be via telephone, if face to face sessions are unable to occur. Court ordered family therapy will follow the mandates of court order. We are here to help you achieve a successful outcome for your program goals and treatment plan. We want to enable you to develop the necessary self esteem and interpersonal skills to function as a self-sufficient and productive member of society. . GOALS 1
OPERATION The daily operation of the program is guided under the principles of Strength-Based Behavior Modification and Therapeutic Milieu (setting). We try to avoid using punishment as a means for correcting behavior. Our goal is to help you learn that being a responsible individual means getting work done before getting a reward for the work. In this model, the team is in a position to help you achieve agreed upon goals for your behavior by supporting and reinforcing your positive efforts, rather than focusing on punishment for mistakes or failure. If your having a difficult day and you are unable to achieve your desired goal, you simply do not earn the privileges for that day, in the same way as people not getting paid when they did not show up for work. Each day, however, is an opportunity for you to start over with hopefully greater success. ACTIVITIES OF DAILY LIVING Staff will ensure a meeting with your assigned therapist and Administrator are scheduled right away. You will be asked to read the Code of Conduct/House Rules and sign off stating you have read and understand them. ADL’s: Activities of Daily Living (ADL) are monitored by staff so you can see how you are doing on a daily basis. These activities include but are not limited to; AM chores, clean room, ready on time, school, proper hygiene, laundry, making bed, PM chores, volunteer, and in room on time. For every item on the chart, you will earn a “C” for completing it and an “R” if you refused or didn’t comply with program expectations. If you were unavailable or it wasn’t your assigned day to do those chores, you would receive an “E” for excused. The ADL chart will help determine your allowance, daily privileges and stage in the program. ADDITIONAL SERVICES In addition to mental health services, Promesa provides all youth referred to the program Substance Use Education and Prevention. These services are required to be completed to advance in the program stages. 2
sTAGE Program EXECUTIVE SUMMARY The first stage is Orientation and is 30 days. Next is Green, then Silver, Gold, Blue, Red and Transition. The Orientation Stage is utilized as a period for the youth to get to know the program rules and expectations. After 30 days, you complete an orientation “Challenge” in order to be promoted to Green. Once you are at Green stage, you will earn 1 star for every day you have received all “C’s” or “E’s” on your ADL chart. After receiving a designated number of stars, you are able to petition to move up to the next stage, Silver. This petition consists of completing a “Promotion Request” and submitting to the house manager. The House Manager, Administrator and Therapist will discuss with you whether you are ready to be promoted to the next stage. If the treatment team feels you aren't ready to promote and haven't met the program expectations, you will be given concrete and detailed goals to work on. You are able to resubmit the “Promotion Request” on the date provided by the treatment team. This process is to be completed at the end of each stage in order to be promoted to the next. Each stage has a designated number of stars to be earned in order to promote to the next. Once the Red Stage is achieved, you are able to move to Transition. You will meet with the Administrator and Therapist to discuss whether you have completed all the program requirements to step down and transition out of the program and/or what goals you will work on if you will still remain in placement. Discharge occurs when your have fulfilled the goals and objectives of your treatment plan. Discharge/Transition planning is completed on a case by case basis and is agreed upon by members of the Child and Family Team. Stage Incentives ORIENTATION GREEN SILVER GOLD BLUE RED TRANSITION $15.00 $20.00 $30.00 $40.00 $50.00 $60.00 $70.00 3
points/ privileges Dues(consequences) are given when you engage in the following behaviors listed below. Dues range from 15 min to an hour depending on behavior. Staff has the discretion to decide on time given. To “work off” dues; you complete tasks approved by your manager or staff, similar to chores. We welcome any ideas you would like to present to staff for approval. OUR GOALS Off Program Offenses o Unauthorized absence o Substance use o Physical and Verbal Threats o Physical Altercations o Stealing o Vandalism &/or Destruction of Property o Failure to Respect Physical Boundaries o Refusal of School/Suspended o Self Piercing and/or Self Tattooing o Dangerous Behaviors Failure to Follow Through with Program Plan Including; Daily Activities of the House, The Community/Public School, and Staff Directives that involves Safety or other Emergency Situations o 3 R's in a row. - while youth have an R Refusals/ = no privileges for the day R's BEHAVIORS THAT WILL EARN DUES o Stepping into the office without asking/receiving permission to step in o Stepping behind the office desk o Cursing (i.e. hell, damn, sh*t, bi*ch, hoe, etc.) o Referring to others inappropriately o Inappropriate boundaries with Youth or Staff o Inappropriate attire (i.e. walking around with only underwear on, spaghetti strap tops) o Walking out of the bathroom with only a towel on o Stepping into another youths room o Opening the front door o Exiting home without permission o Leaving soap, towels, soap container, hygiene box, or med cups with shampoo/conditioner, or any other hygiene product in the bathroom after showering o Taking Documents out of the office o Writing on the Walls, Doors, Appliances, Closets, Counters, Couch, Kitchen Table, and Floors etc. o Damaging the van in anyway, (ex, writing or denting Van) o Wearing another youth’s clothes, shoes, accessories, and underwear. o Eating of any food in the Bedrooms or Bathrooms o Sleeping on a Spare Bed, under the bed, or in another youths room o Changing in room while another youth is present o Instigating/encouraging negative behaviors o Not following directives *** This list is subject to change *** These are examples of SOME things that can result in dues - youth can work off 3 individual chore R's in a week (Mon-Sun) by doing a chore that's worth approximately 15 mins and assigned by the Management. If youth is consistent in earning R's, Management may not allow youth to work off an R. -If youth does not work off all of their dues by 7:30pm, it will result in an R for Overall Behavior. -Youth may lose weekend privileges (Fri, Sat, or Sun) by earning R's in a week (Mon-Sun) * The number of R's earned to lose privileges is based on stage - ORIENTATION/GREEN = 4 R'S - SILVER/GOLD = 3 R'S - BLUE/RED = 2 R'S Program Status Off - TRANSITION = 1 R Off Program Status can occur for the behaviors listed above or for another identifiable reason determined by program manager and administrator. You will be given the reason when you are placed on Off Program status. Also, Off Program status automatically occurs once you accumulate three hours of dues total or 3 R's in a row. While on Off Program status, you are still expected to complete all ADL’s. During this time you do not have privileges, do not earn allowance and are not eligible to earn stars. You can get back to “On Program” status after completing a minimum of two full consecutive days of “C’s” and it is approved by manager and administrator. Off Program will be subject to Administrator approval, Off Program will be a Minimum of Two Days, and a reminder, During Off Program no Stars or Allowance can be Earned………… 4
prog TIO ore A m RM FO IN Privilege Drop Once a youth is on a stage, they will stay at that stage unless promoted to a higher stage. You will not be “dropped” a stage for negative behaviors. Your stage will never be taken away from you. However, often time you can get off track and struggle to meet the expectations for that particular stage. When that happens there are consequences; such as dues and Off Program that will be earned. If you continue to struggle with displaying the behavior expected for the particular stage, the treatment team will meet to discuss a “Privilege Drop”. This would mean that you would be given privileges for the stage below your current stage. For example, if a youth is a blue stage they would earn the privileges and allowance for the gold stage. After a week of having a “Privilege Drop” the youth could petition the treatment team to be back on regular privileges. Please ask manager for petition form. Youth Forum SICK DAYS Sick day is when you; - Have a fever - You have severe symptoms of illness During sick day the expectation is that you are resting in your room recovering from your illness. Privileges are not available while on sick day. No working off dues or participating in other activities (not including therapy). If you become ill or have a condition that is contagious, you will be asked to remain in your room or away from other youth for a specific period of time. Volunteer points can be earned by doing things similar to chores. These points are expected for ADL’s. You can earn extra volunteer points after completing ADL’s. These points cannot be used to work off “R’s”, but can be used to work off dues. You must get approval for all Volunteer points from staff. There is a monthly incentive for the youth with the most points :) Volunteer Points • • • • Resident Council A Youth Forum may be called by either the youth or staff, when there is an issue of importance. These forums may be used to settle conflict issues between peers or between peers and staff. They may also be used for further developing program procedures or for commenting upon particularly commendable behaviors (positive strokes). The objective of the forum is to promote individual input into a structured group. This heightens awareness of the importance of individual opinion. If a policy or program decision made in Youth Forum is to be changed, the procedure requires presenting the change and the reasons for it in another Youth Forum. 2 Resident Council meetings are held throughout the year to provide an opportunity to have a free exchange of ideas and make recommendations to administration to improve the quality of daily living in the home and negotiate the change or implementation of rules and guidelines. One representative is chosen from each home to represent their respective home. Prior to the council meeting, each home will hold a youth forum and agree on the issues to be discussed at the council meeting. The representative from that facility will bring forward those issues to be discussed with the other council representatives and the top three issues decided on by the council group will be presented to administration for review. The results of the issues presented to administration will be provided to you at a youth forum held at each of the home. 5 • • • • • • •
Allowance is based on completion of Activities of Daily Living and the youth’s current stage. Rate of allowance starts at 1.50 per day during Orientation stage Green = 2.00 per day Silver = 2.25 per day Gold = 2.50 per day Blue = 2.75 per day Red = 3.25 per day Transition = 3.50 per day Activities of Daily Living resulting in a “R” that would affect your progress on any given day include but are not limited to; school refusals, unauthorized absences, and any unsafe behaviors. These “R’s” cannot be worked off and no allowance or star would be earned on that day. You may be able to make amends for these behaviors and earn daily privileges back. You may also be required to sit down with your Administrator and/or therapist and write a behavior contract to address recurring or unsafe behaviors. “R’s” Earned for morning chores may be worked off in the evening by picking up an extra chore. SAVINGS EARNING POLICY Telephone use You may receive money from several sources. The most common sources are allowances, earnings from a job, gifts, and monies brought into the program. The Agency will not handle cash resources in excess of $50.00. Placement workers, parents or guardians are informed that any cash resources you may have in the excess of this amount must be entrusted to either a parent(s) or an authorized adult approved by the placement worker. It may also be secured by the facility administrator at the main office or be placed in a savings account. When the treatment team has determined that you are committed to handling money properly, you may be able to carry your money. All money must be kept in the designated locked area in the home or in a savings account. If you accumulate more than $50.00, and decide to open a bank account, the Agency shall keep a written record of all earnings, deposits and withdrawals. All withdrawals must have staff approval and amounts over $100 must have the placement worker’s approval as well. Records are kept in the designated locked area in the home. Youth who have obtained employment are required to save a minimum of 75% of their earnings to prepare for emancipation. You have the right to contact your placement worker or Community Care Licensing at any time. Each home has a designated youth phone line available. You will have access to telephones to make and receive confidential calls, as long as your calls are not prohibited by your treatment plan or a court order and do not violate other youth’s rights. In case of an emergency at the home, staff must have access to the phone, so phone calls may be delayed. In order to be fair to everyone, we have the following guideline for telephone use; • You may not call from one Promesa Home to another Promesa Home unless you have a sibling at another Promesa Home. • Phone hours are listed at each site. You must get permission from staff before you use the phone. • You cannot make or receive calls to/from those individuals and telephone numbers, which are restricted by an order from the court or parent. Your authorized representative will provide staff with this information and it will be kept in your file. • If your program is temporarily suspended, you may still call your family and your authorized representative. • In all homes, the length of phone calls may be limited in order to allow others to make/receive phone calls. • The use of cellular phones should follow the agencies current cell phone use policy. 6
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