Children's Administration, Department of Social and Health Services
Children's Administration, Department of Social and Health Services
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Practices and Procedures Guide

4430. Courtesy Supervision

Purpose Statement Safely support a child, in the care and custody of the department, when placed outside of the originating office catchment area. Provide consistent support for children and families when cases are shared between offices and regions.
Policy
  1. All offices and regions will provide courtesy supervision when a child in the care and custody of the department is placed outside the sending (originating) office's catchment area.
  2. Placement requirements per Practices and Procedures Manual 45274 - Unlicensed Placements-Relatives or Suitable Persons Under Emergent and Urgent Circumstances and 4261 Placement Priorities will be followed.
  3. Courtesy supervision requests will be accepted by receiving office within 72 hours when all requirements are met unless it is an emergent or urgent placement request.
  4. Unresolved issues will be addressed through a dispute resolution process involving Area Administrators from the sending and receiving offices. The Deputy Regional Administrator or designee will determine final decisions.
Procedures
  1. Sending Office Responsibilities (Originating Office)
    1. Complete a Family Team Decision Meeting (unless emergent or urgent placement request.)
    2. Complete Courtesy Supervision Referral Checklist (DSHS 10-459) and send to Regional Gatekeeper Designee for all placements.
    3. Verify the following information is in FamLink:
      1. Most current report to the court
      2. Most current court order
      3. Indian Identity Request Form (DSHS 09-761)
      4. Child Information and Placement Referral Form (DSHS 15-300)
      5. Shared Planning Form with FTDM placement recommendations
      6. Placement Agreement (DSHS 15-281)
      7. Copy of Home Study if completed or Home Study Request
      8. Completed Background check for all members of the household 16 & up per Operations Manual 5500 Criminal History and Child Abuse and Neglect History Checks for Out-of-Home Placement
      9. Unlicensed Caregiver Placement Checklist Intake form (DSHS 15-280)
        (if applicable)
      10. Independent Living (ILS) Information (if applicable)
    4. Document last completed Health and Safety visit in FamLink. Allow at least fifteen (15) calendar days before next health and safety visit is due.
    5. Prior to placement, request walk through of potential unlicensed caregiver home.
    6. When requesting walk through of potential unlicensed caregiver home for emergent and urgent placements, provide receiving office with twenty-four (24) hour notice when possible.
    7. Review Placement Agreement with prospective caregiver telephonically.
    8. Provide caregiver or forward to receiving office to share with caregiver:
      1. Written documentation outlining how to access medical/educational, behavioral treatment
      2. Placement Agreement (DSHS 15-281)
      3. Child information and Placement Referral (DSHS 15-300)
    9. Maintain primary responsibility for case planning, decision making and payments.
    10. Update receiving office worker regarding progress and changes in case plan.
  2. Receiving Regional Gatekeeper or Designee will:
    1. Review all Courtesy Supervision Referral (DSHS 10-459) requests.
    2. Complete assignment of courtesy supervision in FamLink for all approved requests.
  3. Receiving Office Responsibilities
    1. Prior to placement, complete walk through for all unlicensed caregivers unless otherwise negotiated with sending office to complete.
    2. Use Household Safety Assessment (DSHS-10-453) and document assessment in a case note in the provider file.
    3. Verify who lives in the home and assess for safety threats.
    4. After placement, conduct monthly health and safety visits with child and caregiver per policy.
    5. Notify sending office worker if safety issues are identified.
    6. Collaborate with sending office worker on case planning and decision making.
    7. Attend all team meetings for children (including group care/BRS services) unless otherwise negotiated with sending office.
Resources

4431. Placement Out of Area - Family Foster Care or Relative Placement

  1. Inter and Intra-County
    1. Placement of a child in another DCFS office's service area may be necessary. However, before making a request to the court or placing the child on its own authority in the other service area, the placing DCFS office social worker or supervisor must notify the DCFS office serving the area of the proposed placement and obtain from that office a positive home study and/or assessment of the proposed placement.
    2. The assigned receiving office social worker or the placing worker, with the agreement of the receiving office, must conduct the home study in accordance with chapter 5000, section 5231. Such placements may be necessary when:
      1. The child's family or alternate family has moved.
      2. A permanent or other relative placement has been located in another DCFS service area.
      3. There is a specific need for specialized medical, emotional, and/or educational services/facilities not available near the child's family.
      4. The child needs placement outside his/her home community due to the child's behavior and/or the family's situation.
      5. There are no suitable homes available for a child in the original DCFS service area.
  2. Originating Office Duties
    1. The social worker, through the worker's supervisor, requests a foster placement/relative home study from the appropriate supervisor in the receiving DCFS office. The worker or supervisor may make the initial request by telephone to the supervisor in the receiving office, but the social worker sends a written request and the most recent report to the court and court order, on the child within five working days of the initial request.
    2. If the social worker makes a placement following location of a suitable foster home or a positive relative home study, the originating office retains responsibility for case planning, including approval of medical treatment, medication notifications, and confirming acceptance of the child into special education in the new school district if an eligible handicapped child, and maintains the case file data.
    3. Legal jurisdiction remains with the originating area's court, if either parent continues to reside in the original area unless the parent with whom the social worker plans reunification resides in the receiving county.
    4. If neither parent lives in the originating county, the original office may request that the court transfer jurisdiction three months after the parent has established residence of some permanence in the new county. The procedures are:
      1. Prior to requesting transfer of jurisdiction from the originating county, consult with the DCFS local office supervisor for the area in which the parent resides to request permission to transfer jurisdiction and case responsibility. The originating office supervisor does not request transfer of jurisdiction until permission has been obtained from the receiving office supervisor. If there is a disagreement between offices, it is resolved at the lowest possible level through the chain of command in the region(s).
      2. Consult with and advise the AAG/Prosecutor in the sending and receiving areas of the desire/plan to request jurisdiction transfer. An official request for the legal case to transfer shall not be made until the local office supervisor and the AAG in the receiving area have agreed to accept the case.
      3. When the court with original jurisdiction enters an order to transfer jurisdiction, the case must be transferred to the receiving office within five working days.
      4. The receiving office requests that the court schedule a hearing to determine if the receiving county will accept legal jurisdiction.
      5. If the receiving county's court refuses to accept jurisdiction, the case file is returned to the original office. The original office requests that the original court resume reviews and planning for the child.
  3. Receiving Office Duties
    1. Refers suitable licensed homes to the original DCFS office or notifies the original office that there are no suitable homes available.
    2. Contacts the prospective family to complete a relative home study.
    3. Completes the home study within 60 working days of receipt of the request for the study and then immediately notifies the referring DCFS office of findings. Exception: When fingerprint checks through the Federal Bureau of Investigation (FBI) are required prior to completion of the home study, the study shall be completed within 10 days of receipt of satisfactory criminal history reports from the FBI.
    4. Helps coordinate actual placement with the originating office and prospective home, if requested.
    5. Provides courtesy supervision of the placement, including monitoring health and safety, and provides written reports once every six months of the child's progress. The sending office needs to make a written request one month prior to a scheduled court hearing, if the office wants the report for court. Maintains a courtesy supervision file in FamLink per current standards.
    6. Immediately notifies the initiating DCFS office for additional planning if the placement fails.
  4. Other Considerations
    1. When a child in a DCFS foster family placement runs away and is found in the catchment area of another DCFS office, the social worker in the DCFS office where the child is found:
      1. Arranges for the appropriate office to notify or directly notifies, if possible, the child's parents of the child's whereabouts;
      2. Arranges shelter care for the child, if necessary;
      3. Contacts the assigned social worker in the original office to request payment to the temporary care provider for that care;
      4. Arranges for transportation to return the child to the catchment area of the originating DCFS office and requests that the assigned worker establish payment;
      5. Does not open a new case file or assign a new case number;
      6. Forwards documentation of service activity, provided to the child to the office in which the case is assigned for placement in the case file. Such documentation includes the assigned worker's identity and activities, recorded in FamLink.
    2. The originating office retains responsibility for planning and payment in behalf of the child.
    3. When a child in a foster home placement moves with the foster family to another area, the original DCFS office coordinates with DLR and the receiving DCFS office for licensing, continuation of payment, and courtesy supervision of the child.
    4. If the originating office and the receiving office are within the same region, the Regional Administrator may determine that the case will not be transferred from one office to the other.

4500. SPECIFIC SERVICES

4501. Case Management

45011. Service Definition

Case management includes providing continuous assessment of child safety, an assessment for eligibility for services, family conflict or placement, developing permanency plans, advocating for families in brokering services, ensuring that families understand how to access services, monitoring the progress of services/permanency plans, and making recommendations to juvenile courts and other reviewing bodies about the case plan and completing administrative requirements.

45012. Eligibility

Each family opened for DCFS services shall have an assigned DCFS social worker.

45013. Procedures for Access

  1. Social workers refer families for case management by following established CPS, FRS, and CWS intake procedures.
  2. Social workers are assigned by a local office supervisor following intake.
    1. The entry point for case assignment for CPS is a referral alleging abuse and/or neglect. See chapter 2000.
    2. For FRS the entry point is a family's request for services to resolve family conflict. See chapter 3000.
    3. The entry point for CWS is a family's request for such mnl_PnPg/hdrPnPgassessment services. See chapter 4000, sections 4100 and 4200.

45014. Other Sources

Case management services may be available through mental health, DDD, private child placing agencies, and schools in some communities.

4502. Intensive Family Preservation Services (IFPS), Family Preservation Services (FPS)

45021. Service Definition

IFPS, authorized and described in RCW 74.14C.040, and FPS, authorized and described in RCW 74.14C.050, are family-focused, behavior-oriented, in-home counseling, and support programs available in most counties. The services of both programs may be utilized when youth are, for IFPS, at imminent, or for FPS at substantial, risk of placement or for children returning to the home from out-of-home care. See section 45023, below, for procedures to access IFPS and FPS.

  1. For IFPS, services begin within 24 hours of referral, are available 24 hours a day, are short-term, limited to a maximum of 40 days, unless paraprofessionals are used, in which case service is limited to a maximum of 90 days. The service can be up to 80 hours in a 30-40 day intervention or up to 100 hours in a 90 day intervention. Services include both clinical assistance (counseling, case management, parent education) and concrete help (financial, housing, utilities, clothing, food). IFPS services are provided by contracted vendors and are available statewide.
  2. FPS begin within 48 hours of referral, are available 24 hours a day, and can be up to six months in duration. FPS is designed to be less intensive that IFPS, and interventions are focused on improving family functioning and assisting families with getting connected to local community resources. FPS are provided by contracted vendors and are available statewide.

45022. Eligibility

  1. Families and children are eligible for IFPS and/or FPS when a child is in out-of-home placement and can be reunited within 30 days or the social worker has determined that, without intervention, the child, for IFPS, is at imminent risk of out-of-home placement or, for FPS, at substantial likelihood of being placed out-of-home due to at least one of the following:
    1. Child abuse or neglect.
    2. A serious threat of substantial harm to the child's health, safety, or welfare.
    3. Family conflict.
  2. The social worker need not refer otherwise eligible families and family preservation services need not be provided if at least one of the following conditions is met:
    1. The services are not available in the community in which the family resides.
    2. The services cannot be provided because the program is filled to capacity.
    3. The family refuses services. or
    4. The social worker or the service provider determines that the safety of a child, a family member, or persons providing the services would be unduly threatened.
  3. IFPS/FPS may not be used for families in need of an in-home crisis resolution or therapeutic service to avoid possible family disruption or foster care placement at some unspecified time in the future and is not to be used as an interim measure until a planned placement resource is secured.
  4. The family has a case open for service with CPS, FRS, or CWS. The child must be either residing in the family home or be able to go home immediately, within 30 days, with either IFPS or FPS.
  5. The child, for IFPS, has been assessed by the assigned social worker as needing immediate placement or, for FPS, will need placement in the future if family dynamics do not change or is already in placement but could return home immediately with either IFPS or FPS.
  6. F. For IFPS, immediate placement means that the social worker is planning to file a petition with the juvenile court to remove the child from the family home within 72 hours or is planning to obtain a voluntary placement authorization from the child's parents (per 4307 Voluntary Placement Agreement (VPA) policy) within 72 hours.
  7. For FPS, substantial likelihood of placement means the assigned social worker has determined, through assessment, that there is a strong possibility that another injury or crisis will occur in the near future, resulting in the placement of the child, or the child is already in placement but could return home sooner with FPS.
  8. The Regional Administrator may limit the provision of IFPS or FPS to families where children would be receiving paid DCFS placement services.
  9. The social worker has determined that there are no less intensive services available that can meet the family need.
  10. An immediate opening with the contracted IFPS and/or FPS agency is available.

45023. Procedures for Access

  1. Referrals for IFPS or FPS must come through DCFS. Contractors shall not accept referrals directly from families or other sources.
  2. The Regional Administrator or designee:
    1. Appoints a Gatekeeper for each office served by an IFPS or FPS provider. The IFPS/FPS Gatekeeper:
      1. Participates in a review or reviews all IFPS/FPS referrals to ensure conformance with eligibility requirements and the best use of the resource.
      2. Makes final department determinations of family eligibility for IFPS/FPS prior to referral to and intake by the service provider, rejecting all families for whom placement is not imminent or substantially likely.
      3. Facilitates the departmental review of all families entering placement for possible eligibility and referral to IFPS.
    2. Develops a written protocol with IFPS and FPS contractors governing the assessment of client eligibility, procedures for service referrals, approval of service extensions, and utilization of IFPS - Assessment and Aftercare Services.
    3. Distributes copies of the written protocol to IFPS/FPS Gatekeepers, Area Managers, supervisors, and all case carrying DCFS social workers.
    4. Works to ensure that IFPS and FPS eligibility determination and case referral practices in local offices are consistent with statutory and protocol requirements.
    5. Reports to the Assistant Secretary quarterly on the provision of IFPS and FPS in the region.
    6. Monitors payments against allotment and contract dollar limits.
    7. Monitors performance of contractors against standards set by the statement of work.
    8. Notifies contractors when there is a rate change and amend contracts as needed.
  3. The DCFS social worker:
    1. Identifies families who may be eligible for the service in accordance with regional procedures, including consultation with an internal or external team, a supervisor, or a designated IFPS/FPS Gatekeeper.
    2. Following referral, orally or in writing, per contract and regional procedure, supplies the contractor with referral information, release of which is permitted under RCW 13.50.100(3), that is as complete as possible and includes:
      1. Name and case numbers of family caretaker(s).
      2. Names, birth dates, Social Security numbers, and case numbers (if different) for all children at imminent risk of placement;
    3. File a written report with his/her supervisor stating the names of families referred and reasons for which the client was referred. The social worker's supervisor verifies in writing his/her belief that the family referred meets the eligibility criteria in section 45022(A), above. The supervisor reports monthly, through the Area Manager, to the Regional Administrator on the provision of these services. The Regional Administrator reports to the Assistant Secretary quarterly on the provision of these services for the entire region.
    4. Immediately opens payment on the Social Service Authorization, DSHS 14-154(A), utilizing SSPS codes at the time of authorization and sends a copy of the service authorization to the provider. The service termination date will not be entered until receipt of the service termination summary from the contractor.
    5. For FPS, receives a monthly statement from the provider and immediately processes the statement to generate a payment for services provided that month.
    6. During the delivery of contracted service, regularly consults with the IFPS or FPS contractor regarding the progress of the family.
    7. Immediately notifies the contractor if CPS referrals are received on the family.
    8. Participates in exit interviews with the IFPS/FPS therapist.
    9. Enters the service termination date on the Social Service Authorization upon receipt of the contractor's termination report, using the last date of client contact as the termination date. The authorization is immediately processed to generate a payment for services provided by the IFPS or FPS contractor.

45024. Other Sources

Components of DCFS funded IFPS/FPS exist in other service delivery systems in some communities, including the Regional Support Network (RSN) and DDD.

4503. Child Protective Services Child Care

45031. Program Description

The Child Protective Services (CPS) child care subsidy program provides short-term, time-limited subsidized child care for families that are currently involved in a CPS investigation by Children's Administration (CA). CPS child care subsidy must end when the case is no longer classified as a CPS or is transferred to another program.

45032. Eligibility

  1. The CA social worker may authorize child care for a family with an open CPS case when the family is:
    1. Under stress and in need of respite care; or
    2. Working to complete a service plan.
  2. To be eligible for CPS child care subsidy program the family must have:
    1. An open CPS case; and
    2. An income at or below 225% of Federal Poverty Level (FPL) adjusted for family size. See the CA Operations Manual, chapter 9000, section 91300.
  3. The social worker may waive income eligibility and co-payment requirements on a case-by-case basis. See the Operations Manual, chapter 9000, section 91300, for information regarding income eligibility and co-payments.
  4. When the CPS social worker places a child with a relative who is employed, the social worker may authorize Employed Foster Parent Child Care subsidies for the time the relative is at work.
  5. When the family needs child care, the social worker determines if other resources are available to the family before authorizing CPS child care. For example, family members may be available to provide or pay for privately arranged child care. If the social worker determines there are no other resources available, CA may pay for care through the CPS Child Care Subsidy Program.

45033. Procedures for Access

  1. The family's CPS social worker authorizes CPS child care through CAMIS and SSPS.
  2. For more information regarding program requirements and eligibility standards, contact the CPS Child Care Program Manager at (360) 902-8046.

45034. Other Sources

  1. The Division of Child Care Early Learning (DCCEL) maintains an information and referral service for parents who are seeking child care providers. Information on other sources of payment for child care is available through(DCCEL).
  2. Head Start is a federally funded parent-participation pre-school program for low-income children.
  3. The Early Childhood Education Assistance Program (ECEAP) is a state-funded pre-school program for low-income children.
  4. Cooperative Pre-school and Crisis Nursery Services may be available in local communities to provide child care at low fee to parents.

4503. [A] Child Welfare Services Child Care

4503. [A1] Program Description

Child Welfare Services (CWS) child care subsidy program provides short-term, time-limited subsidized child care for families to avoid out-of-home placement or other state intervention.

4503. [A2] Eligibility

  1. If the case was formerly a CPS case, the social worker must close CPS child care and open for CWS child care, using CWS child care eligibility requirements.
  2. CA may authorize CWS child care for a family that:
    1. Has been through a CPS investigation and continues to participate with voluntary services; or
    2. Is in crisis and needs care to avoid out-of-home placement of the child or other state intervention.
  3. To be eligible for CWS child care subsidy program, the family must have:
    1. Documented need for the service; and
    2. An income at or below 225% of Federal Poverty Level (FPL) adjusted for family size.
  4. CWS authorizing workers must use co-payment and income eligibility guidelines. See the Operations Manual, chapter 9000, section 91300, for information regarding income eligibility and co-payments.
  5. When the family needs child care, the social worker determines if other resources are available to the family before authorizing CWS child care. For example, family members may be available to provide or pay for privately arranged child care. If the social worker determines there are no other resources available, CA may pay for care through the CWS Child Care Subsidy Program.

4503. [A3] Procedures for Access

  1. The family's CWS social worker authorizes CWS child care through CAMIS and SSPS.
  2. For more information regarding program requirements and eligibility standards, contact the CPS Child Care Program Manager at (360) 902-8046.

4503. [A4] Other Sources

  1. The Division of Child Care early Learning (DCCEL)maintains an information and referral service for parents who are seeking child care providers. Information on other sources of payment for child care is available through DCCEL.
  2. Head Start is a federally funded parent-participation pre-school program for low-income children.
  3. The Early Childhood Education Assistance Program (ECEAP) is a state-funded pre-school program for low-income children.
  4. Cooperative Pre-school and Crisis Nursery Services may be available in local communities to provide child care at low fee to parents.

4504. Therapeutic Child Development

45041. Service Definition

  1. Therapeutic Child Development (TCD) is child development and family service provided in a licensed child care setting to families of children at risk for maltreatment. Both children and parents receive treatment to reduce the risk of child maltreatment, strengthen the family, and enhance continuity and consistency in the child's environment. Contractors provide a daily day care program during which they monitor the child's safety, complete regular assessments, and provide remediation activities. Services include home visits by TCD social workers, transportation to and from day care, and parenting education.
  2. TCD provides four hours of service daily, in the child care setting, excluding transportation time.
  3. TCD-enrolled children may require a full day of care due to the schedule of the parent or foster parent. The social worker may authorize payment for a ½ day of care to the same or other facility, in addition to the TCD payment, if it is appropriate for DCFS to be supporting a full day of care. The additional authorization would be at the standard half-day rate for that area. In no circumstances should the facility be expected to keep the child for a full day without additional reimbursement.

45042. Eligibility

  1. TCD is available to children who are at risk of CA/N and their families who have open cases with CPS or CWS, including children in out-of-home placement. CA uses the program to support the report to the court and Case Plan. Since this is a daily weekday program, the program is generally structured to serve children who have not yet entered school. The provider's contract with the department further defines the eligible population.
  2. The child's CPS/CWS social worker determines eligibility. The social worker consults regional procedures to determine current availability of slots and other limitations.
  3. The DCFS social worker and the TCD provider must negotiate the estimated length of enrollment at the time of enrollment, based on the report to the court, the family service plan, and/or available intake or assessment information, consistent with the contract.

45044. Social Worker Ongoing Responsibilities

The CA social worker must:

  1. Receive and incorporate information from the service provider's quarterly reports into case planning.
  2. Attend staffings regarding the child/ family as scheduled by the service provider.
  3. Include provider staff, as appropriate, in department-initiated staffings regarding the child/family.

4505. Employed Foster Parent Child Care

45051. Program Description

The Employed Foster Parent Child Care Program pays for child care for the child in the out-of-home care setting to support the foster parent or non-needy relative caretaker's employment.

45052. Eligibility

  1. The social worker for the child may authorize child care to the Children's Administration (CA) foster parent or relative caretaker for children placed by CA or a CA certified agency:
    1. Without regard to the foster parent's or non-needy relative's income;
    2. When the foster parent or non-needy relative needs child care to maintain the foster parent or relative caretaker's employment; and
  2. The Employed Foster Parent Child Care program must not pay foster parents and non-needy relative caretakers for providing child care to their own foster children who live with them.
  3. Children living with non-needy relatives not placed by CA or a CA certified agency do not qualify for Employed Foster Parent Child Care subsidies. The child may qualify for child care subsidies through the Working Connections Child Care Program (WCCC) offered through Economic Services Administration.

45053. Procedures for Access

  1. The child's CA social worker authorizes the Employed Foster Parent Child Care program for foster parents and non-needy relative care takers.
  2. For more information contact the Employed Foster Parent Child Care Program Manager at (360) 902-8046.

45054. Other Sources

See the Operations Manual, chapter 9000, section 91300, for additional information.

4509. Respite For Parents

Respite care offers time limited relief for substitute parenting or care giving of a child. For the purposes of this section, respite care is available for parents whose children are dependent and who are in the custody and control of CA.

  1. Respite care to prevent out of home placement or re-entry into out of home care is:
    1. Based on the child's special needs.
    2. Available on an emergent basis to prevent placement disruption; or,
    3. A planned event as part of the child's safety plan to remain in the home or the child's safety and transition plan during a trial return home.
  2. The respite provider must have experience and/or training to deal with the particular special needs of the child in care.
  3. Social worker responsibilities:
    1. Explore other available resources to assist in providing respite including:
      1. Family resources
      2. Other DSHS divisions, for example, the Division of Developmental Disabilities (DDD)
      3. The Regional Support Networks (RSN) for emergency respite care for mental health clients to prevent hospitalization. Multi-disciplinary "wrap-around" service planning groups may also occasionally authorize respite care in the context of a plan that prevents a child from entering out-of-home care.
    2. Complete the criminal/background check process prior to approval of the services, if not previously completed,
    3. Authorize payment for respite only when utilizing a licensed out-of-home provider or approved provider in home where the child resides.

4510. Respite for Licensed Foster Parents, Unlicensed Relative Caregivers and Other Suitable Persons

Respite services can play an important role in preventing placement disruption. These services are available for licensed foster parents, unlicensed relative caregivers and other suitable persons with placement of children in CA or Tribal custody. Caregivers should be encouraged to access respite care services in emergent situations and to prevent disruption of the child from their home.

45101. Service Definition

  1. Respite care service pursuant to this section (4510) is the temporary, time limited relief for substitute parenting or caregiving of a child. Respite care can be arranged in advance or on an emergency basis.
  2. Respite care services for licensed caregivers, are intended to meet the following needs:
    1. To offer relief from parenting and caregiving responsibilities;
    2. To allow the caregiver personal time away from home;
    3. To provide substitute care in the absence of the caregiver;
    4. To provide opportunities to attend overnight training.
    5. To allow caregivers access to substitute caregiving to meet emergent situations for the caregiver;
    6. To prevent placement disruption.
  3. Respite care services for unlicensed relative caregivers or other suitable persons (See Practices and Procedures Guide Section 4261) are intended to meet the needs of children and families in emergency situations and when the placement is at risk of disruption.
  4. Payment for respite services is not available to individuals who reside or live in the caregiver's residence. Respite services may be provided by a relative of the child or caregiver, only when the respite care provider resides outside the child's current placement.
  5. Respite care that is provided outside the child's caregiver's home must be provided by individuals who are licensed foster parents or licensed child care providers.
  6. Unlicensed respite providers can provide paid respite services only in the child's caregiver's home. Unlicensed respite providers must (1) successfully complete a CAMIS background clearance and Washington State Criminal check and (2) meet the standards identified in WAC 388-148-0040 and 388-148-0045. Background checks for unlicensed respite providers providing respite in licensed foster homes will be completed by Division of Licensed Resources (DLR) staff, or in the case of respite services for unlicensed relative caregivers, background checks will be completed by the assigned CA social worker.
  7. The social worker or licensor will verify that the respite provider has experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile, children who have been sexually and/or physically aggressive or assaultive.
  8. Licensed child care providers may be used to provide respite care services for respite that is less than 24-hour duration. Respite payment to licensed child care providers is paid at the regional child care rates using the appropriate SSPS respite payment code. SSPS child care codes in the 2800 series are not used to authorize respite payment.
  9. Licensed providers for respite service must not exceed their licensed capacity and must meet Minimum Licensing Requirements (MLRs) while providing respite.
  10. Licensed caregivers using paid respite services, may not provide respite to other children (paid or exchange), during the period of paid respite.
  11. Child-specific respite care plans are an element of the child's case plan. As appropriate, the need for continued respite service is reviewed at service re-authorization and/or during multidisciplinary staffings.
  12. Respite care payments remain the fiscal responsibility of the originating region and office during courtesy supervision activities.

45102. Respite Care Category Descriptions

  1. Retention Respite provides licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for CA-placed children, with regular "time off" from the demands of caregiving responsibilities. Retention Respite guidelines are:
    1. Retention respite is intended to provide regular, monthly breaks from the demands of foster parenting and can also be used to meet emergent needs of licensed caregivers.
    2. Retention respite is awarded on a monthly basis per CA, Tribal, or Private Agency foster home caring for CA children.
    3. Retention respite is earned by eligible licensed caregivers at a rate of two (2) days per month.
    4. Retention respite is authorized in daily units only.
    5. The licensed caregiver home may accumulate or 'bank' a maximum of fourteen (14) days of retention respite days to be used at one time. Licensed caregivers should be encouraged to use retention respite as it is earned.
    6. Newly licensed caregivers will have a 30-day waiting period from the first eligible child placement before accruing retention respite.
    7. A licensed caregiver must provide foster care to one or more children at least twenty (20) days in a month to earn retention respite for that month.
    8. When a day of retention respite is authorized, respite is normally paid for each eligible foster child in the home, regardless of how long the child has been in placement in the home. However, a licensed caregiver can elect to use retention respite for only one child, even though more than one child is in the placement. Whether retention respite is used to meet the needs of one or more children, the time used will be deducted from accrued retention respite days.
    9. Licensed caregivers and social workers should be aware of pending respite plans in the caregiver's home when a child is placed. Efforts should be made to avoid changes in caretakers for a child shortly after placement.
    10. The respite provider must have experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile or children who have been sexually and/or physically aggressive or assaultive.
    11. Regions will develop a process to authorize and monitor retention respite eligibility and utilization for CA foster homes.
    12. Tribal and Private Agencies shall monitor retention respite eligibility and utilization for their licensed homes, and will coordinate with CA regional management to develop a process to access and report retention respite usage.
  2. Child-Specific Respite (CSR) provides unlicensed relative caregivers, other suitable persons, licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for children placed by CA, with the opportunity for relief from the caregiving responsibilities that are linked to the medical, behavioral or special needs of an individual child. The CSR guidelines are:
    1. CSR is authorized on a case-by-case basis consistent with the written service plan for the child.
    2. CSR is authorized in half-day or daily increments. Half-day will be authorized for respite services 0 - 5 hours and daily respite will be authorized for respite services greater than 5 hours.
    3. CSR is part of a child's unique service plan. The need for continued service is reviewed at service re-authorization and during multidisciplinary staffing.
    4. CSR for more than 1 week must have Area Administrator approval.
    5. CSR may be discontinued based on an updated assessment of the needs of the child.
    6. In calculating CSR, the worker should consider the availability of relief from caregiving responsibilities provided through retention respite, school, other relatives, visitation schedules, etc.
  3. Exchange Respite is the relief from parenting responsibilities, which is negotiated and arranged between licensed caregivers and does not include payment of CA funds. Exchange respite guidelines are:
    1. Licensed caregivers must remain within their licensing requirements (i.e. capacity, age, gender, etc.).
    2. Licensed caregivers must notify the child's social worker(s) of exchange respite services prior to the respite occurring.
    3. The social worker will verify that there are no licensing complaints pending which would preclude the respite provider from caring for the child.
    4. The social worker will inform the respite provider of any special needs of the child, supervision requirements and safety issues prior to initiating respite.

45103. Procedures for Access

  1. Retention Respite is authorized through SSPS by the regional designee responsible for monitoring the accrual and utilization of retention respite for foster families.
  2. The assigned social worker for each child in a licensed home shall be notified that retention respite is being authorized.
  3. Child-Specific Respite (CSR) is authorized through SSPS by the assigned social worker for the child.
  4. For unlicensed relative caregivers and other suitable persons, the assigned social worker shall explore other family support options prior to requesting respite services.

45104. Respite Care Payment

  1. Child-Specific Respite (CSR) services, from 0 - 5 hours will be reimbursed at the half-day rate posted in the SSPS Manual.
  2. CSR services more than 5 hours will be reimbursed at the daily rate posted in the SSPS Manual.
  3. Retention respite is authorized in daily units only and reimbursed at the daily rate posted in the SSPS Manual.

45105. Respite Care Rates

  1. Respite rates for licensed CA relative and foster homes, licensed Tribal foster homes, and licensed Private Child-Placing Agency foster homes providing care for CA-placed children are determined by the child's assessed foster care rate level and are listed in the SSPS manual. Exceptions to the maximum respite care rate may be authorized only with administrative approval.
  2. Respite rates for unlicensed relative caregivers or other suitable persons would be authorized at the Basic Respite rate listed in the SSPS manual for children in level 1 or 2 foster care.
  3. For unlicensed relative caregivers or other suitable persons, respite rates above the respite rate for a child in level 1 or 2 foster care requires the completion of an Exception request (DSHS form 05-210). The exception request should include an assessment of the supervision needs of the child, behavioral, medical, developmental and social needs of the child, and any special needs that would indicate a higher rate, The exception request will require supervisory and area administrator approval.
  4. Respite for unlicensed relative caregivers or other suitable persons may be authorized for up to 7 days per month. Any respite beyond the 7 days will require area administrator approval.
  5. Payment for respite provided by licensed child care facilities is paid at the Region's established child care rate, using SSPS 3220 or 3221 payment codes. SSPS chapter 2800 Child Care payment codes are not used to authorize respite payment.
  6. Regional management may establish payment rates below the maximum rate listed in the SSPS Manual.

4512. Foster Parent (Licensed Family Foster Home) Training

45121. Foster Parent Training

Approval

By: Jennifer Strus, Asst. Secretary

Effective Date:

Revised Date: May 1, 2014

Sunset Review: June 2018

Purpose Statement Children in out-of-home care have unique needs due to their childhood experiences. Children's Administration seeks to provide the caregiver skills needed to serve the specific behavioral and developmental challenges of our community's children. The training also educates and prepares foster parents to work within the child welfare and the legal system.
Policy
  1. Foster home license applicants must complete the following training prior to licensing:
    1. Orientation, completed online or in person by at least one licensee residing in the home.
    2. Caregiver Core Training (CCT), completed by at least one licensee residing in the home.
    3. First Aid/CPR, completed by all licensees residing in the home.
    4. HIV/BBP, completed by all licensees residing in the home.
  2. The following are exempt from Caregiver Core Training requirement, A(2) above:
    1. New licensing applicants that have completed Parent Resources for Information Development and Education Training (PRIDE) within the last twelve months.
    2. Foster homes that have had a break in service, but were licensed within the previous three years and have completed PRIDE or CCT.
  3. Effective 4/1/2014, Licensed foster parents must complete caregiver continuing education every three years as follows:
    1. First three year licensing period: the foster parent must complete 36 hours of caregiver continuing education training that includes trainings from each of the three competency categories. After 1/1/2015, it must also include a cultural competency training.
    2. Second three year consecutive licensing period: the foster parent must complete 30 hours of caregiver continuing education training that includes trainings from each of the three competency categories. After 1/1/2015, it must also include a cultural competency training.
    3. All subsequent three year licensing periods: the foster parent must complete 24 hours of caregiver continuing education training from any competency category.
  4. Foster homes taking placement of Sexually Aggressive Youth or Physically Assaultive/Aggressive Youth (SAY/PAAY) youth as defined in RCW 74.13.075 must complete either the SAY/PAAY online or in-person training prior to the child being placed or within 30 days of placement. Both caregivers in the home are required to complete this training.
    Note: The caregiver continuing education requirement may be met by one or both parties on a license, in any combination, with the exception of D above. That is, one party on a two parent license may complete all required training hours or two people on a two parent license may each complete part of the required hours as long as the total number of hours meets the requirement.
  5. Training which meets the caregiver continuing education requirement includes:
    1. Conferences and trainings approved by the licensor that meet all of the following:
      1. Related to child welfare or other human services.
      2. Relevant to the foster parent's scope of duties;
      3. Meets at least one of the caregiver competencies established by the Alliance for Child Welfare Excellence.
    2. Training offered by the Alliance for Child Welfare Excellence.
    3. CA approved private agency training courses.
    4. Other training as approved by the licensor.
  6. If a licensed foster home exceeds the required training hours during any licensing period, they may carry over up to twelve hours into the next licensing period.
  7. Division of Licensed Resources (DLR) licensors may require specific and additional training as part of a compliance plan.
Procedures
  1. Prior to licensing, the DLR licensor will verify that foster home license applicants have completed the licensing training outlined in A and B in the policy above.
  2. Each licensing period, the DLR licensor will develop a training plan with the licensee based on the licensee's level of skill, education, age of the child(ren), and behaviors of the child(ren) the caregiver will serve. Each training plan must meet the policy requirements in C, D, and E in the policy section above.
  3. The DLR licensor will verify that the licensed foster parents complete caregiver continuing education as outlined in C, D and E in the policy section above.
  4. If a licensed family foster home reaches re-licensing without completing the required hours in the three year licensing period, the DLR licensor will create a compliance plan for up to six months with the licensee(s). If the compliance plan is not met, the Department may:
    1. Choose not to place children in the licensed foster home.
    2. Change the age, gender or capacity on the foster home license at the time of renewal or,
    3. Revoke the license.
  5. CA staff will enter training into FamLink as follows:
    1. The Alliance for Child Welfare Excellence training manager will enter training completion for Alliance for Child Welfare Excellence in-person classes, with the exception of CCT.
    2. The DLR licensor for the home will enter the CCT and all other training.
Resources
  • WAC 388-148-0040 What first-aid and cardiopulmonary resuscitation (CPR) training is required?
  • WAC 388-148-0045 What HIV/AIDS and blood borne pathogens training is required?
  • WAC 388-148-0020 What are the training requirements for foster parents and prospective foster parents?

Online Foster Parent Training:
http://www.dshs.wa.gov/ca/fosterparents/training.asp

45122. Access to Training

DCFS licensed family foster homes, private agency licensed family foster home, and relative caregivers are eligible to participate in department sponsored training.

45123. Procedures for Accessing Training

The licensed family foster home consults the licensor, private agency and/or regional training manager for class announcements and procedures to access to this service. The web site also maintains a training calendar available to all foster parents, relative caregivers and agency staff.

4514. Family Support Networks

45141. Service Definition

Each individual family's extended family, tribe, friends, and other lay or professional helpers who help resolve current issues of concern constitute a support network. Informal support networks reduce social isolation that may contribute to CA/N and may provide the resources to assist in reduction of family conflict. Supportive networks may be more helpful than professional services because they are generally a life-long part of the client's life.

45142. Eligibility

All DCFS clients are eligible for the service.

45143. Procedures for Access

  1. The social worker uses "reasonable efforts" in locating and contacting extended family members, friends, and lay helpers for potential support and/or placement resources.
  2. The social worker is encouraged to develop informal family support network alternatives to professionally provided services when possible.
  3. The social worker provides the family support network consistent information and support, within the limits of laws on confidentiality.

45144. Other Sources

  1. The RSN, DDD, and local schools may have projects in some communities to facilitate the development/maintenance of family support networks. The social worker is encouraged to explore those systems for help in coordinating a family support network.
  2. Participation in an organization that has culturally-specific ties may reduce isolation for some individuals.
  3. Families may have support available to them through their church. Churches support many social service and recreational programs.
  4. Special interest support groups, including support groups for parents who have experienced a SIDS death or parents with developmentally disabled or medically fragile children, can be helpful and supportive to parents.
  5. Recreational activities can be especially valuable to families needing support. Many non-profit recreational organizations provide scholarships or reduced tuition.

4515. Family Home Support Services

45151. Service Definition

  1. Family Home Support Services (FHSS) provides supportive, culturally appropriate, in-home, skill-building services in partnership with DCFS client families. Services are provided as part of a comprehensive case plan to clients of DCFS. Services may be offered on weekends and beyond normal working hours. Overnight service may be provided in emergent cases where all other appropriate placement options have been determined to be inappropriate.
  2. Services provided by Home Support Specialists (HSS) include:
    1. Teaching and demonstrating basic physical and emotional care of children, including child development and developmentally appropriate child discipline.
    2. Teaching homemaking and other life skills, including housekeeping, economical shopping, nutrition and food preparation, personal hygiene, financial budgeting, time management and home organization, with consideration given to the family's cultural environment.
    3. Helping families obtain basic needs. Networking families with appropriate supportive community resources; e.g., housing, clothing and food banks, health care services, and educational and employment services.
    4. Providing emotional support to families and building self-esteem in family members; aiding family members in developing appropriate interpersonal and social skills.
    5. Providing client transportation/supervision of visits on a time-limited basis.
    6. Observing family functioning, assisting the social worker in identifying family strengths as well as areas needing intervention or remediation, reporting to the social worker on the family's progress in skill-building, family functioning and other areas defined in the case plan.
    7. Providing individual care services, including child care and household management on an emergent, time-limited basis when necessary to maintain a family that is in crisis.
  3. FHSS is not intended to provide long-term maintenance for a family, is not a housekeeping service, and is not interchangeable with CHORE Services. Requests for on-going or repetitive child care or household maintenance are not appropriate for FHSS.

45152. Eligibility

The following criteria determine eligibility, contingent upon available funding, for FHSS:

  1. The family must be a current DCFS client.
  2. The case plan must document the need for teaching, skill-building, or community networking.
  3. Alternatively, an emergent need exists in which the temporary use of an HSS will prevent out-of-home placement. Such situations include:
    1. The temporary absence or incapacity of the primary caretaker, when it is anticipated that other suitable substitute care will be found within 72 hours.
    2. The one-time provision of household chores when the condition of the home may necessitate out-of-home placement.
  4. Families with adolescents are eligible for this service.

45153. Procedures for Access

  1. The social worker initiates the referral and gives it to the FHSS supervisor/coordinator. Referrals for FHSS shall list specific areas for HSS intervention with a family.
  2. The FHSS supervisor/coordinator evaluates the request for service eligibility and determines priority for service within available full time equivalent (FTE) staff resources.
  3. The FHSS supervisor/coordinator gives service priority to cases where the service is in support of time-limited objectives to improve family functioning or to maintain a family in crisis. Priority cases have one or more of the following characteristics:
    1. There is high risk of out-of-home placement and indication that HSS intervention will reduce that risk. This may include planned skill-building services or emergent, one-time provision of household chores, material resources, or child care, including overnight services. The purpose is to maintain a family having a crisis.
    2. There is probability of continued out-of-home placement and indication that HSS intervention will enhance family reunification.
    3. There is need to provide supportive services to a family when a child returns home from out-of-home placement.
    4. There is need to provide support services to foster parents or relative care providers in order to stabilize and maintain placement.
  4. Except in case of emergency provision of service, the social worker initiates a case planning staffing with the HSS and other appropriate individuals prior to initiation of services to set FHSS service planning goals and expectations and to discuss any issues the HSS should be aware of in dealing with the family. The social worker informs the HSS of any known or suspected issues affecting personal safety prior to contact with the family.
  5. On-going case consultation between the HSS and the assigned social worker shall occur on a regular basis. As part of regular supervisory conferences, review of the need for continued FHSS shall occur.

4516. Health Services for Mothers and Children

45161. Service Definition

  1. Services available to detect risk factors that might affect the health or growth of the baby early in the pregnancy. Health related services designed to assist parents with infants and young children. Programs offering health screening, assessment, and treatment for children. Health services provided through the Early and Periodic Diagnosis and Treatment (EPSDT) or Healthy Kids Program and Women, Infants, and Children (WIC) program.
  2. DCFS also contracts with local health departments to provide public health nursing services in-home for families who need them.

45162. Eligibility

Parents with infants and young children who are eligible for the Medicaid program are generally eligible for Healthy Kids services. The family's social worker determines eligibility for DCFS contracted public health services.

4517. Health Care Services for Children In Out-Of-Home Care

Purpose Statement Ensure children in out-of-home placement have an Initial Health Screen (IHS) to identify and address any emergent medical concerns at the time of placement. Children in out-of-home care must also have initial as well as on-going Early and Periodic Screening, Diagnosis and Treatment (EPSDT) and dental examinations to ensure their continued health and well-being.
Policy
  1. Children (birth to 18 years of age) entering out-of-home care must have an IHS within five calendar days by a qualified medical provider as quickly as possible to identify and address any medical concerns.
  2. Children (birth to 18 years of age) must receive an EPSDT examination within 30 days of entering out of home placement.
  3. Children in out of home placement (birth to age 3) must receive an EPSDT examination according to the published schedule for their age group. Children (age 3 to age 20) must receive at least an annual EPSDT examination.
  4. Children in out of home care must have an initial dental examination scheduled within the first 30 days of placement.

    Note: This does not apply to infants/toddlers without their first tooth eruption.

  5. Children in out of home placement must receive at least one dental examination every 6 months.
Procedures

Initial Health Screens (IHS):

  1. Ensure children who enter out-of-home placement receive an IHS by a qualified medical provider as soon as possible but no later than 5 calendar days.

    Note: Qualified medical providers include: Medical Doctor (MD), Advanced Registered Nurse Practitioner (ARNP), and Physicians Assistant (PA).

    Note: Medicaid provider availability in the regions may fluctuate and affect timeframes. Regional efforts to identify providers who complete the IHS should continue in order to maintain and build capacity.

  2. Ensure children see their last known medical provider whenever possible.

    Exceptions to requirement for IHS:

    1. Children released from a hospital (in-patient or Emergency) directly into out-of-home care.
    2. Children receiving services through a Pediatric Interim Care center (PIC).
    3. Children receiving services or scheduled to receive services through a Child Advocacy Center (CAC) or sexual assault clinic.
  3. Provide all known health information about the child to the caregiver(s) prior to the IHS.
  4. Share all known health information about the child with the medical provider who completes the IHS.
  5. Provide all information and recommendations from the IHS to the child's current caregiver(s) as per 4413 Placement Services policy.
  6. Document the initial health screen information in the FamLink Health/Mental Health Pages under the "Health" tab and insert a new "Medical/Dental/Exam" within the required placement documentation timeframes as per Initial Placement and Moves 15400.
  7. Document the reason for an exception to a child receiving an IHS in a case note.

EPSDT Examinations:

  1. Ensure children in out-of-home placement receive EPSDT examinations according to the periodicity schedule below:
    1. Within 30 days of out-of-home placement
    2. Five examinations during a child's first year
    3. Three examinations for children between 1 and 2 years of age
    4. Annual examinations for children between 3 and 20 years of age
  2. Children entering out-of-home placement that received an EPSDT examination within 30 days before placement, do not need another EPSDT unless:
    1. Medically indicated, or
    2. There are allegations of abuse or maltreatment that require medical attention.
  3. Obtain a copy of the EPSDT results and determine if recommended treatments or follow-ups have occurred for the child.
  4. Provide the child's caregiver all EPSDT results and assist them with obtaining any recommended services for the child.
  5. Document child's health condition(s), the dates, and results of all EPSDT examinations including those that occur after the initial 30 day EPSDT. Document exams and health conditions in the FamLink Health/Mental Health Pages under the "Health" tab within the required placement documentation timeframes as per Initial Placement and Moves 15400.

    Note: CHET screeners will document the initial EPSDT examination date and results on the Health and Mental Health Pages in the electronic case file.

  6. Review and record the child's EPSDT information at Shared Planning Meetings and the report to the court.

Dental Examinations:

  1. Schedule the child's dental examination within 30 days of out-of-home placement.
  2. Children in out-of-home placement that received an initial dental assessment within 6 months before placement do not need another dental examination unless medically indicated.
  3. Obtain a copy of the dental exam and determine if recommended treatments and follow-ups have occurred for the child.
  4. Provide the child's caregiver all dental examination results and assist them in obtaining any recommended services for the child.
  5. Document the dates and results of all dental examinations in the FamLink Health/Mental Health Pages under the "Health" tab and insert a new "Medical/Dental/Exam" within the required placement documentation timeframes as per Initial Placement and Moves 15400.
  6. Review and record the child's dental information at Shared Planning Meetings and the report to the court.
Cultural Considerations

Family Centered Approach:
The way CA staff engages the family (or fails to engage the family) can directly affect the willingness of the family to work with other members of the department. The level of trust and integrity established between the agency and the family often has a direct relationship on the child being able to remain/reunify with his/her family. Everyone who meets the family needs to build positive relationships.

For example:
The definition of family varies from group to group. While the dominant culture has focused on the nuclear family, African Americans define family as a wide network of extended family, non-blood kin and community. Native American Indian families traditionally include at least three generations and multiple parental functions delegated among aunts and uncles, as well as grandparents and cousins. Different cultural groups also vary in their traditional practices and views of adoption.

Determine if there are cultural considerations that need to be addressed as part of the planning process, for example, obtaining information about protocols, such as, how to approach a family, use of a cultural elder, matriarch or patriarch or the need for a culturally appropriate support person.

Forms and Tools
Resources
  • Access to Baby and Child Dentistry (ABCDental) website (for children up to age six) - http://abcd-dental.org/
  • HRSA Fostering Well-Being Care Coordination Unit - 1-800-562-3022, ext. 59594 or dhsfwbccu@dshs.wa.gov
  • Well Child/Health Services Consent Card - DSHS 03-338 (5/2006)

45171. Medically Fragile Children

Purpose Statement Children in out-of-home care who meet the definition of medically fragile will be identified. Develop plans with caregivers of medically fragile children to identify necessary supports to meet the day-to-day needs of the child (including respite and emergency situations).
Policy
  1. Children who meet the following criteria are identified as medically fragile:
    1. Child has medical conditions that require the availability of 24-hour skilled care from a health care professional or specially trained family or foster family member.
    2. These conditions may be present all the time or frequently occurring.
    3. If the technology, support, and services provided to a medically fragile child are interrupted or denied, the child may, without immediate health care intervention, experience death.
  2. When there is an indication that a child is medically fragile, refer the child to the ADSA Fostering Well-Being Care Coordination Unit for consultation and determination of the child's need for services.
  3. All children identified as medically fragile and in out-of-home care must have an identified Primary Health Care Provider.
  4. Out-of-home caregivers must be provided a Caregiver Support Plan that addresses training and support needs related to caring for a medically fragile child.
  5. All children identified as medically fragile must be documented in the FamLink Special Needs page.
Procedures
  1. Complete a referral by emailing the Fostering Well-Being Care Coordination Unit at: dhsfwbccu@dshs.wa.gov.
  2. When a medically fragile child is discharged from a hospital:
    1. Participate in a discharge planning meeting with the identified caregiver
    2. Coordinate with hospital or Primary Health Care Provider about the discharge plan to:
      1. Assess appropriate placement,
      2. Identify resources and training to support the care of the child,
      3. Obtain a copy of the child's treatment plan or identify the on-going plan for treatment and examinations, and
      4. Refer the medically fragile child to the Fostering Well-Being Care Coordination Unit.
  3. When the assigned social worker has received confirmation from the Fostering Well-Being Care Coordination Unit that the child meets the medically fragile criteria:
    1. Ensure any recommendations made by medical providers and in the Care Coordination Summary are followed-up on to address the ongoing medical needs of the child.
    2. Document the child as "medically fragile" in the Special Needs page in FamLink.
  4. Develop a Caregiver Support Plan for initial and any subsequent placements with a caregiver. At a minimum, the plan must address:
    1. Caregiver training specific to the child's needs,
    2. Additional supports to meet the child's needs, e.g. Medicaid Personal Care,
    3. Support for the caregiver to have alternate care for the child if needed, e.g. planned and emergency respite care, and
    4. Steps to take in an emergency situation when a caregiver is unable to care for the child.

    NOTE: Children placed in Behavioral Rehabilitation Services group or foster homes, skilled nursing facilities, on a trial return home, or who receive case management services from a Child Placing Agency do not require Caregiver Support Plans.

  5. Determine any additional support and training needs during the initial Social Worker Monthly Health and Safety Visit within the first 7 days of placement.
  6. Review the Caregiver Support Plan with the caregiver at each Social Worker Monthly Health and Safety Visit to determine if any changes to the plan are needed.
  7. Upload the Caregiver Support Plan signed by the caregiver into FamLink. Document the following in FamLink within 10 calendar days of receiving information:
    1. Child's medically fragile status on the FamLink Special Needs page per Medically Fragile Documentation, and
    2. Child's medical conditions/information in the Health/Mental Health page per Health Care Services for Children in Out-of-Home Care policy
Cultural Considerations

Family Centered Approach:
The way CA staff engages the family (or fails to engage the family) can directly affect the willingness of the family to work with other members of the department. The level of trust and integrity established between the agency and the family often has a direct relationship on the child being able to remain/reunify with his/her family. Everyone who meets the family needs to build positive relationships.

For example:
The definition of family varies from group to group. While the dominant culture has focused on the nuclear family, African Americans define family as a wide network of extended family, non-blood kin and community. Native American Indian families traditionally include at least three generations and multiple parental functions delegated among aunts and uncles, as well as grandparents and cousins. Different cultural groups also vary in their traditional practices and views of adoption.

Determine if there are cultural considerations that need to be addressed as part of the planning process, for example, obtaining information about protocols, such as, how to approach a family, use of a cultural elder, matriarch or patriarch or the need for a culturally appropriate support person.

See Also
Resources

4518. Drug/Alcohol Services

45181. Service Definition

  1. Assessment, treatment or monitoring services provided to an individual or family to assist a client in maintaining sobriety.
  2. These may include both in-patient and outpatient services. DCFS contracts or pays for substance abuse services in a variety of ways depending on the availability of state and federal funding. Most adults without income are referred to ADATSA programs contracted through the Division of Alcohol and Substance Abuse (DASA). Several DCFS regional offices contract for urinalysis monitoring. Substance abuse treatment components exist within many DCFS contracted rehabilitative/residential care programs for adolescents. Specific services needed are determined through a drug and alcohol assessment provided by a qualified professional.

45182. Eligibility

DCFS clients where drug and/or alcohol abuse is suspected are eligible for available services.

45183. Procedures for Access

  1. The social worker consults regional procedures for utilization of local drug and alcohol abuse programs within their communities. Obtaining information from the client regarding the availability of insurance coverage is essential to determining the range of resources that are available for any individual client.
  2. The social worker refers clients without resources to the local DSHS Community Service Office (CSO) to determine if they are eligible for state and/or federally funded assessment and treatment services.
  3. Controlled Substance Testing
    1. Children's Administration staff shall not collect urine samples for urinalysis or other tissues from children, their families, or other involved parties for drug testing.
    2. If a court of competent jurisdiction orders that a party to a dependency, Child in Need of Services (CHINS), or At-Risk Youth (ARY) action submit to testing for use of controlled substances, the assigned social worker shall arrange for such testing to be done independently by a qualified drug and alcohol program or laboratory.
    3. If the social worker and the care provider, usually a parent, negotiate an agreement for controlled substance testing of the parent/provider, the social worker shall arrange for such testing to be done independently by a qualified drug and alcohol program or laboratory, in accordance with conditions of paragraph 4, below.
    4. If the department is to pay for the cost of the testing, the social worker shall arrange for the testing to be conducted by an organization or laboratory contracting with the department for such services.
    5. The Regional Administrator, through the Regional Contracts Manager, shall make available to staff the names and contract terms and conditions of entities available for such substance abuse testing.
    6. The social worker authorizes payment for those tests for which the department is financially responsible in accordance with the service provider's contract.

45184. Other Sources

  1. Alcoholics Anonymous, Narcotics Anonymous, Alateen, and Alanon are self-help organizations that are free and available in most communities in Washington State.
  2. Many communities fund specialized programs to meet the needs of particular populations or groups.
  3. Division of Alcohol and Substance Abuse (DASA) Child Care is available to parents who are in a DASA-approved treatment facility. Substance abuse treatment staff are designated to approve child care services.
    1. DASA Child Care is authorized by staff in counties or treatment facilities. DASA Child Care is not authorized by DSHS offices. For information, contact the county alcohol and drug coordinator or the DASA Child Care Program Manager at (360) 438-8068.
    2. Participation of a parent in substance abuse treatment is confidential. Participation may not be disclosed unless a release has been signed by the person in treatment.

4519. Concrete Goods

Approval

By: Jennifer Strus, Asst. Secretary

Effective Date:

Revised Date: May 1, 2014

Sunset Review: June 2018

Purpose Statement

Assist children and families with goods to meet basic needs to maintain children safely in or out of their own homes, prevent out-of-home placement, or facilitate safe reunification.

Policy
  1. Concrete goods may be authorized when necessary to safely maintain a child's placement, prevent a child's placement in out-of-home care, or achieve safe permanency more quickly.
  2. The assigned CA Worker must determine that potential community resources are unavailable before goods are authorized.
  3. Goods must be linked to a case related assessment.
  4. Funding must be available and have received proper approval.
  5. Purchases must be made using the most economical and reasonable approach.
  6. Regions must monitor these limited expenditures to ensure authorizations are focused on child safety, permanency and well-being, and utilized only when other resources are not available.
Procedures
  1. Home Based Goods must meet an identified need through the assessment of the family, as defined in 1140 Family Assessment.
    1. May include child safety items (e.g., safe sleep items, door and window locks, child safety gates, etc.) clothing, shelter, furniture, utilities, transportation, or paraprofessional services (e.g., home cleaning), not purchased under CA's current service contract structure.
    2. Provided only to the family of origin when needed to directly support a family maintain child safety, prevent placement or reunify children in out-of-home placement with their family and:
      1. The family is willing and able to cooperate with services.
      2. The assigned CA worker determines the child is safely maintained in the home or will be safely returned within the next three months.
      3. There is written proof of need, e.g., disconnection or eviction notice.
      4. Community resources are not available to fulfill the need.
      5. The family has a plan on how to resolve this temporary situation and how they will sustain expenses after the one-time subsidies or other monetary assistance are gone.
    3. Consider the following when providing the types of assistance below:
      1. Housing payment and utilities
        1. Provide only first and last months' rent when the family is moving.
        2. Authorize only non-refundable deposits.
        3. Provide monthly housing or utilities assistance when payments do not exceed two consecutive months.
      2. Bus passes or gas vouchers
        1. Submit vouchers used as reimbursement on a monthly basis.
        2. Do not authorize trips made for the convenience of the driver.
        3. Gas voucher may not exceed $50.00 per authorization.
      3. Vehicle repairs which allow parents to participate in services or supports their ability to increase safety.
      4. Food assistance. Authorize only when the family is not eligible for or does not have access to:
        1. A nutritional assistance program, i.e., Supplemental Nutrition Assistance Program (SNAP).
        2. The Women, Infants, and Children (WIC) nutrition program.
        3. A local food bank, community garden, or other food assistance programs.
  2. Ancillary Goods
    1. Must be part of a case plan, meet an identified need through the assessment of the child and support the child in out-of-home care.
    2. May include clothing, furniture, or other paraprofessional services such as tutoring, not purchased under CA's current contract structure. See 4537 Clothing Allowance for Children in Out-of-Home Care when considering clothing vouchers assistance.
    3. Provided to the placement provider when:
      1. The child has an extraordinary need that falls outside of normal costs of care.
      2. It contributes to a stable placement, safety, permanency and well-being of the child.
    4. All requests for orthodontics assistance must be referred to the Health Care Authority (HCA) by the orthodontist for prior authorization. CA will not pay for any orthodontic services denied by HCA.
  3. Follow 45273 and 45274 Relative Placement and 5232 Maintenance Funding for Placement when goods are needed for a child placed in relative care.
  4. Documentation
    1. Initiate a payment request by creating a service referral through casework in FamLink, to generate the authorization and payment.
    2. Document how the provision of ancillary goods will meet behaviorally specific needs and how it supports the child in placement or his or her well-being.
  5. Review
    1. Regions must have gatekeeping functions established to:
      1. Review and evaluate all requests and expenditures.
      2. Maintain, coordinate and document the process to ensure accurate and timely reviews.
      3. Use FamLink data to provide analysis and oversight, which includes identifying trends and communicating this information to management.
      4. Use trends to evaluate gaps in community resources and work with local offices to perform outreach to build community options.
      5. Provide training and technical support to CA workers, fiduciaries, and contracted providers on accessing funds and their appropriate use.
  6. Approvals
    1. Payments for immediate needs to address child safety, safety items, clothing, and utilities per case to prevent placement or to expedite reunification, expenditures:
      1. Up to $200 may be approved by the worker.
      2. $201 to $500 must be approved by the supervisor.
      3. $501 to $1200 must be approved by the Area Administrator.
      4. $1201 or more must be approved by the Regional Administrator.
    2. For other concrete goods to address child safety to prevent placement or expedite reunification (e.g., housing, auto repair, furniture) per case:
      1. Up to $500 may be approved by the supervisor.
      2. $501 to $1200 must be approved by the Area Administrator.
      3. $1201 or more must be approved by the Regional Administrator.
Resources

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