Single Point of Accountability (SPOA)

Erie County Department of Mental Health

Children’s Mental Health Services

SPOA organizes Erie County’s most intensive home based services under one umbrella, centralizing and simplifying the referral, screening, and review process. Services are strength based and family centered. Family members are equal partners on the treatment team, participating in all decisions made about services to the family. SPOA is a process designed to identify, screen, and assign Care Coordination and Wraparound Services to eligible high-need/high-risk children and youth with serious emotional disturbance (SED) and/or behavioral disorder and their families. The SPOA process targets children and youth between the ages of five and eighteen who are at high risk and/or with a history of hospitalization or out-of-home placement. These children and families also have a history of multi-system involvement, substantial functional impairments in the home, school or community, and an unsuccessful treatment history. The primary goals of SPOA include maintaining children in the community with their families, reducing out-of-home placements, facilitating the earlier return of children already placed, increasing access to community-based services, utilizing an individualized care model with a strength-based approach, and assuring active parent involvement at all levels of SPOA.

The Care Coordination Programs directly accessed through SPOA include Mid-Erie Counseling & Treatment Services Intensive Case Management (ICM), Child & Adolescent Treatment Services ICM+, Child & Family Services Responsive Effective Services Promoting Each Child’s Tomorrow (RESPECT), Child & Family Services Home and Community Based Services (HCBS) Waiver, and the Mid-Erie Counseling & Treatment Services Home and Community Based Services (HCBS) Waiver. Available within some or all of the SPOA programs are the following services: individualized care coordination, hourly respite care, family support, skill building, intensive in-home, 24/7 crisis response, and mentoring.

The SPOA Screening Committee meets weekly to review referrals after the SPOA Family Advocate has spoken to with the family to clarify their service needs and willingness to participate with intensive home-based programs. Families are invited to attend the SPOA screening related to their child. When a child/family is deemed appropriate for one of the SPOA programs, the family and program receive a letter confirming the assignment and the name and contact number for the identified provider and program. It is then the responsibility of the assigned program to provide individualized treatment planning on behalf of the child and family. Family advocates and/or program supervisors manage contact with children/families placed on a wait list.

One success within utilizing the SPOA process has included an adolescent returning home early from RTC placement. He received care coordination to facilitate an appropriate school placement; family support was provided to his parents; intensive in-home services were initiated to address family dynamics; respite was utilized and flexible service dollars were approved for supportive needs.

One key to success in these care coordination programs and wraparound models is the ongoing participation of family members and service providers at face-to-face treatment planning meetings. If the family accepts the potential benefits of a diverse group of services, the greater the compliance with treatment and the greater the chance of success. In addition, families prepared and willing to accept treatment interventions and their role/responsibility in the outcome of service provision are more likely to benefit from this service.

Erie County SPOA is also reviewing Residential Treatment Facility (RTF) referrals for Erie County children prior to such cases being forwarded to the Pre-Admission Certification Committee (PACC). The plan is for SPOA to divert some RTF referrals to an SPOA program community level of care, where appropriate, as well as assist in discharge planning from RTFs back to the community with a shortened length of stay. The SPOA Committee has screened several RTF children with these goals in mind and has been successful with SPOA assignments. Erie County SPOA is also managing several beds at our local RTFs, Baker Victory Services, and Child & Family Services (Connors). Bed management means designating a fixed number of RTF beds as Erie County utilization beds and prioritizing admissions of Erie County children to Erie County designated beds. SPOA is monitoring treatment planning, progress, discharge planning and length of stay for children in these RTF beds. The goals of this process are to reduce the wait list for RTF beds and reduce the referrals to RTF.

For more information regarding this program, you can contact the Erie County Department of Mental Health at 716/858-