Background

1. Who should we contact if we need to clarify any survey responses?
 
1a. Name of survey contact  
1b. Title of survey contact  
1c. E-mail address of contact  
1d. Phone number of contact  
   

2. Is your state's health and mental health system administered by the state, supervised by the state and administered by counties, or is it a mixed model, administered by both state and county.
(Check only one answer.)
1.
2.
3.

3. Please consider the following types of oversight:

 --Establish or operate facilities;
 --License or certify county, state, or privately-operated facilities;
 --Investigate complaints (including complaints about the health or safety
     of a facility or physical or sexual abuse or neglect of youth);
 --Monitor or follow-up facilities in the absence of a complaint, including
     contract monitoring;
 --Provide other types of oversight

Does your agency have any authority or regulatory responsibility to provide any of these types of oversight over residential facilities for youth that provide health, mental health, or substance abuse services?
(Check at least one for each row.)
    Establish or operate License or certify Investigate complaints Monitor or follow-up Other oversight authority No oversight authority No response
3a. Residential treatment services for youth with clinically or medically diagnosed behavioral, emotional, mental health, or substance abuse issues
3b. Residential behavior modification or treatment services for youth with potential behavioral, emotional, mental health, or substance abuse issues that have not been clinically or medically diagnosed
3c. Residential services for pregnant teens
3d. Behavioral correction or rehabilitative residential services for pre-adjudicated incorrigible youth
3e. Behavioral correction or rehabilitative residential services for other incorrigible youth (e.g., youth placed in residential facilities by parents or custodians)
3f. Behavior modification, discipline, or character education provided at residential schools or academies for adjudicated youth
3g. Behavior modification, discipline, or character education provided at residential schools or academies for pre-adjudicated incorrigible youth
3h. Behavior modification, discipline, or character education provided at residential schools or academies for other incorrigible youth (e.g., youth placed in residential facilities by parents or custodians)
   


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