10-8 -2026 Prevention SAP Intervention Supplemental Documents R2.docx

Contents

Appendix A: Prevention and Intervention Programs Montgomery County Drug and Alcohol Prevention Programs Elementary Level Programs Botvin Life Skills Training (LST ) (EBP) 3-5 grades: 8 sessions, 30 – 45 minute per session To provide elementary students, middle school/junior high students, and high school students with the necessary skills to resist social pressure to smoke, drink, and use drugs; helps them develop greater self-esteem, self-mastery, and self-confidence; enables children to effectively cope with social anxiety; increases their knowledge of the immediate consequences of substance abuse; and enhances cognitive and behavioral competency to reduce and prevent a variety of health risk behaviors.

Evaluation: Matched student pre/post-test

Second Step (EBP) K through 5th grade: 20-25 lessons, 30-45 minutes per lesson, 12 lessons combined Second Step teaches children to identify and understand their own and others' emotions, reduce impulsiveness and choose positive goals, and manage their emotional reactions and decision making process when emotionally aroused.

Evaluation: K-2nd grade: student post summative assessment and teacher completed DESSA Mini for each child in the classroom; 3rd – 5th grade: matched student pre/post-test

Too Good for Drugs (EBP) K - 3 grades: 8-10, 30 minute lessons 4th & 5th grades: 10, 45 minute lessons Too Good puts social and emotional learning to work through fun and interactive lessons, building the self-confidence young people need to make healthy choices and achieve success. Too Good for Drugs K-5 teach the fundamental elements of social and emotional learning through developmentally appropriate activities that set the foundation for a healthy adolescence. Lessons build the skills kids need to set daily goals, identify emotions and feelings, and make healthy choices that contribute to their overall health and well-being.

Evaluation: K-2nd grade: teacher completed student observation form for each child in the classroom; 3rd – 5th grade: matched student pre/post-test

Need to Know: What are Drugs, Addiction and Marijuana?

5th Grade: 1 session, 45 minutes Age appropriate introduction to drugs, addiction and marijuana Evaluation: Student post-test

Middle School Programs Botvin Life Skills Training (LST ) (EBP) Middle School: Level 1, Grade 6/7 Core Level 15 sessions Middle School: Level 2, Booster Level, 5 Sessions, 30-45 minutes per session To provide elementary students, middle school/junior high students, and high school students with the necessary skills to resist social pressure to smoke, drink, and use drugs; helps them develop greater self-esteem, self-mastery, and self-confidence; enables children to effectively cope with social anxiety; increases their knowledge of the immediate consequences of substance abuse; and enhances cognitive and behavioral competency to reduce and prevent a variety of health risk behaviors.

Evaluation: Matched student pre/post-test

Too Good for Drugs (EBP) 6-8 grades: 8-10 lessons, 50 minutes per lessons Too Good for Drugs 6-8 empower teens to meet the challenges of middle school life and prepares them for high school by addressing more complex emotions and situations. Lessons build on the skills introduced in earlier grades to foster confidence and self-efficacy and resistance to substance abuse through goal setting and achievement, responsible decision making, positive conflict resolution, and healthy relationships.

Evaluation: Matched student pre/post-test

CATCH My Breath Middle School, 4 sessions, 45 minutes Youth e-cigarette and JUUL prevention program developed by the University of Texas Health Science Center at Houston (UTHealth) School of Public Health Evaluation: Matched student pre/post-test

Vaping Prevention Plus Wellness Middle School, 1 session, 45 minutes Vaping PPW is designed to increase wellness-enhancing behaviors including physical activity, sports participation, healthy eating, getting adequate sleep, and practicing stress control. This program helps youth identify how vaping interferes with reaching wellness behavior goals and positive self-image.

Evaluation: Matched student pre/post-test

Signs of Suicide (EBP) 6-8 grades: 1 lessons, 50 minutes per lesson SOS is an evidence-based youth suicide prevention program that has demonstrated an improvement in students’ knowledge and adaptive attitudes about suicide risk and depression. Designed for grades 6-12, SOS teaches students how to identify signs of depression and suicide in themselves and their peers, while providing materials that support school professionals, parents, and communities in recognizing at-risk students and taking appropriate action.

Evaluation: Matched student pre/post-test

Need to Know: Marijuana Middle School Curriculum 6th – 8th grades, 4 sessions, 45 minutes per session A four-session marijuana prevention curriculum paired with worksheets to help middle schoolers understand the risks associated with marijuana use and skills to make healthy choices related to delaying substance use.

Evaluation: Matched student post-test

High School Programs

Life Skills (LST ) (EBP) High School: Grades 9/10, 10 sessions, 40-45 minutes per session To provide elementary students, middle school/junior high students, and high school students with the necessary skills to resist social pressure to smoke, drink, and use drugs; helps them develop greater self-esteem, self-mastery, and self-confidence; enables children to effectively cope with social anxiety; increases their knowledge of the immediate consequences of substance abuse; and enhances cognitive and behavioral competency to reduce and prevent a variety of health risk behaviors.

Evaluation: Matched student pre/post-test

Too Good for Drugs (EBP) 9-12 grades: 8-10 lessons, 50 minutes per lessons Too Good for Drugs build on the prevention concepts of Too Good beginning in Kindergarten incorporating real-world challenges teens face in high school and beyond. The program explores practical guidance for understanding dating and relationships, violence and conflict, underage drinking, substance abuse, and healthy friendships. Lessons further enhance skills for responsible decision-making, effective communication, media literacy, and conflict resolution. Too Good for Drugs are evidence-based, skill building programs designed to migrate risk factors and build the basis for a safe, supportive, and respectful learning environment.

Evaluation: Matched student pre/post-test

CATCH My Breath High School, 4 sessions, 45 minutes Youth e-cigarette and JUUL prevention program developed by the University of Texas Health Science Center at Houston (UTHealth) School of Public Health Evaluation: Matched student pre/post-test

Vaping Prevention Plus Wellness High School, 1 session, 45 minutes Vaping PPW is designed to increase wellness-enhancing behaviors including physical activity, sports participation, healthy eating, getting adequate sleep, and practicing stress control. This program helps youth identify how vaping interferes with reaching wellness behavior goals and positive self-image.

Evaluation: Matched student pre/post-test

Need to Know: Marijuana High School Curriculum 9th – 12th grades, 5 sessions, 45 minutes per session A five session marijuana prevention curriculum paired with worksheets and activities to help high schoolers think critically about the risks associated with marijuana use, review of misinformation associated with it and provide the skills needed to make healthy choices related to delaying use. Evaluation: student post-test

Signs of Suicide (EBP) High School, 1-2 sessions, 50 minutes SOS is an evidence-based youth suicide prevention program that has demonstrated an improvement in students’ knowledge and adaptive attitudes about suicide risk and depression. Designed for grades 6-12, SOS teaches students how to identify signs of depression and suicide in themselves and their peers, while providing materials that support school professionals, parents, and communities in recognizing at-risk students and taking appropriate action.

Evaluation: Matched student pre/post-test

Youth Intervention Programs:

Teen Intervene is an evidence-based program incorporate principles of brief motivational intervention for underage youth using alcohol. Teen Intervene is a three session program, providing two individual sessions to the youth with the third session including the family, when possible.

Evaluation: student satisfaction survey

Marijuana Brief Intervention is also an evidence-based program targeting adolescent’s marijuana use. This program can be tailored to the individual participant needs through one-session, four sessions, or six sessions. Sessions address: preparing for change; strategies for change; managing withdrawal; problem solving; and relapse prevention.

Evaluation: student satisfaction survey

INDEPTH

The American Lung Association’s Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) program is an alternative to suspension or citation program that is offered as an option to students who face suspension for violation of school tobacco, vaping, or nicotine use policies. It is administered by an adult facilitator in a school or community setting. The program consists of four sessions, approximately 50 minutes each, geared towards youth and focused on tobacco use, vaping, nicotine addiction, establishing healthy alternatives, and making the change to be free of all nicotine and tobacco products.

Evaluation: student satisfaction survey

NOT Not On Tobacco (NOT) is an evidence-based teen smoking and vaping cessation program. Ten sessions specially designed for youth in a group setting embraces all types of tobacco users to identify individual reasons for use, education on how tobacco and nicotine affect the body, thinking and emotions and guidance to develop a plan for overcoming obstacles to quitting.

Evaluation: student satisfaction survey Appendix B: Policies

1. SAP01: SAP Parental Permission

2. SAP02: SAP Screening Policy

3. SAP03: SAP Group

4. SAP04: Sap Services Documentation Policy: SAP Group

5. Interv01: Intervention Services

6. YAP01: Youth Aid Panel Policy

7. Prev01: Prevention Program Evaluation Policy

SAP01: SAP Parental Permission

MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES

OFFICES OF DRUG AND ALCOHOL AND MENTAL HEALTH

Linda Moore-Singleton

A. POLICY STATEMENT:

The Pennsylvania Student Assistance Program (SAP) is a systematic team process used to mobilize school resources to remove barriers to learning. SAP is designed to assist in identifying issues including alcohol, tobacco, other drugs, and mental health issues which pose a barrier to a student’s success. The primary goal of the Student Assistance Program is to help students overcome these barriers so that they may achieve, advance, and remain in school.

B. PURPOSE

It is the intention of the Single County Authority (SCA) i.e. Office of Drug & Alcohol in partnership with the Office of Mental Health, to provide SAP liaison services, through contracted D&A/MH SAP Providers, to school districts in Montgomery County. It is the expectation that these services follow all updated published guidelines.

This policy serves to clarify written parent/guardian active permission is needed for the following supports:

· SAP Screenings;

· SAP Drug and Alcohol and Mental Health support groups, including educational and topic oriented intervention groups;

· Teen Intervene, Marijuana Brief Intervention, INDEPTH, and Not on Tobacco (NOT) (“Intervention Services”) and one-time D&A Referral Follow Up student check-ins;

· Referral Follow Up: Mental Health Individual Support Services (MH3)

C. PROCEDURE

It is the expectation of the SCA and the Office of Mental Health that parent or guardian written active permission will be provided by the school and collected by and provided to the SAP liaison prior to any SAP group or SAP individual service (SAP Screenings; SAP Drug and Alcohol and Mental Health support groups; Teen Intervene, Marijuana Brief Intervention, INDEPTH, NOT, and all Referral Follow Up student check-ins and Mental Health Individual Supportive Services). Separate permissions are required for SAP and Intervention services. SAP services include D&A and MH funded SAP Screenings, SAP Groups, and Referral Follow Up/Mental Health Individual Support Services. Intervention services include Teen Intervention, Marijuana Brief Intervention, INDEPTH, NOT, and one associated D&A funded SAP Referral Follow Up student check-in.

This policy reflects Best Practices as indicated by the Pennsylvania Network for Student Assistance Services (PNSAS). PNSAS is an organization that is compromised by the Pennsylvania Department of Education; Pennsylvania Department of Drug and Alcohol Programs (DDAP); and the Pennsylvania the Department of Human Services Bureau of Children’s Behavioral Health Services.

Specific frequently asked questions related to this topic are listed below.

Parent Consent What do liaisons need to do regarding parent/legal guardian permission for a screening/assessment?

First and foremost, the liaison must ensure a signed school SAP consent has been obtained from the parent/ legal guardian giving the team permission for the student to be involved in SAP services. A liaison should never meet with a student for any reason without written parent consent for screening/assessment. It is important that the school and agency both be aware of how parent permission for screenings or assessments will be obtained. Liaisons need to discuss this with the participating school and outline the procedures in the Letter of Agreement. Where agencies conduct assessments in schools, parent permission should be on agency letterhead. In some schools the team case manager is responsible for acquiring the consent and in other schools the liaison may obtain the consent.

PNSAS Commonwealth of Pennsylvania’s Student Assistance Program: Liaison Frequently Asked Questions and Best Practice Responses May, 2014

47. Is written parental/guardian consent needed for the SAP process?

Yes. It is mandatory for the SAP process to continue from data collection to meeting with the student. The Protection of Pupil Rights Act (PPRA) requires that the student's and parent's rights be recognized and respected, especially in instances of surveys, analysis, or evaluations. PPRA requires written parental permission when interviewing students regarding “.....mental or psychological problems of the student or the student’s family; sex behavior or attitudes; illegal, anti-social, self-incriminating, or demeaning behavior....”

50. When a parent/guardian gives written permission for the SAP process, does that permission also cover the mental health and/or drug and alcohol screening/assessment conducted by a SAP liaison or provider agency if recommended by the SAP team?

No. The SAP team has to obtain a separate written parental permission for the screening/assessment. One of the functions of the SAP team is to foster parental/guardian involvement throughout the SAP process. Written parent/guardian permission should be obtained for the following three areas of the SAP process:

A. Initial onset of the SAP process (this can be before or after student information forms are collected as long as it is before student interview);

B. When the SAP team suggests a MH and/or D&A screening/assessment; and/or C. If any in-school supports, such as an educational support group, are recommended.

PNSAS Commonwealth of Pennsylvania’s Student Assistance Program Frequently Asked Questions and Best Practice Responses December 2015

Sample parent permission forms are available for download on the PANSAS website.

http://pnsas.org/About-SAP/SAP-Teams

D. RESPONSIBILITIES

Contracted D&A/MH SAP Providers must obtain written parental permission prior to delivering the supports outlined above. Verbal permission without appropriate documentation as indicated below is not sufficient. Signed parent permission can be obtained electronically by use of digital electronic signatures, scanned form, photo of signed document or fax, or through email as indicated below Permission forms must include a minimum of the following information:

· A definition of all SAP or Intervention services

· Specification of school year when the services will be delivered

· Space for verbal permission to be documented by the signature of 1 witness

· Language offering parent opt-out of one or more services as defined

Permission obtained via email must include a minimum of the following information and be available as part of the service(s) required documentation:

· Clearly stated service(s) for which permission is being requested by parent/guardian

· Language indicating timeframe of service delivery (e.g., during the 2023-24 school year or from 9/1/23 through 11/1/23)

· Attachment of agency permission form(s) for service(s) for which permission is being requested for parent review Parent/guardian response indicating they agree to their child's participation in county-funded SAP services

The County may adjust the parameters of Parent Permission requirement for defined periods of time to account for adaptations to the school year, including time periods of remote learning by students.

E. DEFINITION

N/A

SAP02: SAP Screening Policy

DEPARTMENT OF HEALTH AND HUMAN SERVICES

OFFICES OF DRUG AND ALCOHOL AND MENTAL HEALTH

Erin Seifrit-Townsend

F. POLICY STATEMENT:

The Pennsylvania Student Assistance Program (SAP) is a systematic team process used to mobilize school resources to remove barriers to learning. SAP is designed to assist in identifying issues including alcohol, tobacco, other drugs, and mental health issues which pose a barrier to a student’s success. The primary goal of the Student Assistance Program is to help students overcome these barriers so that they may achieve, advance, and remain in school.

G. PURPOSE

It is the intention of the Single County Authority (SCA) in partnership with the Office of Mental Health, to provide SAP liaison services, through contracted D&A/MH SAP Providers, to school districts in Montgomery County. It is the expectation that these services follow all updated published guidelines.

The purpose of this policy is to clarify the procedures for SAP Screenings, when they are not appropriate, and what information can be released back to the school SAP team.

H. PROCEDURE

· After a student is referred to the SAP team and parent/guardian permission is obtained to proceed, the student should be referred to the contracted D&A/MH SAP Providers who will schedule an appointment with the student and his/her parent/guardian.

· SAP Screenings should NOT be used in crisis situations. If the student is at risk for suicide or other high level crisis behavior the schools’ crisis procedure should be followed.

· Montgomery County contracted D&A/MH SAP Providers currently utilize a screening tool developed by mdlogix called Behavioral Health Works (BH-Works). This is a web-based screening tool that provides a validated and efficient assessment of areas of behavioral and psychosocial problems and risks. This is not a level of care assessment. A blank copy of the screening tool can be provided to the school at their request. Please see BH-Works guidelines attached for best practices in administration of the screening (Attachment 1).

· At the end of the screening, SAP Providers will give written recommendations for next steps and supports to the student and his/her family. These may include community-based supports such as a biopsychosocial assessment at a behavioral health clinic, outpatient individual or family therapy, further drug and alcohol assessments, etc. There may also be recommendations made for school-based supports such as SAP groups or individual mental health or drug and alcohol sessions with SAP liaisons. Please see attached example of a screening summary and recommendation form (Attachment 2).

· Screening recommendations should only be shared with school district personnel if the parent/guardian has signed the release to do so. If the student is 14 and older, the student must sign the release of information. If the screening includes any drug and alcohol use information the student must sign the release, regardless of age. A written summary of the recommendations should be the only information shared with schools, verbal discussions should not occur.

This policy reflects Best Practices as indicated by the Pennsylvania Network for Student Assistance Services (PNSAS). PNSAS is an organization that is compromised by the Pennsylvania Department of Education; Pennsylvania Department of Drug and Alcohol Programs (DDAP); and the Pennsylvania the Department of Human Services Bureau of Children’s Behavioral Health Services.

Specific frequently asked questions related to this topic are listed below.

32. What is a liaison allowed to share from a screening or assessment in writing to the school? Liaisons completing a screening can share recommendations the liaison has for a student, as long as there is an informed, written release signed by parent/guardian. In the case of a drug and alcohol liaison that completes assessments, a student must sign the release of information. In the case of a mental health liaison that completes assessments and the student is over 14, the student must sign the release of information. The agency should not provide the school a copy of the completed screening or assessment. However, they can provide a copy of the blank assessment tool at the beginning of the school year.

If a student who is being assessed does not sign the release of information, the liaison should not conduct the assessment in the school.

In the event a student discloses threat to self/others, the liaison should follow procedure in notifying appropriate individuals (parent, school, emergency delegate, or possibly the police).

33. What do liaisons share verbally verses written? (What should we be telling them so that they can accurately complete the PDE 4092 reporting forms?)

Liaisons should share screening/assessment recommendations in writing to the team, rather than verbally. This should be placed in the student SAP file. No verbal information should be shared with the team that violates confidentiality regulations.

PNSAS Commonwealth of Pennsylvania’s Student Assistance Program: Liaison Frequently Asked Questions and Best Practice Responses May, 2014

28. What routinely should be kept in a student’s SAP educational record?

When in doubt about what should be placed in a student’s SAP record, consider the following suggestions (this list is not all inclusive):

· Referral form with reason for referral (should only include objective, observable behaviors, not opinion and hearsay)

· Date and SAP team action

· Date and outcome of parental contacts

· Student information forms (behavioral observation forms)

· Written parent permission form

· Documentation of parent refusal

· Documentation of follow-up contact with parents

· Date and SAP team action following parent permission

· If applicable, the name of agency and the date the screening or assessment was completed. Do not include dates of Drug & Alcohol Level of Care Assessments in the record without a release signed by the student from the assessment provider.

· If applicable, agency and/or district release of information forms

· Follow-up action taken by SAP team

· Copy of SAP Student Reporting form (PDE 4092) *It is recommended not to include any written copies of reports from treatment agencies with the SAP record

30. Should SAP records for students currently enrolled in school be kept in the student’s main permanent file instead of separately?

Due to the confidential nature of the SAP record, it is advisable to maintain the SAP record separate from the main permanent file. SAP records are part of the student’s educational file; however, they can be maintained in a separate secure location with restricted access. They should be kept in a secure location, such as in a locked filing cabinet or a permanent secure database. Maintenance, access, and dissemination of the records should be done in accordance with the school entity’s records policy.

59. What is the difference between a SAP screening and SAP assessment?

SAP screening-A face-to-face interview between the referred student and SAP liaison. This interview is conducted at the school setting during regular school hours, unless otherwise indicated. The purpose of the interview is to gather information from the student related to school-based data as well as other identified areas of concern impacting student behavior. The screening determines the level of concern, and develops an action plan to include additional services, if necessary. This screening could also determine if a clinical assessment is needed for further evaluation.

SAP assessment-A face-to-face interview with the student and/or family conducted by a Drug/Alcohol or Mental Health professional. Typically, this assessment occurs in an agency, but in some counties may be conducted in the school setting. The purpose of the assessment is to determine the need for and/or level of care of treatment. The assessment may include, but not limited to, the following areas: psychosocial history; drug/alcohol and mental health history; medical, educational, recreational, family, sexual, and/or legal history; other agency/system involvement.

Contact your county administrators for drug and alcohol or mental health as each may have different expectations for the role of the SAP liaison in a school setting

PNSAS Commonwealth of Pennsylvania’s Student Assistance Program Frequently Asked Questions and Best Practice Responses December 2015

I. RESPONSIBILITIES

It is the expectation of the SCA and Office of Mental Health that SAP providers should maintain student confidentially per PNSAS Best Practices. If a conflict occurs between a school district and a provider agency, the SCA and Office of Mental Health should be contacted.

Compliance with the outlined practices above will be monitored through yearly site visits by the Offices of Drug and Alcohol and Mental Health.

In alliance with the Office of Mental Health’s Early Childhood Mental Health Initiative, SAP Providers are expected to partner with their assigned district elementary schools to increase identification of students ages 5-9 for SAP Screenings. The intent of this initiative is to:

1.) Assist with earlier identification of children exhibiting social-emotional, behavioral, or other MH concerns 2.) Provide recommendations and support linkage to community resources or treatment at an earlier age as appropriate.

SAP Providers will enter data as required in the JQRS website, which will be reviewed quarterly to monitor progress related to elementary SAP referrals.

J. DEFINITION

SAP03: SAP Group

OFFICES OF DRUG AND ALCOHOL AND MENTAL HEALTH

Erin Seifrit-Townsend

A. POLICY STATEMENT:

The Pennsylvania Student Assistance Program (SAP) is a systematic team process used to mobilize school resources to remove barriers to learning. SAP is designed to assist in identifying issues including alcohol, tobacco, other drugs, and mental health issues which pose a barrier to a student’s success. The primary goal of the Student Assistance Program is to help students overcome these barriers so that they may achieve, advance, and remain in school.

B. PURPOSE

It is the intention of the Single County Authority (SCA) in partnership with the Office of Mental Health, to provide SAP liaison services, through contracted D&A/MH SAP Providers, to school districts in Montgomery County. It is the expectation that these services follow all updated published guidelines.

The purpose of this policy is to clarify the procedures for Student Assistance Program Groups.

C. PROCEDURE

SAP Groups are an additional service funded through the Office of Drug and Alcohol and Mental Health and are not a requirement of the SAP Process. SAP Groups are a helpful tool in providing short-term support for students already identified through the SAP Process.

Once a student has been identified through the SAP process as a candidate for a SAP Group, the SAP liaison should obtain written parental permission (students 18 years and older are required to have parental permission). Students experiencing similar issues and of a similar age (as defined by no more than two years) should be placed together in a group. Groups may begin with three or more students with the expectation that the census goal is five or more students. Groups can be facilitated if at least two students are present. If all but one student is absent, the group should be rescheduled.

There is no weekly requirement for SAP Groups not utilizing a curriculum.

SAP Groups can utilize an evidence-based program (EBP), if relevant. The EBP should be implemented with fidelity and follow the evaluation guidelines set forth by the developer. SAP Groups utilizing EBPs are to be entered into PA WITS under the name of the program with the SAP Group code assigned to the program.

D. RESPONSIBILITIES

It is the expectation of the SCA and Office of Mental Health that SAP providers follow policy regarding SAP Groups.

Compliance with the outlined practices above will be monitored through yearly site visits by the Offices of Drug and Alcohol and Mental Health.

E. DEFINITION

SAP04: Sap Services Documentation Policy: SAP Group

OFFICES OF DRUG AND ALCOHOL AND MENTAL HEALTH

SAP Services Documentation Policy:

SAP Group

Pam Howard

K. POLICY STATEMENT:

The Pennsylvania Student Assistance Program (SAP) is a systematic team process used to mobilize school resources to remove barriers to learning. SAP is designed to assist in identifying issues including alcohol, tobacco, other drugs, and mental health issues which pose a barrier to a student’s success. The primary goal of the Student Assistance Program is to help students overcome these barriers so that they may achieve, advance, and remain in school.

L. PURPOSE

It is the intention of the Single County Authority (SCA) in partnership with the Office of Mental Health, to provide SAP liaison services, through contracted D&A/MH SAP Providers, to school districts in Montgomery County.

This policy serves to identify documentation requirements for SAP Service Notes (Drug and Alcohol and Mental Health Groups).

M. PROCEDURE

Contracted D&A/MH SAP Providers shall utilize an electronic process for documentation. This policy governs all group sessions. The policy covering individual services is found in Interv01.

The below protocol should be utilized to maintain SAP Group records electronically:

· Follow agency policies and procedures regarding use of shared drives for electronic records

· For example, files should be either password protected or permission only granted to specific staff who need access and program supervisor

· Folder Name should include school district, school and match Group Name in WITS, following WITS Guidelines in the SAP Manual

· E.g., North Penn Penndale MS Social Skills 1

· Within the folder, each student permission should be saved separately or as one file alphabetically by last name. The file name should contain student initials and academic year of permission

· E.g., “KH 23-24” or “GT, KH, PL 23-24”

· Electronic notes may be maintained on the “Group Notes” template in the SAP Prevention

· All associated worksheets or other requirements of an evidence based group program [(ie, Not on Tobacco (NOT), Blues Program] should be uploaded in a separate group sub folder for each group session. Uploaded documents should either be clearly marked per student if saved in one file or, if saved individually, the document should be saved with the student’s initials and group session number.

· Manual. Note should match the name of the group.

· E.g., North Penn Penndale MS Social Skills 1

· Agencies will either download or share the file for review during annual monitoring Below is an example using OneDrive as the protected shared drive maintained by one staff person, and an example of how the folder contents would be organized:

N. RESPONSIBILITIES

Contracted D&A/MH SAP Providers will utilize the standardized forms and process for SAP services rendered including SAP Drug and Alcohol and Mental Health Groups. The files for the standardized forms will be supplied to the providers by the county offices. The SCA and Office of Mental Health will review compliance with this policy during monitoring visits.

O. DEFINITION

The following are services for students already identified through the SAP process. Active written parent/guardian permission is required prior to all services listed.

· Drug and Alcohol Group: A short-term non-evidenced based educational support group without a curriculum or a county-approved evidence based group program.

· Mental Health Group: A short-term support group. Groups focus on specific topics that have been recommended by the SAP team and are based upon the need of the students in each building. Example: bullied students, bullying students, grief and loss, children of divorce, anxiety, family member with special needs or chronic illness or county-approved evidence based group program.

· The Blues Program is a six-week prevention curriculum for middle and high school-aged students experiencing elevated symptoms of depression. The curriculum uses a cognitive-behavioral approach and includes session topics of building group rapport, increasing participant involvement in pleasant activities, learning and practicing cognitive restricting techniques, and developing response plans in future life stressors. Students who are absent from a group session will meet individual with the SAP Liaison to review missed content, and may also receive individual support services for a limited-time basis during the school day.

· Not on Tobacco (NOT) is an evidence-based teen smoking and vaping cessation program delivered in a group setting. Ten sessions specially designed for youth in a group setting embraces all types of tobacco users to identify individual reasons for use, education on how tobacco and nicotine affect the body, thinking and emotions and guidance to develop a plan for overcoming obstacles to quitting.

Interv01: Intervention Services

OFFICE OF DRUG AND ALCOHOL

OFFICE OF MENTAL HEALTH

Drug & Alcohol Intervention Services and Mental Health SAP Individual Support Services Documentation

Mental Health

Linda Moore-Singleton

P. POLICY STATEMENT:

Intervention services are defined as services targeted towards individuals in need of drug and alcohol services or mental health services.

Drug and Alcohol (D&A) Intervention involves the provision of services designed to encourage individuals to examine their own patterns of substance use and reduce risky substance use behaviors. Referral is provided if the need for a structured treatment regimen or other services is indicated.

Mental Health (MH) SAP Individual Support Services (aka individual support services or “MH3”) involve the provision of services designed to provide extra short-term, individual support to students as recommended by the SAP team during the school day in the school building. Referral for a MH SAP Screening may occur prior, during or after individual support services if the need for additional treatment recommendations may be beneficial to the student.

Q. PURPOSE

The purpose of the Intervention and Support Services Documentation policy is to streamline service documentation between the Office of Drug and Alcohol and Office of Mental Health. This policy encompasses all student intervention and individual support services provided on an individual basis funded by the Office of Drug and Alcohol and/or the Office of Mental Health.

R. PROCEDURE

Intervention and support services should not be a substitute for community-based therapy nor be for addressing issues unrelated to a substance abuse or a mental health specific problem. Individuals currently in any type of treatment are not eligible for this service. For extenuating circumstances where individual support services may be needed for a student that is receiving outside treatment please contact a county representative for approval.

1. Providers will document reason for referral to all Intervention and Mental Health Individual Support Services in the first session case note in BH Works.

2. Providers will utilize the BH Works ID number automatically generated in the BH Works system for all services rendered to a particular student and associated WITS data entry.

3. All case notes should be entered in BH Works.

4. Teen Intervene/Marijuana Brief Intervention/INDEPTH worksheets and/or journals are to be completed and uploaded to the associated documented session case note in BH Works. If a worksheet is not completed, a reason documenting this is required.

5. Parents are the focus for the third and final session in Teen Intervene. Documentation of at least one attempt to include the parents in the third session is to be included in the BH Works chart.

6. A discharge summary or conclusion will be included in the last session BH Works case note for Intervention and individual support services. If the client did not complete the Teen Intervene, Marijuana Brief Intervention, or the INDEPTH program, this is to be stated in a BH Works case note.

7. Documentation of parent permission for Teen Intervene, Marijuana Brief Intervention, INDEPTH and/or individual support services will be uploaded to the BH Works student chart.

S. RESPONSIBILITIES

Contracted Providers are responsible for following the procedure listed above. Parent permission must be obtained for any student accessing Teen Intervene, Marijuana Brief Intervention, INDEPTH, or individual support services.

T. DEFINITION

Teen Intervene is an evidence-based program incorporate principles of brief motivational intervention for underage youth using alcohol. Teen Intervene is a three session program, providing two individual sessions to the youth with the third session including the family, when possible.

Marijuana Brief Intervention is also an evidence-based program targeting adolescent’s marijuana use. This program can be tailored to the individual participant needs through one-session, four sessions, or six sessions. Sessions address: preparing for change; strategies for change; managing withdrawal; problem solving; and relapse prevention.

INDEPTH

The American Lung Association’s Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) program is an alternative to suspension or citation program that is offered as an option to students who face suspension for violation of school tobacco, vaping, or nicotine use policies. It is administered by an adult facilitator in a school or community setting. The program consists of four sessions, approximately 50 minutes each, geared towards youth and focused on tobacco use, vaping, nicotine addiction, establishing healthy alternatives, and making the change to be free of all nicotine and tobacco products.

MH SAP Individual Support Services provide individual assistance to students referred by the school SAP Team including: students returning to school from an inpatient/partial or other out-of-school placement, students who are in the process of accessing community based mental health treatment, students who are awaiting the start of a group, and/or students that are experiencing distress that is best served in time limited and solution-focused sessions.

YAP01: Youth Aid Panel Policy

MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES

OFFICE OF DRUG AND ALCOHOL

Revision No:

U. POLICY STATEMENT:

The Montgomery County District Attorney's Youth Aid Panel (YAP) Program has been giving juveniles a second chance to have a clean criminal record. The YAP Program is an alternative to having a juvenile charged with their criminal infraction and having the matter handled in Juvenile Court. Successfully completing YAP means the child won’t have a criminal record that can be found through background checks routinely done by colleges and employers. The program is also designed to help juvenile offenders avoid future contact with the juvenile justice system through the involvement and support of local community volunteers, who serve on the more than 30 active Youth Aid Panels across Montgomery County.

V. PURPOSE

It is the intention of the Single County Authority (SCA) i.e. Office of Drug & Alcohol through its contracted youth drug & alcohol intervention providers to partner with the Montgomery County District Attorney’s Office Youth Aid Panels to offer evidence-based youth intervention services. It is the expectation that these services follow all updated published guidelines.

This policy serves to clarify contracted provider expectations related to YAP referrals.

W. PROCEDURE

It is the expectation of the SCA that contracted youth drug & alcohol intervention agencies partner with their local Youth Aid Panels (YAP) to offer the following youth drug & alcohol intervention services, as applicable, to the individual youth: Teen Intervention, Marijuana Brief Intervention, INDEPTH. In most cases, the youth undergoing the YAP procedure is expected to reach out to the SCA’s contracted provider to schedule an intake. It is the SCA’s expectation that contracted providers respond to the youth outreach within two (2) business days.

The SCA’s contracted providers should create a written procedure outlining how student referrals will be handled. This procedure should be on file for monitoring purposes and available upon request by the SCA. The procedure should include, at a minimum, details on the following:

· Timeframe for referral follow-up by provider

· Parent permission

· Communication with YAP volunteers

· Communication with DA’s YAP office

X. RESPONSIBILITIES

Contracted SCA providers must finalize a written YAP procedure no later than July 30, 2023 and send to the SCA for initial review. All current youth drug & alcohol intervention policies including, but not limited to the parental permission policy, are to be followed for these services. All worksheets are required to be uploaded into BH Works as well as electronic notes.

Contracted providers are expected to adhere to the fidelity of the youth drug & alcohol intervention. Any deviation from the evidence-based curriculum must be requested in writing to the SCA for permission before implementation.

Y. DEFINITION

Prev01: Prevention Program Evaluation Policy

OFFICE OF DRUG AND ALCOHOL

Revision No:

Z. POLICY STATEMENT:

As per the DDAP Prevention Manual, “Pre/post tests, surveys, or other short term outcome measures approved by DDAP in the SCA’s Prevention Action Plan must be administered/collected for all Evidence-Based and Evidence-Informed Programs as well as all session-based,/recurring Supplemental Programs under the federal strategies or Education and Alternative Activities. Results data from the completed tests, surveys or other measures should be analyzed, and a summary or other record of the pre/post tests and survey results should be maintained on file per record retention requirements in the DDAP/SCA Grant Agreement.”

“SCA/providers are required to use the developer’s pre/post tests and/or surveys for all Evidence-Based and Evidence-Informed Programs for the purposes of capturing outcomes. The use of alternative instruments requires prior approval from DDAP. Justification to utilize an alternative instrument must be provided to the SCA’s assigned DDAP Prevention Analyst by the requestor.”

The United States Department of Education Student Privacy Policy Office oversees the Protection of Pupil Rights Amendment (PPRA) as defined below:

PPRA (20 U.S.C. § 1232h, 34 CFR Part 98) affords parents of students certain rights regarding, among other things, participation in surveys, the collection and use of information for marketing purposes, and certain physical exams. These include, but are not limited to, the right to:

· Consent before students are required to submit to a survey that concerns one or more of the following eight protected areas (protected information survey) if the survey is funded as part of a program administered by the U.S. Department of Education (Department) (applicable program) –

1. Political affiliations or beliefs of the student or student’s parent;

2. Mental or psychological problems of the student or student’s family;

3. Sex behavior or attitudes;

4. Illegal, anti-social, self-incriminating, or demeaning behavior;

5. Critical appraisals of others with whom respondents have close family relationships;

6. Legally recognized privileged or analogous relationships, such as with lawyers, doctors, or ministers;

7. Religious practices, affiliations, or beliefs of the student or student’s parent; or

8. Income, other than as required by law to determine program eligibility.

AA. PURPOSE

It is the intention of the SCA to provide high quality Evidence-Based and Evidence-Informed Programs, through contracted D&A Prevention Providers, to school districts in Montgomery County. It is the expectation that these services follow all updated published guidelines, including but not limited to: DDAP Prevention Manual, SCA Program Evaluation Manual, and any other relevant state and federal regulations such as the Protection of Pupil Rights Amendment (PPRA). SCA contracted D&A Prevention Providers are expected to know all applicable policies, procedures, state and federal regulations surrounding data collection.

The purpose of this policy is to clarify the procedures for prevention programs funded by the SCA.

AB. PROCEDURE

As an administrative SCA, meaning no direct service is provided by SCA staff, all DDAP requirements must be upheld by contracted D&A Prevention Provider agencies. The SCA has relieved the burden/DDAP requirement for analyzing and producing a summary or other record of survey results for each program implemented in the Provider service plan by contracting with an external evaluator. It is the responsibility of the D&A Prevention Provider to administer and collect pre/post tests for all Evidence-Based and Evidence-Informed Programs.

The SCA’s external contract evaluator will assist D&A Prevention Providers in reviewing pre/post tests for Evidence-Based and Evidence-Informed Programs to ensure measures meet all state and federal regulations. It is the expectation that the D&A Prevention Provider take an active role in communicating needs to the external evaluator in a timely manner (survey needs communicated with advanced notice, at least two weeks prior to program delivery. The external evaluator will create an appropriate version of the survey instrument for the Provider to administer and collect (paper copy or electronic version). If DDAP approval is required, the Provider and external evaluator should collaborate to inform the SCA of this approval.

Program evaluation procedures are created and revised annually by the SCA’s contracted external evaluator. It is the responsibility of the contracted D&A Prevention Provider to understand the program evaluation procedures, train staff accordingly, and actively communicate with their designated evaluation liaison as questions and/or support needs arise.

AC. RESPONSIBILITIES

It is the expectation of the SCA that D&A Prevention Providers be familiar with and follow all policies, procedures, state and federal regulations regarding evaluation.

Compliance with the outlined practices above will be monitored through yearly site visits by the Office of Drug and Alcohol/Office of Performance and Planning.

AD. DEFINITION

DDAP Evaluation and PPRA definitions provided above.

Appendix C: Monitoring

1. SAP Intervention Monitoring Tools

a. MH SAP Review

b. D&A SAP Review

c. Marijuana Brief Intervention Review

d. Teen Intervene Review

e. INDEPTH Review

D&A SAP Review

Marijuana Brief Intervention Review

Teen Intervene Review

INDEPTH Review

NOT Review

Appendix D: WITS Guidelines

Appendix E: Work Statements MH SAP Scope of Work Contract Agency:

Scope of Work 2026/27 for Montgomery County Mental Health Student Assistance Program (MH SAP) Provider will facilitate…