Program Services and Capabilities
Legacy Families provides therapeutic foster care through specially trained foster parents. The foster parents and staff provide supervision and treatment for the children who have special needs that require the specialized care. A specialized treatment plan (an Individual Program Plan, or IPP, for Regional Center consumers) is developed for each child in collaboration with the placing agency representative, and the social work staff and foster parents utilize the plan to meet the child's needs. Social work staff also pays close attention to the needs of the foster families and works towards helping the family to maintain a normal and nurturing atmosphere. Guidelines for the IPP are included below.
Legacy Families' foster parents provide the needed services after having been specially trained in the concept of therapeutic care in a "normalized" home setting. These foster parents regard their homes as the primary environment in which the children receive the therapeutic care, and do not rely primarily on outside services. Foster parents are clear that they are members of the treatment team, and are usually the primary givers of care to the children. The foster parents keep in mind that their care is consistent with the accepted treatment plan and with the child's rights.

Substance Abuse Counseling:
Counseling for substance-abusing children will be provided by community-based providers who specialize in providing these services. The services may occur in the foster home (if there is a sufficient number of children there) or at the program's location.

Smoking/Tobacco Usage:
Rules and policy addressing this issue is covered in Section 10 of this Program Statement. The Agency and foster parents will work towards the child's cessation of the use of tobacco by including the goal in the child's treatment program. The Agency recognizes the potential harm of tobacco use and will support the child's decision to discontinue tobacco use.

Dual Diagnosis:
The Agency accepts children who have a dual diagnosis and will treat the child from a team approach utilizing the Agency social worker, the placing agency worker, the foster parents and any community-based providers.

Mother/Child and Pregnant Girls Placements:
Legacy Families encourages foster parents to be open to these placement possibilities. For those children placed with the Agency, special services will be located to provide these children with the skills needed to deal with their unique challenges.

Drug and Alcohol-Exposed Infants:
The Agency is eager to having these children placed, and will support the foster parents by providing specialized training and support for meeting the special needs of these children.

Emancipation Program:
The Agency augments the Agency social worker's emancipation efforts by enrolling the eligible child in a local emancipation program located at the local community college. At this program, the children are provided transportation and financial incentives to attend.

Design of Regional Center Services:
The services designed to enhance the capabilities of consumers/children in Service Levels 2, 3, and 4, include:¹

1. Regular visits from social work professionals. At least monthly, often weekly, the social worker visits the foster family and child in the foster home.
2. Assistance to foster families in meeting children's educational, medical, therapeutic and other needs.
3. Initial and ongoing foster family training and education.
4. Support services to the foster family.
5. Nurse consultation when serving children with special health care needs.
6. Living in homes rather than in "home-like environments."
7. Natural inclusion in families and day-to-day family activities.
8. Consistent parenting throughout normal daily routines.
9. Becoming part of an alternate or extended family.
10. Child-centered and family-centered services and supports.

Caseload Levels:
The overall program features a maximum caseload of 15 clients per social worker, unless treatment requirements dictate a lesser caseload and resources permit. In order to ensure the highest quality foster care, foster parent selection is carefully and conscientiously performed. Combined with the selection process is comprehensive foster parent training and frequent interaction with the social work staff and other professional care providers. As funding and resources allow, extensive use is made of professional and licensed practitioners of medical, behavioral, and psychological treatment.
Program emphases include emergency placements, both temporary and long-term clients, reunification services, chemical dependency intervention, self-help skills, and emancipation skills.

Service Outcomes: With Instructional Methods and Techniques for Desired Outcomes:²
These twenty-five expected service outcomes for Regional Center clients were developed with the assistance from people with developmental disabilities, family members, regional center staff, services providers, advocates, professional and community members. The individual life quality outcomes represent things that people have identified as being important in their everyday lives and to their overall quality of life. The expected service outcomes (grouped by category in bold, and along with a few suggested methods and techniques to produce the desired outcomes, in italics) for children/consumers to be served include:

Choice

1. Individuals identify their needs, wants, likes and dislikes When individuals make major life decisions (and everyday decisions), they often need information and support. Service provider activities that support people to make decisions include spending time with a person talking about their needs, wants, likes and dislikes, making available understandable information about possible choices and or ensuring opportunities for choice-making. Know the goals in each person's IPP
2. Individuals make major life decisions. Provide each person with understandable information about the choices he or she has (e.g., videotapes, talking with peers). Provide each person with opportunities to learn about the options.
3. Individuals make decisions about everyday matters. Provide each person with opportunities to make major and daily decisions. Contact a person who knows the consumer well enough who can speak for the consumer to make decisions.
4. Individuals have a major role in choosing the providers of their services and supports. Make available understandable information about needed services to any individual, family members, or others involved in a service selection.
5. Individuals' services and supports change as wants, needs and preferences change. Adapt services and supports to the individual's changing needs and preferences. Assist the consumer to prepare for and make the change (e.g., finding a new job, learning a new hobby, participating in new social activities).

   Relationships
   

6. Individuals have friends and caring relationships. Promote regular contact with family and friends (e.g., providing privacy for telephone calls, helping with transportation for visits). Promote opportunities to develop friendships with whomever they choose. Provide a place to spend time with their friends at home or elsewhere.
7. Individuals build community supports which may include family, friends, service providers/professionals and other community members. Help the consumer have or promote a formal or informal support group of non-paid community members (e.g., friends, neighbors, co-workers, etc.).

   Lifestyle
   

8. Individuals are part of the mainstream of community life and live, work and play in integrated environments. Help the consumer to live in a home or neighborhood similar to those of their peers without disabilities. Help the consumer to have opportunities to choose and participate in everyday activities (e.g., shopping, banking, eating, learning, meeting friends) with other community members on a regular basis. Provide the consumer with opportunities to work in typical community jobs with other community members.
9. Individuals' lifestyles reflect their cultural preferences. Promote opportunities for the consumer to communicate with others who understand their primary language. Provide the consumer with opportunities to practice religious, cultural or ethnic traditions and holidays.
10. Individuals are independent and productive. Provide adaptive technology and assistive devices (e.g., wheelchair, environmental controls) with personal attendants as needed. Provide the consumer with a method of communication (e.g., speech synthesizer, computer, adapted telephone).
11. Individuals have stable living arrangements. Help the consumer to experience a sense of security that they can continue to live in their present home if they choose, with any needed emergency and crisis intervention services, as needed.
12. Individuals are comfortable where they live. Provide the consumer with a key to his home (adults or older teens), access to living space, his or her own bedroom or one that is shared with someone that he or she chooses, personal privacy, security for personal belongings, personal things that express his or her individuality, personal furniture or decor items, and special equipment.
13. Children live in homes with families. Provide the supports and services that allow the consumer to stay with a family on a long-term basis.

    Health and Well-Being
    

14. Individuals are safe. Provide the consumer a fire extinguisher, smoke alarm, and safety training.
15. Individuals have the best possible health. The consumer is provided information, training and services that promote the consumer's best possible health by supporting him or her to eat a healthy diet, get regular exercise, take prescribed medicine, maintain a safe weight range for their height, practice safe sex or abstinence, avoid addictive substances, and to avoid high-risk situations.
16. Individuals know what to do in the event of threats to health, safety and well-being. Help the consumer to know the possible danger or risk to health, environment, and to his or her person. Help the consumer to know how to report possible dangers and to seek help.
17. Individuals have access to needed health care. The consumer's representative or social worker ensures that the consumer has access to health care professionals and services, including a physician who knows them and knows how to work with their special needs, a dentist who knows them, emergency medical care as needed, mental health services as needed, a way to get health care as needed, and support in understanding and making health care decisions.

    Rights
    

18. Individuals exercise rights and responsibilities. The consumer is supported in the exercise of their rights and responsibilities, have frequent opportunities to use them, know how to make a complaint, and have someone to assist them.
19. Individuals are free from abuse, neglect and exploitation. The consumer is supported to be free from abuse, neglect, and exploitation. The consumer is supported to have a healthy physical appearance; no symptoms of abuse, neglect exploitation or over-medication; a bank account or safe place to keep their money and access to it as desired; training and support on how to report abuse; and a family or friend who the consumer can contact to report problems.
20. Individuals are treated with dignity and respect. The Agency social worker has positive interactions with the people he or she serves. The Administrator ensures that the staff has positive interactions with the consumers. The consumers are treated as people with unique talents and gifts.
21. Individuals receive appropriate generic services and supports. The consumer is supported to access Social Security, Medicare/Medicaid/Medi-Cal, and IHSS benefits (if eligible); public elementary and secondary education; local community resources (e.g., public parks, library, transportation services).
22. Individuals have advocates and/or access to advocacy services. The consumer is supported to have a family member, friend, and/or services coordinator who will advocate for them when they cannot or do not advocate for themselves; training and support in self-advocacy, as needed and desired; and persons to accompany and/or represent them in IPP meetings or other important discussions or activities.

    Satisfaction
    

23. Individuals achieve personal goals. The consumer is supported to feel good about what they have accomplished of their progress toward their goal; to express pride in their achievement of goals such as in self-care, using a toothbrush, exercise, learning new skills at work, getting involved in community activities, and making new friends.
24. Individuals are satisfied with services and supports. The consumer is supported to express their satisfaction when asked; to want to continue with their current services and supports and/or their service coordinator; and to show their satisfaction if they cannot express or show it themselves.
25. Individuals are satisfied with their lives. The consumer is supported express their satisfaction when asked; to express a positive outlook on life; to show their satisfaction in other ways when they cannot communicate it; and to seek to maintain what they have.

Addendum for Regional Center Definitions
Following are Regional Center definitions of terms used that may be different from traditional terms used by child protective services or foster family agencies. They are found in Title 17, Chapter 3, Subchapter 4.

"Administrator" means the licensee, or the adult designated by the licensee to act in his or her behalf who assumes responsibility for facility operations.

"Authorized consumer representative" means the parent or guardian of a minor, conservator of an adult, or person who is legally entitled to act on behalf of the consumer.

"Child with special health care needs" means a child with a developmental disability who 1) is receiving services and service coordination from a regional center; 2) is placed in a foster family home, small family home or a group home; and 3) has a medical condition that can rapidly deteriorate, resulting in permanent injury or death; or who has a medical condition that requires specialized in home health care, including and internal feeding tube, total parenteral feeding, a cardiorespiratory monitor, intravenous therapy, a ventilator, urinary catheterization, ministrations imposed by tracheostomy, colostomy, ileostomy, or other medical or surgical procedures; or special medication regimens, including injection, aerosol treatment, and intravenous or oral medication which requires specialized in-home health care.

"Consumer" means an individual who has been determined by a regional center to meet the eligibility criteria of the Welfare and Institutions Code Section 4512, and of Title 17, California Code of Regulations, Sections 54000, 54001, 54010, and for whom the regional center has accepted responsibility.

"Consumers' Rights" means the rights of regional center consumers residing in facilities, as specified in Welfare and Institutions Code Sections 4502, 4502.1, 4503, 4504, 4705, and 4710.6; and Title 17, California Code of Regulations, Division 2, Chapter 1, Subchapter 5, Sections 50510, 50515 (a) (2), (b) (2) and (c), 50520 (b), 50530, 50532, 50534, 50536, 50540, and 50960.

"Facility liaison" means the person, or his or her designee, assigned by the regional center as the principal coordinator between the regional center and the facility.

"Individual Program Plan" (IPP) means a written plan that is developed by a regional center Interdisciplinary Team, in accordance with the provisions of Welfare and Institutions Code Sections 4646 and 4646.5. Guidelines for the IPP are listed below.

"Normalization" means life conditions which enable consumers to lead more independent, productive and normal lives which approximate the pattern of daily living of non-disabled persons of the same age and reflect personal choice. All activities are based upon the principles of normalization as measured by consumer (child) participation in a variety of integrated, age-appropriate activities which take place in natural environments, at home, at work, in the community and during leisure time.

"Relocation" means the process the regional center and the consumer complete to enable a consumer to move from one facility to another.

"Residential service(s)" means the direct supervision and special services which facility staff provide to a consumer during the process of implementing the program design and achieving the objectives of the Individual Program Plan (IPP) for which the residential service provider is responsible.

"Self help" means providing for, or meeting, a consumer's physical and personal needs in the areas related to eating, dressing, toileting, bathing and personal hygiene.

"Service coordinator" means the regional center or designee agency employee, or his/her designee, who has responsibility for implementing, overseeing and monitoring the consumer's IPP and for maintaining the consumer's regional center record. Service Coordinator is synonymous with regional center case manager and regional center counselor. Nothing shall prevent a consumer, the consumer's parent, legal guardian, or conservator, from being the service coordinator if the regional center director agrees with such an arrangement.

"Service level" means one of a series of 4 levels which has been approved for each facility by a regional center. Service Levels 2, 3, and 4 have a specified set of requirements that a facility must meet which addresses the direct supervision and special services for consumers within that facility.

Guidelines for the Individual Program Plan (IPP)³
The IPP is designed around the concept of person-centered planning. It is accomplished by listening to persons with developmental disabilities about where to live, how to spend time each day, who to spend time with, and hopes and dreams for the future. It's also about supporting people in the choices they make about their life.

The Lanterman Developmental Disabilities Act is the guiding legislation for using person-centered planning in the IPP. It says that regional centers will: use this way of planning; make sure that the choices made by the planning team are written into the Individual Program Plan; give people all of the information they need to make choices for themselves; and support the many different ways that people choose to live.

Person-centered planning is one way of concluding where someone is going (life goals) and what kinds of support they need to get there. Part of it is asking the person, their family, friends and people who work with him or her about the things she or he likes to do (preferences) and can do well (strengths and capabilities). It is also finding out what things get in the way (barriers) of doing the things people like to do. If people can't talk for themselves, then it's important to spend time with them and to ask others who know them well.

Important things to remember about person-centered planning are: people with developmental disabilities (or their families and friends if they can't speak for themselves) are in the driver's seat; and, it's about supporting the many different ways that people choose to live. Children under 3 years old (and their families) get a plan called the Individual Family Service Plan (IFSP), very similar to an IPP. It's important to make sure that people have all the information they need to make choices for themselves.

When someone finds out that they can get regional center services, a team gets together within 60 days to make the IPP. Later, if someone asks for a meeting to talk about their IPP, he or she can ask for it within 30 days. The team meets at least every 3 years and people are told of the meeting far enough ahead so they can attend.

The Interdisciplinary Team (ID Team, or, the planning team) is the group that meets to help the developmentally delayed person to do an IPP. The people on the team must include the person who uses regional center services (and family members if someone is under 18 years old), the regional center service coordinator (social worker, case manager, or counselor) or someone else from the regional center. The team can also include people who are asked to be there by the individual (or consumer) like family and friends. For children living at home, someone should be on the team who can help figure out what will support the family right now, and to figure out what support is needed to make sure that children can stay living with families.

The IPP meeting is more than a meeting. A person-centered IPP is about 5 things:

1. Getting to know someone really well;
2. Finding out about someone's life choices;
3. Supporting someone's choices about where they want to live, how they want to spend each day, who they want to spend time with, and hopes and dreams for the future;
4. Working with others to come up with a way to make those choices to be a part of someone's everyday life; and,
5. Figuring out what supports and services someone needs and wants.

It's important to make sure that people have all the information they need to make choices for themselves. It's also the job of the team to look at the IPP to make sure that the services that people are getting are supporting their choices and are making a difference in their lives. The basic parts of a plan are: goals, objectives and action plans (steps we take to move toward the goals, having a date written into them so that everyone will know if something is getting done or not), family plan component (when someone is under 18 and living at home), schedule of services and supports (the kinds of help, who will help, and how he or she will help), and review schedule (when the team will meet again). If a consumer is dissatisfied with the planning meeting, the consumer can ask for a fair hearing at which the consumer's concerns will be heard.

The IPP also lists the kinds of services and supports that people need; tells who will provide that service and support; and, tells how that service and support will help people get where they want to go. The kinds of services and supports are: a place to live, a place to learn or work, and family support.

Record keeping includes making sure that someone's choices about life are supported; and, that when people need services, the ones they get make a difference in their lives.

A regional center representative plays the part of the services coordinator. The services coordinator helps write the IPP, looks for service and support when needed and makes sure that the services that people get are the ones they need and want and that they make a difference in someone's life.

The person-centered IPPs are plans that have written into them the choices of the planning team. The consumer's choices are about where to live, how to spend each day, who to spend time with and hopes and dreams for the future.