San Francisco CSEC Multi-Disciplinary Teamsfgov.org/dosw/sites/default/files/San Francisco Flowchart...San Francisco CSEC Multi-Disciplinary Team 3 San Francisco CSEC MDT Flowchart

San Francisco CSEC Multi-Disciplinary Team

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DEPARTMENT POINT PERSON NAME PHONE EMAIL MDT/AVAILABILITY

FCS Hotline 800-856-

5553 24/7

Behavioral Health Child Crisis 415-970-

3800

Triage, CRR (after

hours)

Behavioral Health

Coordinator,

Community

Behavioral

Health Services

Alison

Lustbader

415-225-

7022

[email protected]

g

Triage, CRR, Non-

Emergency MDT,

Ongoing MDT (business

hours)

SF Child Abuse

Prevention Center

Ongoing MDT

Convener To be determined Ongoing MDT

CSEC Advocate Out for professional

solicitation All MDTs, 24/7

District Attorney

Managing

Attorney, Child

Abuse/Sexual

Assault Unit

Julius

DeGuia

415-553-

1376 [email protected] Ongoing MDT

District Attorney

Victim Services

Deputy Chief of

Victim Services

Jackie

Ortiz

415-558-

2408

[email protected]

g

Triage (during business

hours)

District Attorney

Victim Services

Chief of Victim

Services

Gena

Castro

Rodriguez

415-537-

0503

gena.castrorodriguez@sfg

ov.org

Triage (after business

hours)

District Attorney

Victim Services

Supervisor of

the Sex

Abuse/Assault

and Human

Trafficking Unit

Delia

Montiel

415-

553-9474

[email protected]

CRR, Non-Emergency

MDT, Ongoing MDT

Huckleberry House

Youth Program

Director/Manag

er

Mollie

Brown/Patr

ick

Buckalew

(415)

225-8115

Mbrown@huckleberryyo

uth.org Ongoing MDT

FCS ER Program

Director

Julie

Lenhardt

415- 558-2369

[email protected] Ongoing MDT

Legal Services for

Children

Dependency

Project Director

Eliza

Patten

415-780-

6351 [email protected] Ongoing MDT

Legal Services for

Children

Youth’s

attorney

To be determined case by

case

Non-Emergency MDT

(if client), Ongoing

MDT (if client)

Education To be determined case by

case

Physical Health CASARC

Manager Janet Hines

415-206-

6722 [email protected]

Triage and CRR (during

business hours), Non-

Emergency MDT,

Ongoing MDT

*when youth is under 18

Physical Health

Rape Treatment

Center (RTC)

Manager

Jessica

Dodge

415-437-


Triage and CRR (during

business hours), Non-

Emergency MDT,

Ongoing MDT

*When youth is 18+

Physical Health

Rape Treatment

Center (RTC)

On Call

415-437-

3000

Triage, CRR (after

hours)

mailto:[email protected]


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Provider *After hours can take

info for any age and will

consult with CASARC

MD for under 18

Probation

On Duty

Probation

Officer

415-753-

7800 or

753-7500

7800-business hours

7500-24/7

Probation Intake

Supervisor

Derek

Hom

415 753-

7531

[email protected]

Non-Emergency-MDT,

Ongoing MDT

Public Defender Managing

Attorney

Patricia

Lee

415-753-


Triage/CRR Consult,

Ongoing MDT

SFPD (primary

contact) Officer, SVU

Lt. Michael

Dudoroff

415-553-

4900 (o)

415-716-

8838 (c)

michael.dudoroff@sfgov.

org All MDTs

SFPD (secondary

contact)

Officer in

Charge, SVU

Lt. Ed

Santos

415-553-

9826 (o)

415-802-

7059 (c)

[email protected] All MDTs

mailto:[email protected]


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San Francisco CSEC MDT Flowchart Accompanying Document

1. Triage (represented with “1”s in flowchart)

Overview All known or suspected CSEC up to age 21 must be reported to the FCS

Child Protection Hotline. This includes out-of-county CSEC and CSEC 18-

21 who are ineligible for non-minor dependent services.

If the Hotline Worker determines that the CSEC is 18-21 and ineligible for

non-minor dependent services, the Hotline refers the youth to the CSEC

Advocate on the Community-based Services track (#5). If the Hotline Worker

determines the youth is under 18 or is 18-21 and eligible for non-minor

dependent services, the Hotline follows FCS internal protocol, including the

Structured Decision Making Tool (SDM)*, to determine whether there is an

immediate safety threat. If there is an immediate safety threat, the Hotline

Worker assigns an Emergency Response Worker (ER) who initiates the

Coordinated Rapid Response (CRR) MDT, dispatching the 2-Hour Crisis

Response (#2a) and beginning the coordination of the members of the 72-

Hour Stabilization phase (#2b) of the MDT. If there is not an immediate

safety threat, the Hotline Worker determines whether more information is

needed before assigning an Emergency Response Worker to initiate an MDT

(#3a-b OR #4a-b).

Note that if a known CSEC already under the jurisdiction of FCS presents

with a new allegation of CSEC, the case-carrying worker will follow existing

protocol and a new report to the hotline is not necessarily required.

Purpose Determine the safety threat to the suspected or identified CSEC, which will

dictate the speed of the response and the parties required to respond.

Parties and

Responsibilities

The following agencies must:

1. FCS Hotline Worker:

a. Field hotline calls

b. Determine the age of the child

i. If the child is under 18:

1. Determine whether the child is currently under

Child Welfare or Probation jurisdiction

ii. If the child is over 18:

1. Determine whether the child is eligible for

extended foster care.

a. If yes, proceed to 1(c) (“Determine

whether child is out-of-county”) next

step.

b. If not, refer to community-based

services track (#5).

c. Determine whether child is out-of-county:

i. If yes, follow Bay Area inter-county protocol and

report child to child welfare in county-of-origin, and

continue with courtesy MDT response if there is an

*SDM is statewide set of assessment tools used by Child Welfare to assess safety, risk and protective capacity. The SDM tools are currently under revision, and will include CSEC factors beginning in Nov. 2015. FCS will bring the revised SDM tools to the CSEC Steering Committee for review.


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immediate safety threat.

d. Determine whether there is an immediate safety threat

i. If yes, assign ER worker, utilizing the SDM and in

consultation with other partners

ii. If no, determine whether more information is

necessary, which will dictate whether to follow the

Non-Emergency MDT track

e. Cross-report to law enforcement pursuant to the law

enforcement protocol

f. Determine the necessity of SFPD’s presence pursuant to law

enforcement protocol, and, if needed, contact SFPD for

dispatch with ER Worker

2. FCS Emergency Response Worker:

a. Contact CSEC Advocate and provide the child’s location

b. Respond to child’s location within 2 hours

c. Coordinate appropriate response including contacting parties

and sharing pertinent information (e.g., child’s location, safety

threat, etc.)

3. San Francisco Police Department

Provide for safety needs of youth and staff

4. Other partners (including, Probation, Physical Health, Behavioral

Health, SVU, and DA Victim Services):

a. Provide phone consultation to Hotline Worker as needed

Timeline Follow internal FCS protocol; timing for other MDTs begins with assignment

of FCS Worker (2 hours).

Next Step If there is an immediate safety threat CRR (#2a)

If there is not an immediate safety threat move to “Is more info

needed?”

o Yes Initial Contact phase of Non-Emergency MDT (#3a)

o No Non-Emergency MDT (#4a)

2a. Coordinated Rapid Response (CRR) MDT: 2-Hour Crisis Response

Overview The 2-Hour Crisis Response, the first of two phases of the CRR MDT, is

initiated when the FCS Hotline worker identifies an immediate safety threat.

The Hotline assigns an ER Worker and provides the ER Worker information

about the child’s location. The Hotline Worker will cross-report the allegation

of sexual exploitation to law enforcement pursuant to the law enforcement

protocol. The ER Worker contacts the CSEC Advocate and together they meet

the child at the location provided by the Hotline Worker. Other parties will be

consulted by phone, as needed. After meeting the child’s immediate safety

needs and initiating a child abuse investigation, the ER Worker and CSEC

Advocate will identify the needs the child has and which additional parties

need to respond to those needs - either immediately or during the 72-Hour

Stabilization period (#2b).

Purpose Address the immediate safety needs, make a temporary placement decision,


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and develop a safety plan, which will include the support and services the

youth will need during the period starting with the 2-Hour Crisis Response and

through the first 72 hours. This will include:

Responding to the child’s location within 2 hours

Collaborating with multiple child-serving agencies

Engaging with youth and family/caregiver(s), if appropriate

Ensuring basic needs are met such as food, shelter, and clothing

Assessing and addressing immediate and long-term needs

Advising on appropriate placement

Conducting a safety plan once at the placement with the

parent/guardian/caregiver

Meaningfully involving youth in planning and decision-making, should

the youth choose to participate

Parties and

responsibilities


a. Respond to child’s location within 2 hours

b. Begin to conduct a child abuse investigation, including

involving parents and caregivers.

c. Address the child’s safety needs

d. Address the child’s placement needs, including identifying an

emergency placement, if necessary

e. Collaborate with CSEC Advocate to determine whether to

request a phone consultation or in-person support from other

parties

2. CSEC Advocate:

a. Respond to child’s location within 2 hours

b. Address youth’s immediate needs

c. Provide a humanitarian bag

d. Develop rapport with the youth

e. Prepare safety plan along with ER Worker and other partners

f. Help transition from a crisis to a stabilization response

g. Collaborate with ER Worker to determine whether to request a

phone consultation or in-person support from other parties

3. San Francisco Police Department

Provide for safety needs of youth and staff


Health, SVU, and DA Victim Services):

Provide phone consultation and/or in-person assistance

5. Youth:

Engage in planning process, if the youth agrees to participate

Timeline Must interface with the youth within 2 hours, although the placement, safety

planning, etc. may last for several hours.

Next Step CCR (#2b) and engage other necessary partners to ensure youth’s needs are

met throughout the first 72 hours.


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2b. Coordinated Rapid Response (CRR) MDT: 72-Hour Stabilization

Overview The 72-Hour Stabilization is a continuation of #2a and the second phase of the

CRR MDT. Once identified, CSEC need intensive support and supervision to

stabilize. The first 72 hours is a critical period to address safety concerns and

medical needs. Services and supports will vary depending on the youth’s needs

and may include a comprehensive medical evaluation, intensive support and

supervision by the CSEC Advocate, and/or a mental health evaluation.

Purpose Stabilize the youth and provide intensive supervision, support and services.

Parties and

responsibilities

The parties listed below may not need to be involved in every case, but will be

required to be available for telephonic consult and in-person support when

necessary.


a. Continue conducting a child abuse investigation, including

engagement with the family/caregivers.

b. Provide additional input on placement decision

c. Collaborate with CSEC Advocate to determine whether to


agencies

d. Contact and coordinate with additional agencies, e.g. schedule

appointment with physician

e. Refer child to CASARC (<18) or RTC (+18) for sexual assault

examination, if needed

f. Request other parties’ input on the child’s preparedness for a

CAPC forensic/regular interview, if relevant, and schedule

when appropriate

2. CSEC Advocate:

a. Engage and support youth throughout the 72-hour period, this

may include regular interactions with the youth throughout the

day.

b. Transport youth to appointment(s), if needed

c. Collaborate with FCS ER Worker to determine whether to


parties

d. Contact other team members that need to be involved

e. Refer case to Ongoing MDT

3. On-Duty Probation Officer (if under jurisdiction):

a. Engage youth

b. Provide support on placement decisions

c. Respond to a warrant

4. CASARC Manager (youth <18 during business hours) OR Rape

Treatment Center (RTC) Manager (youth +18 during business hours)

OR RTC On Call Provider (all youth, after hours):

a. Schedule an expedited appointment

b. Provide comprehensive medical evaluation

c. Coordinate appropriate responses and services


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d. Provide information, services and medication related to

reproductive and sexual health, including access to

contraceptives, HIV prophylaxis, and treatment for STIs/STDs.

e. Conduct forensic exam, if needed

f. Refer youth for additional services, if necessary

5. Community Behavioral Health Services Coordinator (business hours)

or Child Crisis (after hours):

a. Provide crisis stabilization

b. Complete comprehensive mental health evaluation

c. Refer youth to appropriate mental health provider, if necessary

6. Special Victims Unit (SVU) Officer:

a. Consult regarding safety

b. Provide in-person support as necessary (pursuant to law

enforcement protocol

7. Youth:

a. Engage in decision-making process, if the youth agrees to

participate

Timeline After the 2-Hour Crisis Response and within 72 hours

Next Step Youth continues to receive coordinated services and case referred to Ongoing

MDT (#6)

3a. Non-Emergency MDT: Initial Contact (more information is needed)

Overview When the Hotline worker determines:

(1) there is no immediate safety threat AND

(2) more information is needed before convening a full MDT,

the ER OR the case-carrying worker (when there is a new allegation on an

open case with a history of CSE) and the CSEC Advocate will make initial

contact with the youth within 10 days. The FCS Worker (either ER or Case-

Carrying) and the CSEC Advocate will gather more information and determine

the necessity of an MDT and whether additional FCS or community services

are needed.

Purpose Make initial contact with the youth and gather additional information to

determine whether a full Non-Emergency MDT should be held.

Parties and

responsibilities


1. FCS case-carrying/ER Worker:

a. Make initial contact with the youth

b. Assess the youth’s safety

c. Gather information for child abuse investigation

d. Determine whether there is an immediate safety threat

i. If yes, follow procedure related to the Coordinated

Rapid Response (2a and 2b)

ii. If no, proceed to next step

e. Assess whether to convene a full Non-Emergency MDT

f. Collaborate with CSEC Advocate to determine whether to



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parties

g. Refer child to CASARC (<18) or RTC (+18) for sexual assault

examination, if needed

2. CSEC Advocate:

a. Address immediate needs

b. Engage with the youth to build relationship

c. Assess whether to convene a full Non-Emergency MDT

d. Collaborate with FCS ER Worker to determine whether to


parties

e. Provide the youth a humanitarian bag


Health, SFPD/SVU, and DA Victim Services):

a. Provide phone consultation and/or in-person assistance

Timeline Within 10 days of the call to the hotline

Next Step If additional FCS and/or community services are needed hold Non-

Emergency MDT (#3b) within 72 hours

If no additional FCS and/or community services are needed close

and do NOT refer to Non-Emergency MDT (#3b) or Ongoing MDT

(#6)

Note: If an immediate safety threat is identified during initial contact, the ER

Worker convenes the CRR MDT (#2a-b) instead of the Non-Emergency MDT

(3b)

3b. Non-Emergency MDT: MDT (more information is needed)

Overview If FCS and the CSEC Advocate determine that a Non-Emergency MDT is

needed, convene the MDT telephonically within 72 hours. Other parties will

be involved as needed. Members develop a case plan, coordinate services, and

assign responsibilities among the agencies. The youth does not directly

participate in the MDT, though their perspective may be represented by CSEC

Advocate.

Purpose Non-Emergency MDT coordinates and plans how to address the needs of an

identified or suspected CSEC within 72 hours following Initial Contact (#3a),

including but not limited to:

Collaborating with multiple child-serving agencies

Assessing and addressing immediate and long-term needs1

Coordinating service plans to achieve desired outcomes for the youth

Advising on appropriate placement

Designing a safety plan that will be discussed with the youth

Assigning responsibilities to each agency

Parties and

responsibilities

The FCS Worker and the CSEC Advocate will identify which other agencies,

such as DA Victim services will also participate in the MDT. In addition to the

1 See CAL. CHILD WELF. COUNCIL, CSEC ACTION TEAM, HOLISTIC NEEDS OF COMMERCIALLY SEXUALLY EXPLOITED CHILDREN

(2015) available at http://youthlaw.org/wp-content/uploads/2015/05/Holistic-Needs-of-CSEC.pdf.

http://youthlaw.org/wp-content/uploads/2015/05/Holistic-Needs-of-CSEC.pdf


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above responsibilities, the agencies must:

1. FCS Worker:

a. Convene the MDT (e.g., coordinate scheduling with partners,

handle relevant administrative tasks, follow up with partners)

b. Continue to investigate the child abuse allegation

c. Collaborate with CSEC Advocate to determine other parties to

include

d. Provide input regarding placement

2. CSEC Advocate:

a. Participate in Non-Emergency MDT

b. Identify CSEC-specific resources and services

c. Collaborate with FCS ER Worker to determine other parties to

include

d. Refer case to Ongoing MDT

3. Intake Supervisor (for youth under Probation jurisdiction):

a. Participate in Non-Emergency MDT within 72 hours from

initial contact

b. Provide input regarding placement

4. CASARC Manager (Youth <18) OR RTC Manager (youth 18+):


initial contact

b. Provide input on potential physical health needs

c. Provide any necessary referrals to medical services

5. Community Behavioral Health Services Coordinator:


initial contact

b. Provide input on potential mental health needs

c. Provide any necessary referrals to mental health services

6. Law Enforcement:


initial contact

b. Provide input on the safety needs of the youth and family

c. Provide update during MDT about any potential case against an

exploiter

Timeline Within 72 hours following Initial Contact (#3a)

Note: the full MDT process can extend past 10 days total

Next Step Youth continues to receive coordinated services; moves to Ongoing MDT (#6)

4a. Non-Emergency MDT: MDT (no additional information is needed)

Overview When the Hotline determines there is:

(1) no immediate safety threat AND

(2) there is sufficient information,

a Non-Emergency MDT is convened telephonically within 72 hours. This is an

agency-only MDT. The MDT may recommend earlier contact by CSEC

advocate in order to provide support and services. The youth does not directly


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participate in the discussion.

Note: FCS and the Advocate may not have had contact with the child prior to

this convening. Following the Non-Emergency MDT, FCS will make initial

contact with the youth (#4b) as required by the FCS 10-day response.

Purpose See #3b

Parties and

responsibilities

See #3b

Timeline Within 72 hours so that there is time after the MDT to engage youth within 10

days

Next Step Initial Contact (#4b) within 10 days

4b. Non-Emergency MDT: Initial Contact (no additional information is needed)

Overview Following #4a, and within 10 days of the call to the Child Protection Hotline,

FCS and the CSEC Advocate will make contact with the child.

Purpose Make initial contact with the youth, conduct a child abuse investigation, and

initiate plan developed by the Non-Emergency MDT (#4a).

Parties and

responsibilities


1. FCS Worker:

a. Meet with youth within 10 days of call to the Child Protection

Hotline (following existing protocols)

b. Determine whether there is an immediate safety threat to the

child

i. If yes, follow procedure related to the Coordinated

Rapid Response MDT (2a and 2b)

ii. If no, proceed with Non-Emergency MDT

c. Conduct child abuse investigation

d. Gather information

e. Discuss the safety plan developed by the Non-Emergency MDT

and further develop it with the youth and the CSEC Advocate

f. Collaborate with CSEC Advocate to determine whether to


parties

2. CSEC Advocate:

a. Address immediate needs

b. Engage with the youth to build relationship

c. Discuss the safety plan developed by the Non-Emergency MDT

and further develop it with the youth and the CSEC Advocate

d. Provide the youth a humanitarian bag

e. Explain to the youth how the MDT process works

f. Collaborate with FCS ER Worker to determine whether to


parties

g. Refer case to Ongoing MDT

3. Other partners as determined by #4a (including, Probation, Physical

Health, Behavioral Health, SFPD/SVU, and DA Victim Services):


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a. Provide phone consultation and/or in-person assistance

Timeline Within 10 days of call to the Hotline

Next Step Youth continues to receive coordinated services and case referred to Ongoing

MDT (#6)

Note: If an immediate safety threat is identified during initial contact, the ER

Worker convenes the CRR MDT (#2a-b).

5a. Community-based Services Track (18-21 who are ineligible for non-minor dependency):

CSEC Advocate Contact

Overview When the Hotline determines that the youth is 18-21 and ineligible for non-

minor dependent services, the Hotline refers the youth to the CSEC Advocate

on the Community-based Services track (#5). The CSEC Advocate will then

connect the youth to appropriate community-based services within same time

periods as under 18.

Purpose CSEC Advocate will make initial contact with the child and identify needed

services.

Parties and

responsibilities

The following party is responsible for:

1. The CSEC Advocate:

a. Engage and support youth

b. Identify and connect youth to resources and services, including

TAY-specific services

c. Transport youth to appointment(s), if needed

Timeline Same timelines as with youth under 18

Next Step Youth continues to receive community services and the case is referred to the

Ongoing MDT (#6)

5b. Community-based Services Track: Community-based Services

Overview After the Hotline connects the 18-21 year old, non-dependent youth with the

CSEC Advocate, the CSEC Advocate will help the youth identify and secure

appropriate community-based services.

Purpose Ensure the youth receives appropriate community-based services and support

from the CSEC Advocate.

Parties and

responsibilities

The following party is responsible for:

1. The CSEC Advocate:

a. Check in on youth

b. Connect the youth with additional services, if needed

c. Refer case to Ongoing MDT

Timeline Within 10 days

Next Step Youth continues to receive community services and the case is referred to the

Ongoing MDT (#6)


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6. Ongoing MDT

Overview The Ongoing MDT meets on a monthly basis to review all new CSEC cases up

to age 21, as well as cases that pose challenges requiring the additional

attention of partners (e.g. preparation to testify against an exploiter, etc.) The

Ongoing MDT will revisit the cases of all CSE minors regularly

Criteria for which cases to be reviewed at Ongoing MDTs will be developed.

Purpose Meets monthly at San Francisco Child Abuse Prevention Center (SFCAPC) to

review cases and address coordination of services for identified and suspected

CSEC to ensure their ongoing needs are met.

The Ongoing MDT is designed to accomplish the following:

Gathering information from each agency regarding cases for case

planning

Providing feedback on case planning and troubleshooting individual

children’s cases

Assigning responsibilities of each of the parties’ designees

Preparing a report-out to the MDT for each individual child’s case

Collecting data on the identified CSEC cases, as process for data

collection is developed.

Providing analysis on trends and policy recommendations to the

Steering Committee

Reviewing the efficacy of the Ongoing MDT’s organizational structure

Parties and

responsibilities As Ongoing MDT convener, SFCAPC has the following responsibilities:

a. Coordinate, facilitate, and host Ongoing MDT meetings

b. Serve as liaison to the Steering Committee

The following parties agree to participate in monthly case review and

discussion of service coordination. All parties agree to share information for

case planning purposes with SFCAPC, in compliance with all State, local and

federal laws regarding confidentiality and information sharing.

1. FCS Emergency Response/Case-carrying Worker

2. FCS ER Program Director or designee

3. Intake Supervisor (Probation)

4. CASARC Medical Director (Physical Health)

5. Rape Treatment Center (RTC) Director (Physical Health)

6. Community Behavioral Health Services Coordinator(Mental Health)

7. Designee, Legal Services for Children

8. Managing Attorney (Public Defender)

9. Managing Attorney, Child Abuse/Sexual Assault Unit (District

Attorney)

10. Supervisor of the Sex Abuse/Assault and Human Trafficking Unit

(District Attorney Victim Services)

11. Officer in Charge, SVU

12. Education designee


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13. CSEC Advocate(s)

Timeline Ongoing meetings held monthly

Next Step Ongoing MDT Convener shares trends and relevant information with the

Steering Committee

Documents

San Francisco CSEC Multi-Disciplinary Teamsfgov.org/dosw/sites/default/files/San Francisco Flowchart...San Francisco CSEC Multi-Disciplinary Team 3 San Francisco CSEC MDT Flowchart