Michigan
Chippewa County Substance Abuse/Child Welfare Protocol - Sample Interagency Communication Protocol


CHIPPEWA COUNTY SUBSTANCE ABUSE/CHILD WELFARE PROTOCOL

Collaborative Agreement between Court Systems, Tribal Entities, Local Substance Abuse Providers, Community Mental Health Systems and the Chippewa County Family Independence Agency.

PURPOSE:

To ensure Child Safety and Well‑being through effective substance abuse treatment for mutual customers of Chippewa County Tribal Entities, Court Systems, Community Mental Health Systems and the Family Independence Agency.

GOALS:

REFERRAL PROCESS:

A referral process will be developed in conjunction with all parties to ensure the availability of services and to determine a realistic expectation of service delivery response and  to determine reporting elements.*

REPORTING/CONFIDENTIALITY:

Specific guidelines for sharing information will be developed, in accordance with State and Federal requirements for confidentiality/HIPAA compliance (to include, but not limit to MH Code, Child Welfare policy, Tribal Codes, and 42CFR Part2 regulations) to assure the safety and well‑being of children through effective service delivery.

CONTINUING EDUCATION:

Within the first six months of this protocol being signed, a joint orientation will be organized and provided for individual  agency staff and substance abuse providers to discuss the referral process, reporting process and confidentiality/HIPAA guidelines, as well as the continuing education planning process.  Thereafter, protocol members will meet a minimum of two times per year to review and discuss relative issues or areas of concern, and to address any gaps in services.  Annual training will be organized and  offered to protocol members to address needs, changes in laws or procedures, and pertinent current practices.

CONFLICT RESOLUTION:

This group will act in concert with agencies or providers in addressing complaints regarding substance abuse/child welfare issues that cannot be resolved at the agency or provider level.  It is the intent of this partnership to resolve disputes at the level closest to the onset of the concern, following Federal 42 CFR Part 2 Regulations and HIPAA requirements.  If concerns arise that cannot be resolved at the worker or middle management level, the directors of the respective agencies will meet to review and resolve any issues.

* REFERENCE: INTERAGENCY COMMUNICATION PROTOCOL DOCUMENT

SIGNATURE PAGE

_____________________________________________           ______________    

PROBATE COURT  REPRESENTATIVE                                    DATE

_____________________________________________            ______________  

SAULT TRIBE OF CHIPPEWA INDIANS‑                                          DATE

ANISHNABEK COMMUNITY/FAMILY SERVICES                                                          

_____________________________________________              _____________

SAULT TRIBE OF CHIPPEWA INDIANS/TRIBAL COURT            DATE

_____________________________________________             ___________

BAY MILLS INDIAN COMMUNITY                                                DATE

_____________________________________________           ____________

A NEW LEAF‑SUBSTANCE ABUSE PROVIDER                       DATE

SIGNATURE PAGE

_______________________________________________                __________                                        

NEW HOPE HOUSE‑SUBSTANCE ABUSE PROVIDER                     DATE

_______________________________________________               __________

UPPER MICHIGAN BEHAVIORAL HEALTH                                             DATE                                                                          SUBSTANCE ABUSE PROVIDER

________________________________________________             ___________

DIANE PEPPLER RESOURCE CENTER                                            DATE

_______________________________________________                __________

FAMILY INDEPENDENCE AGENCY                                                   DATE

_______________________________________________               __________

HIAWATHA BEHAVIORAL HEALTH                                                   DATE