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Referrals: Referrals are accepted for children and youth 4-21 years of age. Requests for service may be made for children and youth who reside with biological parent, in foster care, or in residential treatment centers.
To initiate services, written approval from a DCF supervisor, SOC Care Coordinator, Probation Officer or Parole Officer is required. The approval must include provisions for a minimum service term of 3-6 months, with minimum of 4-6 hours of service provided weekly.
Services are billed at a rate of $40 hourly for therapeutic support, $35 hourly for support service and $45/hr for Supervised Visitation.
Please download referral packet from this site, and send completed referral to Sue Rumanoff at srumanoff@midymca.org. In addition, please fax authorization for services and release forms to Sue at 203 287-9014.
**Supervised Visitations and Respite require a different referral form. Please contact Sue Rumanoff directly to have it forwarded to you.
Start of Services: Once the referral and authorization is received, the program director will contact prospective providers from our staff pool to discuss specifics of the case. Following initial conversation, if staff is interested, the referral packet is sent to the TSS/SS provider for review.
Once the Staff agrees to accept the case, a pre-service meeting is scheduled. Participants include the client, TSS/SS provider , program director or case manager, clinician and/or primary caregiver. Goals and anticipated outcomes as submitted by referral agent, as well as mutual expectations of the TSS/SS, client, clinician and/or primary caregiver are discussed and agreed to. Finally, a schedule of proposed visits is developed.
The program strives to initiate services within 30 days of receiving the completed referral. While this timeframe will be met in most cases, based upon the needs of the specific needs of the client, and the availability of a suitable TSS/SS, additional time may be required.
Reauthorization Process: The program will submit an electronic status report to the referral source no later than two weeks prior to the end of the authorized service period. If continuation of services is recommended, the referral agent must issue a written reauthorization prior to the current end date, or services will be put on hold until reauthorization is issued. If referral agent decides to discontinue services, the program requests an extension of one additional month to provide proper closure with the client. Written authorization of one month extension for closure is required.
Clinicians and/or primary care giver will be contacted by the program director or a case manager prior to the end of the authorization period to request information regarding service benefits and outcomes. Program staff include Sue Rumanoff (Director),Brooke Hopkins (Assistant Director), and Dani Forko (Assistant Director).
All authorizations and reauthorizations should be submitted via e-mail to srumanoff@midymca.org or fax 203 -287-9014
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