STATE OF NEVADA - Division of Child and Family Services

SECTION V: CHILD AND FAMILY WELL-BEING
Trends in Child and Family Well-Being
Initiatives
Statewide: The State has been engaged in a variety of initiatives, workgroups and projects over the past year.
Independent Living has been one of those major initiatives related to child and family well-being. Independent Living (IL)
programs in Nevada are intended to prepare foster and former foster youth for adulthood and self-sufficiency. The IL
program continues to assist and prepare foster and former foster youth in making the transition from foster care to
adulthood by providing opportunities to obtain life skills for self-sufficiency and independence. To be eligible to participate
in the Independent Living Program, a youth must be at least 15 years of age and have been a dependent ward of the
State of Nevada or the Tribal system and removed from their home. In an effort to improve the IL program, the State
recently contracted with FosterClub to utilize of the FosterClub CONNECT program as a means of not only marketing The
National Youth in Transition Database (NYTD) but in the completion of the survey and collection of the appropriate data
for upload into the State’s SACWIS system. The program also developed a brochure to showcase the IL program within
Nevada and to supplement local marketing efforts. In addition, the IL program has expanded its work with the Youth
Advisory Board (YAB). The YAB was expanded in the Rural Region with a newly formed board in Carson City and
Pahrump. The YAB published their first newsletter, The Advisory, in March 2010 after many months of discussion and
hard work. Both the YAB’s in Clark County and Washoe County have established their own web pages with links to each
other as well as Foster Club.
Agency Level: On the agency level, efforts have been made to improve child and family well-being. Washoe County
reports that their staff pediatrician and medical unit has successfully implemented the initial placement wellness screening
and EPSDT referral. A particular strength of this program is that WCDSS is fortunate to have a Pediatrician and
Advanced Nurse Practioner (APN) specially trained in child abuse and neglect on staff. An area that presents a challenge
is the inability to implement medical care managers. These positions would ensure timely follow-through to medical
requests. As a result, some services are not provided as quickly as desired.
The DCFS Rural Region indicates that they have seen improvements in out-of-state placements. These placements are
now monitored by a DCFS Rural Region Clinical Manager in an effort to track and lower the total bed days for out-of-state
youth and to improve transition planning. In addition, the Rural Region reports that Placement Review Team meetings
are held in each District Office with the Rural Region Clinical Staff. Children who are placed in a higher level of care are
reviewed quarterly or on an as needed basis in order to ensure that their needs are being addressed in their higher level
placement. This results in discharge planning/placement, decreased disruptions, and increased efforts made to decrease
and shorten placements in higher levels of care.
Clark County Department of Family Services has participated in a variety of projects related to child and family well-being.
Since July 2009, CCDFS initiated a memorandum of understanding (MOU) with local psychiatrists to partner in reviewing
psychotropic medications prescribe to foster children in Clark County. This step will provide the county with a medical
team that will independently review psychotropic prescriptions. A challenge anticipated is that some psychiatrists may be
reluctant to review their peers. The Department has also implemented a medication log that is included in the medical
passport for every child that comes into care. The Medical Case Management unit collects and monitors those logs on a
monthly basis and reports all psychotropic medication to Family Clinical Services for review. The promise of this practice
is that a uniform procedure has been implemented, however currently only 20% of foster parents are completing the
required paperwork. Another promise initiative is that the Department has increased efforts to produce an accurate and
timely medical passport for each child in foster care. The Medical unit monitors medical care through the passport
program and assures that the child’s medical information is entered into UNITY and included in the passport provided to
each caregiver. This process has been made possible through receipt of a grant which allowed the Department to double
the staff dedicated to this task. To date it has been very successful. 97% of placements receive a passport upon initial
placement within 72 hours.
In addition, the Medical Case Management unit has begun tracking and pursuing compliance for the EPSDT exam for all
children within 14 days of placement by routinely pulling UNITY and COGNOS reports for compliance and contacting
caregivers to schedule exams and provide transportation to the exam when needed. The Department has been able to
increase EPSDT compliance within 14 days of placement from about 16 days by approximately 48%. A challenge to this
Nevada APSR – SFY 2010
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