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9 <br /> Agency professionals evaluate the client’s problems and capabilities, utilizing <br />placement at Emerson Hospital if necessary for the immediate short term. They assign a <br />case manager, create a team of staff, and begin a program of therapy, medication, and day <br />program participation. <br /> Edinburg copes as well as it can with what it deems to be a number of serious <br />impediments to the provision of adequate services. These impediments include the <br />difficulty of achieving coordination between the many towns and jurisdictions they serve; <br />seriously insufficient funding for outpatient services; and very inadequate transportation <br />services - no public buses operate between Lexington or Waltham and the Center. In <br />addition, this large and bustling professional center has no budgeted resources for research <br />and development, program planning, or staff training and development. The director also <br />noted that the Center’s overall annual funding is not growing. <br />Lexington High School Guidance Department(LGD). LGD consists of eight full time <br />professionals, a psychologist, counselors and social workers, and a director. The director <br />referred us to his staff because he was new to the town and the school in 2002. We <br />interviewed five members. <br /> LGD serves a caseload of 200 students per staff member. About 80 percent of their <br />time is devoted to college and job placement counseling. Social adjustment and mental <br />health issues received 20 percent or less of their time. The mental health service provided <br />by staff in LGD is of an emergency kind - disruptions and episodes that come up <br />unexpectedly during the school day in particular - and is devoted to very short term <br />problem solving. <br /> The Lexington school district does not permit professional staff to engage in <br />therapeutic counseling. This is part of the district’s risk management strategy as devised by <br />the legal counsel for the school committee. As part of the same strategy, LGD members <br />cannot refer or make related arrangements with outside mental health practitioners. They <br /> <br />