Referrals

 Admission Criteria:
* Children and youth ages 6 - 18 who have a mental health diagnosis.
* Are at-risk for out-of-home placement or in need of support transitioning home from an institutional setting like residential treatment centers and juvenile hall.
* Have Medi-Cal or if not, must be eligible for SB163 funding (must have system involvement, i.e. Child Welfare Services dependents, Probation wards, or AB2726).

Referral Sources:
* AB2726
* CWS
* Probation
* Self-referrals
* Other (Anyone can make a referral!)

How to make a referral:
1) For children with Medi-Cal, a one-page referral form must be completed and faxed or mailed to the program.

* See Forms below

2) For children without Medi-Cal, an SB163 referral form must be completed and submitted to their System representative:

* See Forms below
 
• AB2726;
Sharon Massoth
Phone: (619) 758-6240
Fax: (619) 758-6250
• Child Welfare Services;
Nilanie Ramos
Phone: (619) 767-5457
Fax: (619) 767-5418
• Probation;
Judith Goldberg
Phone: (858) 541-5287
Fax: (858) 694-4649
 
You will receive a letter from Families Forward no later than 5 business days confirming that the referral has been received. You will then receive a phone call from a Families Forward Supervisor to inform you of the intake process and answer any questions you might have. At any time during the referral process, you are invited to contact the Program Manager at 858-380-4676 with any questions or concerns.

For families that do not meet eligibility criteria, our “No Wrong Door” policy provides up to 10 hours of linkage to community resources. An Information and Referral line specialist from Building Bridges Together will follow up on the “No Wrong Door” referral to ensure that the family’s needs are met with the appropriate resources.
 
Request for Wraparound (English)
 
Request for Wraparound (Spanish)
 
SB 163 Referral Form