As used in reference to the planning, implementation, and evaluation of the Guam System of Care Council for Children with Serious Emotional Disturbance, the following terms are defined:

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(a) ‘Access to services’: the right to, and ease in securing desired and needed services.

(b) ‘Capacity building’: refers to a component of the system of care that provides information, training, education or other resources to enable people (family and personnel) to carry out the needed and desired activities.

(c) ‘Case Management/Care Coordination’: the task of coordinating various service components and ensuring that service needs are assessed and reassessed over time. In systems of care, case management also denotes the actual provision of services, as opposed to the limited ‘brokering’ of services in traditional mental health systems. In some settings, the term ‘care coordination’ is used instead of case management to connote broader job requirements and to describe the actual case management model being used.

(d) ‘Care coordination’: the task of coordinating various service components and ensuring that service needs are assessed and reassessed over time. In systems of care, care coordination also denotes the actual provision of services, as opposed to the limited ‘brokering’ of services in traditional mental health systems.

(e) ‘Care Coordinator’: an individual assigned with the responsibilities of coordinating the care of the child and family. The care coordinator is key to ensuring that the system is truly responsive to the needs of the individuals it is designed to serve.

(f) ‘Child and Family Team’: members identified by the parents of a child with a serious emotional disturbance to work together as a team to help the child and family meet their needs.

(g) ‘Child with serious emotional disturbance’: a person who is under the age of eighteen (18) years old, or is under the age of twenty- two (22) years old and has been receiving services prior to the age of eighteen (18) years old that must be continued for maximum therapeutic benefits, and who exhibits any of the following characteristics for more than six (6) months:

(1) has received a DSM-IV diagnosis on axis I or II; or

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(2) exhibits severe behavioral, emotional or social disabilities that cannot be attributed solely to intellectual, physical or sensory deficits, such as, but not limited to:

(A) behaviors that are sufficiently intense or severe enough to be considered seriously detrimental to the child’s growth, development, or welfare, or to the safety or welfare of others;

(B) behaviors that, although possibly provoked, are judged to be extreme or out of proportion to the provocation, or an inappropriate age reaction;

(C) behaviors that have been judged sufficiently disruptive to lead to exclusion from school, home, therapeutic or recreational settings; or(iv) behaviors that require interdisciplinary services and intensive, well- coordinated care to be successfully managed.

(h) ‘CMHI qualifying child with a serious emotional disturbance’: for the purposes of the Child Mental Health Initiative cooperative agreement, the target population for CMHI/ Project I Famagu’onta is: Children and Adolescents who: a) are under twenty-two (22) years of age; b) have an emotional, behavioral, or mental disorder diagnosable under DSM-IV or its ICD-9-CM equivalents, or subsequent revisions with the exception of DSM-IV ‘V’ codes, substance use disorders and developmental disorders, unless they co-occur with another diagnosable serious emotional, behavioral, or mental disorder; c) are unable to function in the family, school, or community, or in a combination of these settings; or, the level of functioning is such that the child or adolescent requires multiagency intervention involving two (2) or more community service agencies, such as mental health, education, child welfare, juvenile justice, substance abuse, and health; and d) have a disability that must have been present for at least one (1) year, or on the basis of diagnosis, severity, or multi-agency intervention, is expected to last more than one (1) year.

(i) ‘Child Mental Health Initiative, (CMHI)’: a Congressionally- funded program initiative under the U.S. Department of Health and Human Services, managed by its Substance Abuse and Mental Health

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Services Administration (SAMHSA), and designed to provide funding for the infrastructure development needed to create a system of care.

(j) ‘Child at risk for serious emotional disturbance’: a child or adolescent is considered to be at risk for a serious emotional disturbance, as defined by this Act, if the child would be subject to a serious emotional disturbance for any length of time.

(k) ‘Child-centered’: a core value of the system of care whereby the needs of the child and family dictate the type and mix of services provided rather than expecting the child and family to conform to preexisting service configurations. This approach is seen as a commitment to providing services in an environment and in a manner that enhances the personal dignity of children and families, respects their wishes and goals, and maximizes opportunities for involvement and self-determination in the planning and delivery of services.

(l) ‘Collaboration’: the process of bringing together those who have a stake in children’s mental health for the purpose of interdependent problem-solving that focuses on improving services to children and families.

(m) ‘Community-based (Based in the Community)’: a core value of the system of care which emphasizes the need for services provided to children in less restrictive, more normative environments which are within or close to the child’s home environment.

(n) ‘Culturally competent’: a set of behaviors, attitudes and policies of a system, agency, or among service providers that enables them to work effectively in cross-cultural situations.

(o) ‘Early identification and intervention’: a process for recognizing warning signs that children are at risk for emotional disabilities and taking early action against factors that put them at risk. Early intervention can have a significant effect on the course of emotional disturbance in children and can help prevent problems from reaching serious proportions.

(p) ‘Family’: is defined by its members and each family defines itself. Families can include biological and adoptive parents and their partners, siblings, extended family members and friends who provide a significant level of support to the child or primary caregiver.

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(q) ‘Family-focused’: an approach to designing and providing care that supports all family members involved with the child’s care; decisions about services are made considering the strengths and needs of the family as a whole, as well as the individual child with a severe emotional disturbance. Further, family members are also involved in all aspects of planning and evaluating the service delivery system. This approach is seen as a commitment to support families in their role as caregivers and to preserve family integrity to the greatest possible extent.

(r) ‘FILAK’: a grant awarded to Guam to build consensus for using the ‘wraparound’ approach as a best practice service delivery process and to pilot its implementation.

(s)’Guam System of Care Council’ (‘GSOCC’): the Council established by this Act is responsible for policy development and implementation of plans and strategies to foster collaboration among stakeholders so that the system of care policy is substantially embraced in every program ministering to children with serious emotional disturbances, and as otherwise provided by this Act.

(t) ‘Individualized services’: services that are designed specifically to address the unique needs and strengths of each child and family.

(u) ‘Integrated services’: services that are provided in a community through multiple agencies with decreased overlap and decreased gaps in services.

(v) ‘Least restrictive setting’: means that children and adolescents are served in as normal an environment as possible. Preferred interventions are those that provide the needed services and at the same time are minimally intrusive in the normal day-to-day routine of the child and family. An implicit goal of the system of care is to maintain as many children as possible in their own homes by providing a full range of family-focused and community-based services and supports.

(w) ‘Ombudsmen’: government of Guam agency representatives chosen to act as systems of care liaisons for their agencies. They are given decision-making powers for their agencies and act as a resource and trouble-shooter for those involved with the system of care in their agencies.

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(x) ‘Parent’: biological and adoptive mother or father, or the legal guardian of the child, or a responsible relative or primary caregiver, including foster parents, with whom the child regularly resides.

(y) ‘PROCEED’: Parents Reaching Out for Children Experiencing Emotional Disturbance, a non-profit parent support organization founded on Guam to help parents of children with severe emotional disturbance and to promote systems change and family empowerment.

(z) ‘System of Care’ (‘SOC’): a comprehensive spectrum of mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of children and adolescents with severe emotional disturbances and their families. A system of care not only includes the program and service components, but also encompasses mechanisms, arrangements, structures or processes to ensure that the services are provided in a coordinated, cohesive manner.

(aa) ‘Wraparound’: a philosophy of care that includes a definable planning process involving the child and family that results in a unique set of community services and natural supports, individualized for that child and family to achieve a positive set of outcomes.

SOURCE: Added by P.L. 25-141:1 (May 26, 2000). Repealed and reenacted by P.L.
27-047:1 (Dec. 17, 2003).

2013 NOTE: Pursuant the authority granted by 1 Guam Code Ann. § 1606, numbers and/or letters were altered to adhere to the Compiler’s alpha-numeric scheme.