INTAKE PROCESS

How families begin services with Extra Pass Mentoring

Step 1: Referral or Inquiry

A referral can come from a county case manager, school, or parent.
Our Intake Coordinator will gather the following information:

Child’s name & date of birth
Parent/guardian contact information
Diagnosis / identified needs
County case manager name
Services requested (mentoring, skill-building, transportation, health/wellness support, respite, counseling, etc.)

Step 2: Eligibility & Service Matching

We verify program eligibility and CLTS authorizations.

Confirm CLTS approval (if already authorized)
If not authorized, we assist the case manager with needed descriptions
Match the youth with a mentor who fits their goals, interests, strengths, and schedule

Step 3: Family Introduction & Expectations Call

A 10–15 minute welcome call to explain:

What Extra Pass is
How mentoring works
Safety policies
Reporting expectations
What parents can expect
What we expect from families
Upcoming next steps

Step 4: Intake Meeting

Virtual or in-person at The Workshop

During the intake meeting, we complete:

Consent forms
Photo/video release (optional)
Transportation consent (if needed)
Crisis & safety plan
Review of goals and service schedule

PARENT WELCOME PACKET

WELCOME TO THE EXTRA PASS MENTORING PROGRAM

Thank you for trusting us with your child.
Our mission is simple: assist, support, and empower youth to grow socially, emotionally, and personally through mentorship, skill-building, and healthy connection.

WHAT WE PROVIDE

One-to-one mentoring
Life skill development
Community integration outings
Junior Trade Program (barbering, cooking, art, hands-on skills)
Health & wellness experiences at The Workshop
Transportation support (to and from programming)
Counseling (through licensed therapist)
Respite care (unlicensed)

OUR APPROACH

Trauma-informed
Strength-based
Culturally aware
Relationship-centered
Goal-oriented

WHAT YOU CAN EXPECT FROM US

Safe and supportive mentorship
Clear communication
Progress updates
Flexible scheduling
Professional boundaries
Respect for your home, culture, beliefs, and values

WHAT WE EXPECT FROM FAMILIES

Communication about schedule changes
Sharing relevant behavioral or medical information
Helping set realistic goals
Following safety procedures (transportation, pick-up, etc.)

YOUTH SAFETY

All mentors pass background checks
Mandatory reporting compliance
Safety protocols for all outings
Crisis response plan
Secure check-in and check-out procedures
Seatbelts required for all transportation

HOURS & LOCATION

Primary location:
The Workshop — 740 Centerline Drive, Hobart, WI
Sessions occur at The Workshop, in the community, or in the home depending on goals.

CONTACT

General Email: extrapassmentoringgb@gmail.com
Phone: 920-313-0209
Case Manager Communication: via secure email or phone

CRISIS PROTOCOL

THE EXTRA PASS – CRISIS RESPONSE PROTOCOL

1. Purpose

Ensure the safety of youth, mentors, and the community during any emotional, behavioral, or medical crisis.

2. Definition of Crisis

A crisis includes any situation where:

A youth is at risk of harming themselves or others
A youth is unable to regulate behavior
A youth is missing/runaway
There is a medical emergency
There is suspected abuse or neglect
A parent or guardian cannot be reached during an urgent incident

3. Immediate Safety Steps

The mentor will:

Stay calm and ensure the environment is safe
Remove other youth (if present)
Maintain visual contact at all times
Use de-escalation techniques:
- Calm tone
- Space and time
- Offering choices
- Redirection
- Sensory supports

If needed, move the youth to a quiet and safe area

Extra Pass does NOT use physical restraints.

4. Emergency Steps (if risk escalates)

If the youth presents immediate danger:

Call 911
Then notify:
- Parent/guardian
- County case manager
- Extra Pass leadership

If the youth runs:

Maintain sight if safe
Call local police if needed
Contact parent immediately

5. Medical Emergencies

If there is:

Injury
Loss of consciousness
Allergic reaction
Illness requiring care

Mentor will:

Call 911
Administer EpiPen or first aid if trained and necessary
Notify parent ASAP
Notify county case manager
File an incident report within 24 hours

6. Mandatory Reporting

Extra Pass staff must report suspected:

Abuse
Neglect
Threats to safety

Reports are made to CPS or law enforcement as required.

7. Documentation

Within 24 hours:

Full crisis report submitted to county
Description of incident
Timeline
Actions taken
Follow-up recommendations

Parents receive a copy if appropriate.

8. Post-Crisis Follow-Up

Within 48–72 hours:

Review crisis
Update safety plan
Provide skill-building to prevent future incidents
Communicate outcomes with county