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PROPOSAL FOR THE COUNSELING SERVICES PROGRAM
[Named] COUNTY SCHOOL DISTRICT
[Named] SCHOOL
BY
KURT LaROSE, MSW
FLORIDA LICENSE # ISW3858
PURPOSE
Purpose for the Youth. The goal of the Counseling Services Program is to allow students to address: interpersonal factors (school and familial relationships), behavioral concerns (non-compliance, oppositional responses, peer conflicts, and truancy issues), anger management (verbal/physical outbursts), aggression (verbal/physical), suspensions (ISS & OSS), developmental tasks (bio-psycho-social-sexual), as well as various other functional and dysfunctional issues. Through counseling methodologies youth are provided an outlet to openly identify and address dynamic interpersonal processes, often related to life stressors, that otherwise cannot be attended to in the classroom setting.
Purpose for the School. Counseling services are designed to provide the school with an avenue to address mental health needs and concerns for youth in an environment where such services are traditionally not provided. There are a multitude of issues that children must address in order to be successful in the academic setting, however some children require counseling services that occur simultaneous to academic instruction. Counseling allows the school system to provide a forum where expressive needs of children can be facilitated, simultaneously enabling children to remain increasingly focused on classroom factors - while their expressive needs are addressed and resolved. Cognitive and Behavioral issues are addressed with youth who may/may not have mental health needs, but nevertheless need more intense and directive interventions to help them succeed in the school setting.
Purpose for the Teachers. The Counseling Services Program offers assistance, suggestion and direction to teachers related to specific youth who are identified in the classroom as "in need of services." In conjunction with, and with the approval of school administrators, techniques to assist teachers who interact with emotionally, verbally, physically, and/or sexually aggressive youth in the classroom. The provision of services to teachers occur in multiple formats: in face-to-face meetings, IEP and Individual Team Assessment meetings, Study Team meetings, telephone calls and email communications. Such services to teachers can be enhanced with the "Add On Services" component of the Counseling Services Program, listed at the end of this proposal.
Purpose for the Parents. Parental involvement in counseling services is facilitated under the Counseling Services Program on an "as needed" basis. When the counselor identifies that meetings are indicated between the youth and the parents, school administrators are advised that a meeting will be taking place. Parental / youth meetings occur for the purpose of facilitating improved interpersonal relationships, particularly when such relationships appear to be of clinical concern and can be directly or indirectly linked to the academic environment.
Purpose for Administration. School administrators often see themselves as one of the final places whereby youth and instructor issues (academic and/or behavioral) are resolved. In many school environments such issues often are referred to administration prematurely or without adequate intervention prior to referral. And while the Counseling Services Program does not have an academic component, good communication to the counselor allows for academics to be used as one measure of success and/or failure in social/occupational functioning for youth; in other words if the counselor knows that a student is performing poorly in certain academic areas (often initiated by the counselor in review of report cards) the youth can be challenged to consider the variables that perpetuate poor performance. From a behavioral standpoint, when outbursts are reduced, referrals reduce. A key consideration for administrators to relate to the Counseling Services Program as benefactors is in the provision of information to the counselor, which can then be incorporated into weekly sessions. Reciprocity occurs in that the counselor provides intervention ideas, feedback, and commentary on methods that are suited to the individual needs of the most problematic youth who often return to administrators due issues involving recidivism.
Summary of Purpose. The reduction of outbursts and improved academic performance is facilitated and addressed in the previously identified ranges of service in the five categories of "Purpose for Youth, School, Teachers, Parents, and Administration." The key indicators of success are not limited to academic and behavioral variables, because other issues involving time consumed in dealing with problematic youth is a factor, improved internal processes for youth is a factor, general life satisfaction for youth is a factor, and the impact of these improvements as they appear in interactions with an entire student body must be considered as well. For outcome considerations please see "Program Evaluation and Outcome Measures" section of this proposal.
SERVICES TO BE PROVIDED
Counseling. Counseling will be provided to youth at the school. Youth will be divided into two kinds of counseling formats: groups and individuals. Counseling services will include common mental health treatment methodologies: Cognitive, Behavioral, Supportive, Narrative / Bibliotherapy, Play therapy, Art therapy, Music therapy, Relaxation therapy, and Psycho-Education. Various theoretical perspectives will be utilized as well, dependent upon the specific needs of the youth in order to facilitate improvement.
Progress Reports. Progress reports will be provided to the school upon request, explicating general information about students' participation in counseling services. At a minimum, progress reports will be submitted to the school district on two different occasions during the course of the academic year: 1) at the initial phases of service provision where certain youth are indicated to be "in need of services" and 2) near or at the end of the services provision time frame (the school year) to summarize overall outcomes. Finally, monthly service provision sheets are included with each invoice to the district whereby services are generally described (see attached progress report format: COUNSELING SERVICES PROGRESS SHEET). The Counseling Services Progress Sheet that accompanies each monthly invoice, outlines administrative contacts and tasks between the counselor and certain school personnel, parent/teacher meetings, family meeting times, youth seen in groups and in individual sessions, length of time services are provided (listed in 15 minute minimum increments), travel time (to and from the school), as well as reasons why youth missed sessions, and any other service provided such as in-services, group presentations, and telephone contacts.
Mediation. Mediation will be provided to the school, for those youth who are involved in the counseling program. Mediation is available during the days of the week when the counselor is on school grounds. This service includes parent/teacher meetings, IEP meetings, teacher/student meetings and telephone contacts to parents, teachers and students.
Introductory Seminar. The counselor provides the school with an introductory seminar on the benefits of counseling services. Topics for the 10-20 minute seminar include:
- Expectations for those youth who are referred to counseling: When students get better and if students get worse.
- Desired Outcomes vs. Actual Outcomes: The benefits and limitations of counseling.
- Confidentiality: Legal limitations regarding the release of counseling records, confidentiality in the school setting between students / teachers, and legal requirements regarding reports of self-injury, abuse, and/or threats of injury.
- Logistics: How students will be called to session each week, how to best avoid taking students from core classes (and what happens when it can't be avoided), and how the counselor keeps teachers notified as to the whereabouts of youth who attend counseling.
- Question / Answer period.
When this seminar cannot be provided due to logistic limitations at the school level, the school administration and the counselor will partner to allow teachers to access the seminar content via a web-based program summary and introduction. The Counseling Services Program provides the web-based service, and it can be useful throughout the year for teachers, students, and parents. The web-based approach is an effective alternative to the actual seminar, however the Introductory Seminar is most functional when it is done in person and on location with the teachers and staff who will interact with the counselor throughout the school year. The web-based information for the seminar can be accessed via the following web links or via the URL's:
1) School Counseling (SC) program explanation.
URL: http://www.nettally.com/klroze/page5.html
2) SC continued: children, teachers, administrators.
URL: http://www.nettally.com/klroze/page6.html
3) Common concerns & other thoughts.
URL: http://www.nettally.com/klroze/page15.html
4) Parental consent for counseling services.
URL: http://www.nettally.com/klroze/pag14.html
Wrap-up Seminar. The counselor provides the school with a wrap-up seminar at the end of the academic school year. The topics of the wrap-up seminar are focused on the likes and dislikes of the counseling program with feedback and commentary. If the school opts out of the wrap-up seminar, upon completion of the counseling services program the counselor will contact the principal and ask for feedback from school personnel and district personnel (using informal commentary and/or formal surveys). Please see the PERSONNEL EVALUATION FORM that is attached to this proposal.
LOGISTICS
Referrals. Referrals are made to the counseling services program according to the processes that are best suited to the desires and needs of the school, using standardized referral forms (for example, see attached form: SCHOOL REFERRAL FOR COUNSELING SERVICES). School and county personnel identify children who may benefit from counseling and a permission slip is sent home to the legal guardians. Identification often occurs via teachers who commonly must deal with behavioral issues in the classroom, however guidance counselors, coaches, school administrators and even parents themselves may refer children to the program. Services can be provided to any child whose parents will give permission, however counseling services may be limited to a certain population (ESE, LD, EH, etc.) as the County deems appropriate and according to the mandates and stipulations of funding authorities.
Permission to Serve. Any child who is referred to the counseling program must have the written consent of their parent / guardian. Written parental consent is a legal requirement, except in certain cases (such as when an IEP already requires counseling services). When a child is referred to counseling, the referring party sends home a permission slip that must be signed and returned to the school before services can be provided (see attached form: PERMISSION SLIP FOR SCHOOL COUNSELING SERVICES). On the reverse side of the permission slip is an optional and informative question/answer commentary for parents/guardians to read as they confront the proposition that the child may need counseling (see attached form: SEND MY CHILD TO A COUNSELOR?).
In addition to the written consent of guardians, the minor child must give the counselor "assent" in order for services to begin. Assent is usually obtained verbally. Consent and/or assent can be withdrawn at any time, but if either is withdrawn, counseling services will be terminated.
Length of Service. Counseling occurs one day each week (usually on the same day) and is provided during the course of the academic school year. The number of days that counseling services occur can be increased as needed by the school, dependent upon provider availability, funding, and the agreement terms that are negotiated.
Counseling sessions usually last for one clinical hour (45 - 50 minutes; whether group or individual), and generally will not exceed the length of a standard classroom period. The length of sessions will vary (longer or shorter in duration) due to a number of circumstances (travel time, the length of the school day, holiday/testing schedules, crisis interventions, youth absences, and other variables) but youth will be seen consistently on a weekly basis for approximately the same amount of time each week. Sessions may be limited to 30-minute increments, in part to accommodate the number of youth served, but particularly in cases where travel time to the school exceeds one hour.
DOCUMENTATION AND CONFIDENTIALITY
Primary Concern. The primary concern in counseling is rooted in the needs, goals and desires of the person who receives counseling; this principle is equally true for adults and children. As a result, information about what occurs in counseling and/or what is discussed in counseling cannot be disclosed outside of the confines of the counseling session, unless the recipient of the services provides consent for the information to be released. Confidentiality is protected by the Standards of Care in the profession of Clinical Social Work and mental health counseling and confidentiality is protected via legal mandate (see FLA. §§ 491.0147 - 491.0148).
Intake. An Intake opinion will be generated following the initial interview of a child, who is referred to counseling services. The initial assessment includes general clinical impressions and a brief treatment plan. Intake is a part of the confidential counseling record for each student and it is a confidential counseling record, and it becomes a part of the youth's Case Note file(s). Assessments (and all case note documents) cannot be released due to confidentiality, except in certain legal situations (often by court orders that have been properly served), and access to persons outside of those clinically involved in the counseling process is prohibited. Additional confidentiality information is provided in the "case notes" section of this proposal.
Case Notes. Case notes are the details of specific information that is exchanged between the student and the counselor during each session. These notes are confidential records that are maintained by the counselor (usually up to three years) and cannot be released except under certain legal requirements (see FLA. §§ 491.0147 - 491.0148; often by court order). Teachers, administrators, other school personnel, county personnel and various other professionals do not have access to Case Notes even in cases where such records are requested - and even if the request is initiated by the parents of the youth.
General Access. General access to Case Notes is limited to the counselor (and to the clinical supervisor of the counselor) and cannot be released to anyone except under certain and unusual circumstances. Case Notes are maintained in the confidential files of the counselor according to legal mandates and licensing board requirements - at a minimum. The Case Notes are the property of the counselor and the Counseling Services Program and may be kept in a confidential file longer than the minimum standard, as set by law.
Exceptions. Confidentiality standards do not apply in cases where state and federal law provide for exceptions. Exceptions to confidentiality include cases of suicidal-homicidal ideation/intent, abuse or neglect, and real/perceived threat of harm to others. If an instance of confidentiality breach is necessitated by the reports of the youth, a formal risk assessment will be completed and crisis intervention methods will be implemented. If stabilization attempts are unsuccessful, or under certain other safety concerns, a confidentiality exception occurs. Depending on the type of confidentiality exception the school staff may be notified immediately, for example in a case where the risk for self-harm is evident, at which time constant and direct supervision of the youth must be ensured until the process of legal commitment is addressed and resolved.
Release of Information. In the event confidential information is requested, a written release of information must be provided to the counselor, signed by the legal guardian. The counselor reserves the right to verify all requests for information and in most cases released information will be summary in nature related to the process of counseling, rather than the specific content of counseling services. In some cases, the counselor may require the requesting party (who is attempting to gain access to confidential records) to pursue additional legal means to access confidential counseling records, which is deemed necessary in order to ensure treatment efficacy on behalf of the client.
CONTRACTUAL TERMS
Contract. The counselor and the school district are bound by a written agreement that includes the terms of service, the rate of pay per day, a breach clause, a retainer fee declaration, and a 30-day written termination clause (allowing either party to terminate the contract with written notification). The contract is a standard contract that has been successfully used with other school districts (see attached form: AGREEMENT FOR THE COUNSELING SERVICES PROGRAM) however - it can be modified to meet the specific needs of the district.
Rate. The daily rate for counseling services is $425.00. The daily rate includes traveling time (up to 2 standard hours). The rate is assessed for each day the counselor comes to the school to provide services (unless the school is closed), even in cases where youth are absent, the teacher refuses to release the student for counseling, the child refuses to attend, and/or during early release days and schedule shifts due to testing and/or various other school events when the counselor is on campus to provide such services. The rate is generally based upon a full day of counseling services beginning at 9:00 AM. The counseling day ends upon the release of the children from the school, however an additional hour of time each day is included at the end of the school day for meetings, phone calls and paperwork. The counselor is available to provide up to 7 clinical hours of counseling per day (a clinical hour usually lasts between 45 and 50 minutes), but times may be adjusted according to logistical matters that necessitate such adjustments (for example, when travel time exceeds that daily total of 2 hours). The maximum number of hours in the contracted day, regardless of the number of clinical hours provided to students, regardless of the number of traveling hours, and regardless of the number of hours offered for daily follow-up meetings, is 9 standard hours. If the total number of hours combined in any given day exceeds 9, the counselor may assesses an additional hourly fee for every hour over the 9 hour maximum. The additional hourly fee will begin at fifteen minutes past the 9-hour maximum, and will be billed in hourly increments.
Optional Retainer. Upon acceptance of the contract by the school board, other governing body or authority, the retainer fee that is listed in the Agreement for Counseling Services becomes immediately due and payable, if the district wishes to utilize the retainer aspect of the proposal and contract. The optional retainer fee, when utilized by the district, ensures the availability of the counseling days and services that are requested by the district. The retainer fee is based upon the overall contract costs for the school year, and is not included in the contract for services fee. When accepted, the Counseling Services Program will enlist, train, and provide the appropriate number of professionals to meet the needs of all schools who require services, in the event other support professionals are needed to fulfill the number of requested days (see "additional support staff" section of this proposal for more information).
Indemnity. Some districts require an indemnity clause, although Florida Statute protects school districts as an "agent of the state" under its sovereign immunity laws (see FLA. §§ 768). The statute does not fully indemnify the school district from liability in cases where alleged harm is considered intentional and even in the intentional cases Florida Statute provides for a $100,000 and/or $200,000 maximum risk (with an attorney fee maximum of $25,000). The law is less clear as to whether or not the contract incorporates the sovereign immunity liability protection standards to the counselor, who might also be construed by some as "an agent of the state." Districts are advised to seek legal counsel in this regard, provided there are concerns related to indemnity. Regardless, the counselor assumes all risk and responsibility of liability related to the counseling services program, particularly and especially in cases where indemnity is determined as not applicable to the Counseling Services Program.
Liability. The counselor carries professional liability insurance that provides for sufficient coverage in cases where legal issues may arise. A liability declarations page is copied and provided to the school district upon request, prior to beginning counseling services in the school showing the insurance company, the policy number, the amounts of coverage per incident, and the expiration date of the policy. As a pre-requisite to obtaining this insurance the history of prior claims, lawsuits, or professional conduct violations must be reported and/or investigated.
Legal Sanction History. There has never been a professional code of conduct, professional ethics violation, a lawsuit (filed or threatened), or a legal sanction or settlement levied against LaRose or entered into by LaRose, or the Counseling Services Program. Code of conduct violations can be tracked through the State of Florida, Department of Health, Division of Medical Quality Assurance website (accessible through the MyFlorida.com portal).
Workers Compensation. Some school districts require a legal statement regarding Workers Compensation coverage to be included in the contract. State Statute regulates Workers Comp coverage requirements (see FLA. §§ 440; a company with 4 or more employees must carry Workers Comp). It is not necessary to include a clause in the contract at this time because Kurt LaRose, MSW is self-employed. There are currently no other providers employed by the Counseling Services Program, however in the event the program requires additional counselors, when 3 or more are added, the program will fulfill all legal mandates related to Workers Compensation coverage. LaRose is covered with medical health insurance under the Department of Justice's Federal Employees Program with a family insurance plan.
Billing. The Counseling Services Program will submit a bill each month to the school district, in the amount of $425.00 for each contracted day; billing may occur more frequently depending upon the pay cycles that are currently in place at the district. The bill will include a copy of the Counseling Services Progress Report record for each week that counseling services were provided. Payment is to be made to Kurt LaRose in a timely manner (consistent with the normal payment processes of the district office). Late payments, those that are outside of the normal payroll processes for the school district for its own employee payroll, may be considered a breach of the contract terms (see the breach section of this proposal).
Document Submission. All documentation will be submitted to the district office electronically using Microsoft Office® software applications. In cases where signatures are required, the documents will be scanned into an Adobe Acrobat® file (or other commonly utilized application) so that signatures are unlikely to be manipulated. The scanned files will be submitted to the district electronically as email attachments. If original "hard copy" documentation is needed, these forms will be mailed to the district office upon request, and may include a document processing fee of $1 per page. All electronic files will serve as original documentation. Requests and agreements made via electronic mail will meet the written request stipulations of this proposal, and any subsequent contract, as is known and accepted with laws related to email identifying such communications as binding.
OTHER SERVICES AVAILABLE
Diagnostics. Diagnostics are not included as a standard component of the counseling services program, except as is needed by the counselor to provide interventions. Mental Illness diagnosis (and/or the rule out of a mental illness diagnosis) is available to the district, upon written request. Diagnosis can be made via formal interview intake procedures and analysis and/or via psychometric instrumentation. Psychometric instrumentation usually, but not always, requires a longer assessment period, but in general formal diagnosis requires separate, concentrated, and more individual time with the specified youth - often several hours per youth and per diagnosis. When diagnostics are requested an additional fee will be assessed to perform diagnostics (see diagnostic fees section of this proposal). Written permission from the child's guardian must be obtained prior to formal diagnosis, and the permission must include a Release of Information for the district and the counselor.
Written Diagnostic Assessments. Detailed written assessments for youth who are referred for diagnostics can be provided, upon written request of the district. A written report of Significant Clinical Information, Psychiatric History, Medication History, Family of Origin Information, Clinical Diagnostic Impressions, Rule Out Considerations & Contraindications, Preferred Intervention Methodologies & Techniques, Treatment Plan, Outside Referral Recommendations, and Session Number Indications are included in formal written assessments. One copy of the diagnostic impression is made available and provided to the district and to the parents/guardians of the child. Written permission from the child's guardian must be obtained prior to the diagnostic report being written, and the permission must include a Release of Information for the district.
Other Services Logistics. "Other Available Services" are provided, upon written request of the district, after the school obtains the written consent of the child's guardian. A written consent form is available for the district to use, specific to the counseling services program, upon request. The written consent form will include a request directed to the parent, instructing the counselor to begin formalized diagnosis and/or written assessment, with a Release of Information for the district.
Diagnostic Fees. When formal diagnostics are requested and provided, a formal Written Diagnostic Assessment is included. Written diagnostic assessments are mailed via standard US mail, sometimes via certified mail, within 30 days of the clinical interview and diagnostic testing date(s). The fee for Diagnostic interviews and the written diagnostic assessment is $645 per youth. Assessment copies are mailed to the school district making the request, with a carbon copy mailed to the legal guardian. Fees for "Diagnostics" and for "Written Diagnostic Assessments" are due prior to the generation of the Written Diagnostic Assessment" and will be included in the monthly billing processes of the counseling services program.
Add On Services. A request made by school administrators, teachers and students, is frequently a request for more counseling days at the school. An additional day of services is included below as an Add-On Service. Additional days of counseling should be considered according to program outcomes and according to the student body population size. Generally, it is unnecessary to provide more than one day of counseling services at a school when the school population is less than 150 students and when the referral ratio is 10% (or less) of the student body population.
Add-On Services are listed below, and include options that generally are directed to school personnel, parents, and other support staff who are directly and indirectly involved in helping youth succeed in the academic setting. Add-On services must be contracted, and they can be purchased yearly, or the services can be broken down into smaller sets.
It is required by the Counseling Services Program that at least one staff person from the school attend all add-on services where groups of students will be assisted (except in the case of additional days of counseling). Generally, all Add-On Services fall into the category of continued education or psycho-education. Available Add-On Services are listed in the chart below:
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