ChildNet FY 10-11 Q2 Rprt - R2 - Florida`s Center for Child Welfare
Transcription
ChildNet FY 10-11 Q2 Rprt - R2 - Florida`s Center for Child Welfare
2nd Quarter 2010/2011 In Broward County every year, several hundred children enter the child welfare system due to abuse, abandonment or neglect. As the local Community Based Care lead agency, ChildNet manages the local system of services and supports for Broward's most vulnerable children. Our mission is to protect Broward's abused, abandoned and neglected children. Case Management Base, Side-by Side, In-Depth Review, and Council on Accreditation (COA) Reviews for FY 2010-2011 CHILDNET, INC. C A S E M A N A G E M E N T R E V IE W RE P O R T TABLE OF CONTENTS 1 Date of 2nd Quarter Review and Period under Review …………………. Page 2 Methodology …………………………………………………………………… Page 2 Analysis of Case File Review Data ………………………………………… Page 2-3 Case Management Practice Trends………………………………………… Pages 3-7 Areas of Excellence…………………………………………………………… Pages 7 Opportunities for Improvement …………………………………………… Page 8-9 Quality Improvement Plan (QIP) Progress Findings …………………… Page 9-12 DCF In-Depth Side-by-Side Review Findings…………………………….. Pages 13-15 Requests for Action (RFA) ………………………………………………….. Page 15-16 Summary and Recommendations ………………………………………… Page 16-17 List of Standards and Data Roll Up ………………………………………. Pages 18-24 Date of DCF Base Review: October 25, 2010 – October 29 2010 Date of DCF Side-by-Side Review: October 11, 2010 – October 15, 2010 Date of COA Review: October 1, 2010 – December 31, 2010 Period under Review: January 1, 2010 – December 30, 2010 Methodology Eighty (80) cases were reviewed during the FY 2010/2011 second quarter (Q2). Of the eighty (80) cases reviewed, seventeen (17) were reviewed as part of the Florida Department of Children and Families’ (DCF) Regional Quality Assurance (QA) Model for Case Management Base, sixteen (16) were reviewed as part of the Florida Department of Children and Families’ (DCF) Regional Quality Assurance (QA) Model for Case Management Side-by-Side and the remaining forty-seven (47) cases were reviewed to increase the sample size based on guidelines from the Council on Accreditation (COA). An in-depth review was also completed on two (2) cases selected from the sixteen (16) Florida Department of Children and Families’ (DCF) Regional Quality Assurance (QA) Model for Case Management Side-by-Side sample. These reviews consisted of case specific interviews with the focus child as well as other individuals, such as child advocates, caregivers, service providers, and other child care staff, who were or are currently involved with the child under protective supervision. All case reviews were completed by ChildNet’s Continuous Quality Improvement (CQI) department, Florida Department of Children and Families’ (DCF) Regional Quality Assurance office and ChildNet’s Client Services staff. The eighty (80) cases reviewed consisted of the following services: Foster Care (29); Adoption (19); Kinship Care (17); and Independent Living (15). All eighty (80) cases were reviewed for specific indicators utilizing the standardized DCF electronic tool to determine whether safety, permanency and well-being were achieved for the children under review. The below definitions were used to categorize cases to COA service standards: Foster Care includes children in foster care who are younger than 13 years old, or any child in an unlicensed placement such as non-relative placements, and children who receives services through In-Home (Petition for Adjudicate Dependent and Voluntary Protective Supervision). Adoption includes children with goals of adoption (regardless of placement). Kinship Care includes children residing with relatives that do not have goals of adoptions. Independent Living includes children placed in licensed out-of-home care age 13 and older. Analysis of Case File Review Data ChildNet’s overall second quarter (Q2) performance in achieving safety was 67.8%, a decrease of 3.4% from the FY 2010/2011 first quarter (Q1) report. The overall performance in achieving permanency was 74.9%, a decrease of 8.3% from the FY 2010/2011 Q1 report. Regarding child well-being, the overall performance was 75.3%, a decrease of 11.6% from the FY 2010/2011 Q1 report. The overall performance for all of the quality practice standards was 73.9%, a decrease of 8.1% from the FY 2010/2011 Q1 report. The chart below represents ChildNet’s performance for FY 2010/2011 Q2 (in yellow); ChildNet’s performance from the FY 2010/2011 Q1 (in blue); and statewide Community-Based Care Lead Agencies performance for FY 2010/2011 Q2 (in orange). 2 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 70.2% 73.9% 85.2% 81.7% 67.8% Safety ChildNet FY 10/11 Q1 74.9% Permanency 74.0% 75.3% Well-Being ChildNet FY 10/11 Q2 73.3% 80.5% 73.9% 73.2% Overall Practice Standards Statewide FY 10/11 Q2 Case Management Practice Trends Assessment: Initial family assessments averaged 68% (17/25) for completion while the up-dated family assessment averaged 59.7% (40/67). In comparison to the FY 2010/2011 Q1 report, this was a decrease of 15.9% and an increase of 22.6%, respectively. A safety assessment was conducted of a home prior to a reunification or placement in an unlicensed placement in 92.9% (26/28) of cases and concerted efforts were made during postplacement supervision to manage the risks following reunification and prevent re-entry into outof-home care in 91.7% (11/12) of the cases. In comparison to the FY 2010/2011 Q1 report, there was an overall increase of 17.3%. Multi-disciplinary staffings/assessments were conducted before each placement in 78.6% (22/28) of the cases. In cases involving a child in a licensed placement setting, an exit interview was conducted in 45.5% (5/11). Exit interviews continue to present an opportunity for improvement since this standard continues to fall below 50% during each of the previous four quarters under review. Ongoing assessment of the children’s needs was achieved in 88.8% (71/80) of the cases; 89.2% of the mother’s (58/65); 77% of the father’s (35/45) needs and 91.8% (56/61) of the outof-home caregivers. ChildNet achieved 60% (3/5) in completing an assessment for residential group care when required, which was a 34.9% decline from FY 2010/2011 Q1 report. When the case involved a youth who has reach 13 but not yet 15 years of age and he/she is living in a licensed, out-of-home care placement, a pre-independent living assessment was completed that identified service needs and services in 50% (3/6) of cases. ChildNet achieved 73.2% (30/41) on ensuring the child’s educational needs were assessed. In comparison to the FY 2010/2011 Q1 report, this was a decrease of 8.5%. 3 The child’s physical health care needs were assessed in 65.2% (45/69) of the cases and the child’s dental health care needs were assessed in 46% (20/43) of the cases. In comparison to the FY 2010/2011 Q1 report, there was an overall decrease of 12.1% The child’s mental/behavioral health needs in 82.5% (47/57) of the cases were assessed. Family Engagement: ChildNet achieved 79.2% (19/24) in ensuring parents are notified all of placement changes, which was a 19.2% decrease from FY 2010/2011 Q1 report. ChildNet achieved 78.5% (51/65) in ensuring and maintaining children’s important connections while in out of home care, which was a decrease of 17.4% from FY 2010/2011 Q1 report. Concerted efforts were made to ensure visitation (or other contact) was sufficient between the child and parents to maintain or promote the continuity of their relationship in 85.2% (46/54) of cases. In addition, concerted efforts were made to ensure visitation between the child and his/her siblings to maintain or promote the continuity of the relationship in 75% (21/28) of applicable cases. However, this standard has shown a steady decline since FY 2009/2010 Q4 report. ChildNet achieved 73.1% (38/52) as to the mother and 58.8% (20/34) as to the father for concerted efforts to encourage and support participation in making decisions about child's needs and activities. ChildNet achieved 88.7% (55/62) as to the mother and 77.3% (34/44) as to the father in concerted efforts to support parents’ engagement in services. In addition concerted efforts were made to actively involve all case participants in the case planning process in 82.1% (64/78) of cases, which was a decrease of 9.3% from FY 2010/2011 Q1 report. ChildNet achieved 100% (7/7) on ensuring informed consent or a court order was obtained for the use of psychotropic medications deemed necessary by a physician. This standard continues to show improvements since FY 2009/2010 Q4 and had an increase of 8.7% from FY 2010/2011 Q1 report. Service Planning and Provisions: There were seven (7) children with verified findings of abuse and/or neglect for both in-home and out-of-home cases; however 100% (15/15) of the children were provided immediate and ameliorative interventions, and concerted efforts were made to provide or arrange for appropriate services for the family to protect the child and prevent the child’s entry into out-ofhome care in 79.3% (23/29) of cases. ChildNet achieved 97.3% (73/75) for documentation that service referrals were consistent with the child’s needs and/or assessments relating to safety, and 90.9% (40/44) of the children all immediate and emerging safety concerns were addressed. Concerted efforts were made to identify, locate, and evaluate other potential relatives and possible permanent placements for children in 87.1% (54/62) of applicable cases. 4 ChildNet ensured each child in out-of-home care experienced no more than two out-of-home placement settings during the period under review in 83.3% (55/66) of applicable cases. This was a decrease of 8.2% from the FY 2010/2011 Q1 report. The court was informed of the child’s placements and reasons for changes in placement in 90.3% (28/31) of applicable cases. Although, ChildNet has achieved over 90.0% on this standard for the past four quarters, this standard has shown a slow decline since FY 2009/2010 Q4 standard score of 100%. For youth 15 years of age but not yet 18, ChildNet monitored progress towards successfully transitioning from foster care to independence through regular informative staffings in 40% (4/10) of applicable cases, which was a decrease of 57.5% from the FY 2010/2011 Q1 report. Another area of opportunity for improvement is with ensuring teen-aged children are afforded opportunities to participate in normal life skills activities in the foster home and community that are reasonable and appropriate for his/her respective age or special needs. This standard was achieved in 35.7% (5/14) of the applicable cases, which was a decrease of 36.2% from the FY 2010/2011 Q1 report. The frequency of the services worker’s visits with all case participants declined 13.3% since FY 2010/2011 Q1 report. This standard was achieved in 73.8% (59/80) of cases reviewed. Frequency of visits with fathers, which ChildNet achieved 28.9% (11/38) of applicable cases, continues to be an area for improvement. The quality of the services worker’s visits with case participants was sufficient to address issues pertaining to the child’s safety, permanency, and well-being in 92.5% (74/80) of applicable cases. When educational needs were identified services were engaged in 84.2% (16/19) of the cases and 80% (12/15) of applicable cases in which services were initiated, services effectively reduced/resolved the focus child’s education needs. When physical health care needs were identified services were provided to 62.5% (25/40), which was a decrease of 20.7% from FY 2010/2011 Q1 report. When dental health care needs were identified services were provided to 56.6% (13/23). Ensuring children’s dental health needs are appropriately addressed continues to be an area for improvement When needs were identified to address mental/behavioral health issues; services were provided in 80% (12/14) and the agency followed up on all treatment plans that were ordered in 81.5% (22/27) of cases. Promoting Case Progress: ChildNet achieved 84.7% (50/59) with placement stability and has achieved 40% (2/5) in children who did not re-entry out-of-home care in less than twelve months following a discharge. Although this standard is only applicable to five (5) cases out of eighty (80), there was a significant decrease of 46% from the FY 2010/2011 Q1 report and a significant decline since FY 2009/2010 Q3 standard score of 100%. ChildNet continues to perform well with ensuring the case is designed to achieve permanency (out-of-home cases) and safety and stability (in-home cases) through appropriate tasks for the case participants in 95.7% (45/47) of cases. There were current case plans in 64% (48/75) of 5 cases and 97.9% (47/48) of those case plan had appropriate permanency goals based on the child’s and family’s circumstances. Ensuring case files contain a current (not expired) case plan continues to be an area for improvement. In terms of the case plan specifically addressing visitation and other contact plans with all case participants, ChildNet achieved 94.3% (33/35) of applicable cases The case worker communicated with service providers about the effectiveness of services for involved case participants in 73.6% (53/72) of cases. This standard had a significant decrease of 20.6% from the FY 2010/2011 Q1 report. ChildNet continues to do well in regards to maintaining the child’s current placement within close proximity to the parents to facilitate face-to-face contact between the child and parents while the child was in out-of-home care. This standard was achieved in 90.4% (47/52) of applicable cases and for children who were not placed within close proximity to the parents, 100% (6/6) of applicable cases were based on the child’s needs and achieving the case plan goal. ChildNet achieved 44.4% (16/20) on placing child with siblings who were also in licensed and/or non-licensed out-of-home care, which was a 13.4% decrease from FY 2010/2011 Q1 report. Sixty (60) percent (12/20) of those cases where the child was not placed with siblings documented clear evidence separation was necessary to meet the child’s needs, which was a decrease of 33.4% from FY 2010/2011 Q1 report. ChildNet continues to need improvement in ensuring an inquiry to determine if a child was of Native American or Alaskan Native heritage and the completed Indian Child Welfare Act (ICWA) form is maintained in the case file. This standard was achieved in 28.2% (22/78) of the case. ChildNet achieved 66.7% (2/3) for cases in which an out-of-state placement was, or is being, explored for the focus child, a completed Interstate Compact for the Placement of Children (ICPC) packet requesting a non-priority home study was submitted within the required timeframe. This standard increased 35.6% from FY 2010/2011 Q1 report. If the child was in out-of-home care for at least 12 of the most recent 22 months or met other Adoption Safe Families Acts (ASFA) criteria for Termination of Parental Rights (TPR), a TPR petition was filed in 59.5% (22/37) of applicable cases. However, if a TPR petition was not filed, the case file contained compelling reasons and an exception for not filing the petition was documented in 73.3% (11/15) of applicable cases. In comparison to the FY 2010/2011 Q1 report, there was an overall decrease of 12%. ChildNet achieved a 93.3% (14/15) in documenting appropriate steps taken to identify/recruit an adoptive family that matched the child’s needs. In addition, appropriate steps were taken to process and approve an adoptive family that matched the child’s needs in 93.8% (15/16) of applicable cases. ChildNet has provided guidance and assistance in developing an educational and career path based on the child’s needs in 57.1% (8/14) of applicable cases, which had a 32% decrease since FY 2010/2011 Q1 report. ChildNet achieved an 84.5% (60/71) in ensuring Judicial Reviews are being held timely and Judicial Review Social Study Reports providing a thorough investigation and social study regarding all pertinent details relating to the child, and area ChildNet had maintained a 90% or 6 above average in the last five (5) quarters. However, this quarter the standard decreased 11.2% from FY 2010/2011 Q1 report. Supervisory Review and Oversight: ChildNet continues to show a need for improvement on documenting qualitative supervisory reviews. Qualitative supervisory reviews and follow through were conducted in 57.5% (46/80) of cases. More specifically, supervisory reviews were completed quarterly in 48.1% (38/79) of cases; supervisor considered all aspects considered all aspects of the child’s safety, permanency and well-being in 86.3% (69/80) of cases; and supervisors ensured follow through on guidance and direction provided to the case worker in 64.6% (51/79) of cases. Areas of Excellence Case Management excelled in several of the areas related to safety, permanency and wellbeing. Safety: • 100% (15 of 15) of the children re-abused or re-neglected, immediate and ameliorative interventions were initiated on behalf of the child • 97.3% (73 of 75) of the cases had service referrals that were consistent with the needs identified through investigative and other assessments related to safety. • 92.9% (26 of 28) of the cases had a thorough safety assessment of the home completed prior to reunification or placement of the child in an unlicensed out-of-home placement. Permanency: • 97.9% (47 of 48) of the cases documented the current case plan goal was appropriate based on the child’s, and family’s circumstances. • 94.3% (33 of 35) of the cases specifically addressed visitation and other contact plans with all case participants. • 100% (3 of 3) of cases ensured the information provided in the ICPC packet regarding the focus child was sufficient to enable the receiving state to make an appropriate decision concerning approval of the proposed placement for the focus child. • 93.3% (14 of 15) of the cases ensured appropriate steps were taken to identify and recruit an adoptive family that matched the child’s needs. • 93.8% (15 of 16) of the cases ensured appropriate steps were taken to process and approve an adoptive family that matched the child’s needs Well-being: • 100% (7 of 7) of the cases documented expressed and informed consent or obtained court authorization for the use of each psychotropic medication deemed necessary by a physician to address the child’s mental/behavioral health needs. 7 Opportunities for Improvement The review also identified some opportunities for improvement, including: Safety: • 68% (17 of 25) of initial family assessments conducted following the investigative safety assessment sufficiently addressed child safety factors and emerging risks. • 59.7% (40 of 67) of updated family assessments focused on the immediate and prospective safety of the child, as well as any changes and implications in the family’s situation related to emerging concerns and services needs. Permanency: • 40% (2 of 5) of cases ensured the child remained safe in his/her home after being discharged from out-of-home care and did not re-enter out-of-home care at least twelve (12) months following discharge. • 64% (48 of 75) of cases contained a current (not expired) case plan. • 44.4% (16 of 36) of cases ensured the child was placed with siblings who were also in licensed and/or non-licensed out-of-home care. • 28.2% (22 of 78) of cases documented that an inquiry was made to determine if the child was of Native American or Alaskan Native heritage. • 58.8% (20 of 34) of cases documented the father was encouraged and supported to participate in making decisions about his child’s needs and activities. • 59.5% (22 of 37) of cases ensure if the child was in out-of-home care for at least twelve (12) months or met ASFA criteria for Termination of Parental Rights (TPR), a TPR petition was filed or joined. Well-being: • 50% (3 of 6) of cases involving a youth who has reached 13 but not yet 15 years of age and he/she is living in a licensed, out-of-home care placement, a pre-independent living assessment was completed that identified service needs and services were provided. • 57.1% (8 of 14) of cases involving a child 13 years of age or older and in licensed foster, received guidance and assistance in developing an educational and career path that is based on the child’s individual abilities and interests. • 35.7% (5 of 14) of cases ensured the teen-aged focused child is afforded opportunities to participates in the normal life skills activities in the foster home and community that are reasonable and appropriate for his/her respective age or special needs. • 40% (4 of 10) of cases ensured the agency appropriately monitored each youth’s, 15 years of age but not yet 18, progress towards successfully transitioning from foster care to independence through regular informative staffing. • 65.2% (45 of 69) documented that concerted efforts were made to assess the child’s physical health care needs. • 62.5% (45 of 69) documented that concerted efforts were made to provide appropriate services to address the child’s physical health care needs. • 46.5% (20 of 43) documented that concerted efforts were made to assess the child’s dental health care needs. • 56.5% (13 of 23) documented appropriate services were provided to address the child’s identified dental health care needs. • 25% (1 of 4) of cases with the goal of Another Planned Permanent Living Arraignment (APPLA), the agency made concerted efforts to ensure the child is adequately prepared to transition into independent living and is living in a “permanent” arrangement until he/she reaches the age of majority. 8 Federal Child and Family Services Review: • 57.5% (46 of 80)) documented qualitative supervisory reviews and follow through were conducted as needed and required to include being completed quarterly; supervisor considering all aspects of the child’s safety, well well-being being and permanency; and ensuring follow through on guidance and direction. Quality Improvement Plan (QIP) Progress Findings Child and Family Services Reviews (CFSR) Item Measurement based on QA standards Outcome Safety 2: Children are safely maintained in their homes whenever possible and appropriate. appropriate • Item 3: Services to Family to Protect Child (ren) In In-home home and Prevent Removal or Re-entry entry into Foster Care. The three case management standards for Item 3 are: services to protect the child ((79.3%, 79.3%, 23/29); service referrals (97.3%, 73/75) and management of risks 91.7%, 11/12). ). The overall performance for all the quality practice standards was 9 92.2%. 100.0% 80.0% 93.4% 92.2% FY 10/11 Q1 FY 10/11 Q2 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 • FY 10/11 Q2 Item 4: Risk Assessment and Safety Management. The four case management standards for Item 4 are: initiation of immediate interventions (100%, 15/15); ); initial family involvement ((68%, 17/25); ); immediate and emerging safety concerns (90.9%, 90.9%, 40/44 40/44) and safety assessment (92.9%, 92.9%, 26/28). 26/28 The overall performance for all the quality practice standards was 87.5%. 87.5 100.0% 80.0% 85.0% 87.5% FY 10/11 Q1 FY 10/11 Q2 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 9 FY 10/11 Q2 Outcome Permanency 1: Childre Children n have Permanency and Stability in Their Living Situations. • Child. The case management standard for Item 7: Permanency Goal for Child Item 7 is case plan goals (97.9%, 47/48). The overall performance for all the quality practice standards was 97.9%%. 100.0% 80.0% 95.8% 97.9% FY 10/11 Q1 FY 10/11 Q2 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 • FY 10/11 Q2 Item 10: Other Planned Permanent Living Arrangement – The case management standard for Item 10 is the agency made concerted efforts to ensure the child is adequately prepared to transition into independent living and is living in a permanent arrangement until he/she reaches the age of majority (25%, ( 1/4). The overall performance for the quality practice standard was 25% 100.0% 80.0% 60.0% 75.0% 40.0% 20.0% 25.0% 0.0% FY 10/11 Q1 FY 10/11 Q1 FY 10/11 Q2 FY 10/11 Q2 Outcome Well-Being 1: Families have Enhanced Capacity to Provide for Their Children’s Needs. • 10 Item 17: Needs and Services of Child, Parents, and Foster Parents. Parents The six case management standards for Item 17 are: ongoing assessments of the child’s needs (88.8%, 88.8%, 71/80 71/80); ); ongoing assessments of the mother’s needs (89.2%, 58/65); ); engaging the child’s mother ((88.7%, 55/62); ); ongoing assessment a of the father’s needs ((77.8%, 35/45); ); engaging the child’s father (77.3%, ( 34/44) and ongoing assessment of out out-of-home care providers (91.8%, 56/61). 56/61 The overall performance for all the quality practice standards was 86.6% 86.6 100.0% 80.0% 94.5% 86.6% 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 FY 10/11 Q1 • FY 10/11 Q2 FY 10/11 Q2 Item 18: Child and Family Involvement in Case Planning. The case management standard for Item 18 is: case planning process: family involvement (82.1%, 64/78). ). The overall performance for all the quality practice standards was 82.1%. 100.0% 80.0% 90.6% 82.1% 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 FY 10/11 Q1 • FY 10/11 Q2 FY 10/11 Q2 Item 19: Caseworker Visits with Child. The two case management standards for Item 19 are: frequency of service worker’s visits with the child (80%, ( 64/80) and quality of the service worker’s visits with the child ((93.8%, 75/80). 75/80 The overall performance for all th the quality practice standards was 86.9%. 86.9 100.0% 80.0% 93.7% 86.9% 60.0% 40.0% 20.0% 0.0% FY 10/11 Q1 FY 10/11 Q1 11 FY 10/11 Q2 FY 10/11 Q2 • Item 20: Caseworker Visits with Parent(s). The four case management standards for Item 20 are: frequency of service worker’s visits with the mother (33.3%, 21/63); ); quality of the service worker’s visits with the mother (68.3% ( 41/60); ); frequency of service worker’s visits with the father ((28.9%, %, 11/38) and quality of the service worker’s visits with the father ((67.5%, 27/40). 27/40 The overall performance for all the quality practice standards was 49.8%. 100.0% 80.0% 60.0% 70.0% 40.0% 49.8% 20.0% 0.0% FY 10/11 Q1 FY 10/11 Q2 FY 10/11 Q1 FY 10/11 Q2 Item Numbers for FY 10/11 Q2 Quality Assurance Progress on CFSR Items 96% 93% 95% 85% 91% 94% 70% 97.9% 92.2% 75% 86.6% 87.5% 82.1% 86.9% 49.8% Item Numbers for FY 10/11 Q1 Quality Assurance Progress on CFSR Items 25.0% Item 3 Item 4 Item 7 Item 10 Item 17 Item 18 Item 19 Item 20 Arrow represents ents increase or decrease from FY 2010/2011 Q1 REPORT. REPORT 12 ChildNet In-Depth Review Findings: In-Depth Case #1 The AM case involved a mother, father and a fifteen (15) month old girl. The family is currently under non-court ordered in-home supervision. The case is under supervision due to threatened harm allegations; the mother has had a number of children removed from her care in the past and both parents have a history of substance abuse; the child did not test positive for drugs at the time of birth. Prior to a Petition Adjudicating Dependency (PAD) no legal sufficiency was found and the family has been receiving voluntary services the entire life of the case. The father is currently involved with Drug Court and the mother is prescribed pain medications for a physical condition. This in-depth consist of an interview with the child advocate, the mother and father. Telephone interviews were scheduled with an in-home provider; however this interview was not successfully completed at the date of this writing. Interviews: Child Advocate (CA): States that she has been assigned for approximately a year and has been the only child advocate assigned to the case. The family’s assessed needs were successfully matched with community services with no wait lists and the family is actively engaged in completing case plan tasks. The CA explained that the mother is a stay-at-home mom and that the father is a hard worker. The father has been able to utilize his handyman skills to pay the rent and also has a trust fund that is controlled by his adult sister. The family also receives food stamps and Medicaid benefits. The mother has numerous prescriptions for pain due to a variety of back/skeletal issues and has recently agreed to accept services through Susan B. Anthony to wean off the medications. These services are provided in the home. The father’s drug court involvement has now been extended due to a recent positive test. The family’s progress is monitored through regular contact with providers and the family is encouraged and supported to complete their tasks; there is no court involvement at this time. The child’s safety is monitored through at least every thirty day visits (regularly unannounced); the parents are very cooperative and the child is thriving in their care. The case has currently been staffed on two occasions for legal sufficiency; none was found. Biological Mother and Father: The parents were interviewed in their home with the child present. The child was observed to be clean, healthy and developmentally appropriate, demonstrating a good bond with both parents. They explained that their involvement in the child welfare system was due to the mother’s past and she was “red-flagged” when the child was born. The parents both were familiar with the tasks required of them under their voluntary supervision agreement and had completed the majority of those tasks. They are/had been involved with Gulf Coast, Spectrum, Women in Distress (which mother felt was inappropriate), drug court, a psychological evaluation, Work Force One and Susan B. Anthony. The father and mother discussed the recent abuse report openly due to the father testing positive for drugs. The only change they would wish to be made is to “shorten it” as it had been going on a year. The parents confirmed that the child advocate visits at least monthly; she checks the baby, takes her picture and checks if the family needs anything. They expressed always being able to get in touch with their child advocate; she responds to their calls and requests for assistance. Additional services for the family would involve help with transportation and diapers for the child. 13 The parents expressed they have a support system in the community that consists of maternal and paternal relatives. Strength: The family’s assessed needs were successfully matched with community services with no wait lists and the family is actively engaged in completing case plan tasks. The parents stated they are always able to get in touch with their assigned child advocate; she responds promptly to their calls and requests for assistance. Weakness: While under non-court ordered in-home supervision, several abuse reports were generated due to the father testing positive for drugs. In-Depth Case #2 The JF case involved a ten month old infant who was sheltered directly from the hospital at birth and placed under court ordered Protective Supervision with the maternal grandparents. The case came into care due an allegation of being a substance exposed newborn. Although the infant tests results were negative the mother admitted to abusing substance during her pregnancy and initially opted to go for residential treatment. The father of the infant was not in a position to care for the child and as a result, the baby was placed with the maternal grandparents following a positive home study and background checks. The mother also has a six year old daughter that was being cared for by the maternal grandparents via a mutual agreement between the grandparents and the mother. This in-depth review consist of an interview with the CA, Guardian Ad Litem office (GAL), and the maternal grandparents; the focus child and the six year old siblings were physically observed by reviewers when they visited the home. The CA was unsuccessful in obtaining interview appointments with either parent as both them have been avoiding contact with the agency. Interviews: The CA stated that she has been assigned to this case since December 2009 after court order was obtained sheltering the child into the Protective Supervision of the DCF/ChildNet. The CA stated initially the mother agreed enter rehabilitation and accepted services, but shortly after she told her mother that she wasn’t ready to give up her life style and told the grandparents that she wanted them to take care of the child. The CA stated she has made regular attempts to contact both the mother and the father by following up on any address leads that she can find, via certified mail, phone calls, and relaying messages through the maternal grandparents. The CA reports she has had occasional contact from the mother by phone, but no success in reaching the father. The CA stated she still makes referrals and sends them certified mail to addresses she has on file for either parents in addition to conducting ongoing diligent searches. The CA states the grandparents provide excellent care of JF and his sister. States at the last court hearing the judge changed the goal from reunification to adoption and a TPR petition is pending. The CA stated the sibling was not included in the case since the inception because she was not at risk. When asked about referrals for relative care, the child advocate stated the grandparents were not receiving relative caregiver funding and that they were financially able to care for child. 14 The GAL and her supervisor were also interviewed. The GAL stated she has been assigned to the since August 2010. Stated she has visited with the child at home with his grandparents and sibling and the grandparents are taking very good care of JF. States she has never met either parent, but based on the case file she agrees with the judge’s decision to change the goal to adoption. The interview with the grandparents took place in their home, which was located in a nice upper middle class neighborhood in Fort Lauderdale. Upon entering the home it was spacious and clean with working utilities and adequate rooms for each child. The focus child JF and his six years old sister were also present both observed and reviewers made small talk with the six year old. Reviewers observed both children appeared healthy and developmentally normal for their age and both were observed to be free of any marks or bruises indicative of abuse or neglect. Reviewers also observed interactions between the grandparents and the children as well as the sibling with each other; they all appeared to be loving and appropriately affectionate towards each other. The grandparents held JF when he beckoned to get out of his high chair and neither child displayed any signs of fear or discomfort towards either grandparent. The grandparents stated their daughter has had a problem with drugs since she was a teenager. They were not aware of the second pregnancy with child JF until after the baby was born; when the mother asked them to take care of him so he would not have to go into foster care. The grandparents and their other daughter also help out. The grandmother states the children’s mother asked her to she wants JF to stay with them because she is not ready to enter rehabilitation or give up her life style. The father of the child only contacts them to ask for money, but he shows no interest in the child. They stated at the hearing in September they spoke to the judge and shared their concern about the parents and expressed that they wanted to adopt the child because they wanted stability for the child’s life. As a result of the grandparents statements the judge ordered the goal change to adoption. The grandparents’ states they would like to adopt both children; they were encouraged to speak with the CA, GAL and the Office of Attorney General (OAG) to inquire if it was possible to add the six year old sibling to the TPR petition. Overall the grandparents stated that they were very satisfied with the CA and they felt she was gone above and beyond to work with the parents, visit the child each month and has kept them informed of the court hearings and staffing on the case. Strength: The caregivers (grandparents) stated they are very satisfied with the CA assigned to the case and feel she has gone above and beyond to work with the parents while keeping all parties involved informed of any changes occurring in the case. Weakness: Visits with the mother and the father were not conducted every thirty-days when child’s permanency goal was reunification. Both parents have court ordered supervised visitation, but both parents have not been exercising their visitation rights. Efforts have been made to engage the mother in the case planning process, but case file lacked documentation of efforts to engage biological father in the case planning process. Requests for Action (RFA) RFA’s were only issued during the seventeen (17) cases reviewed as part of the DCF Regional QA Model for Case Management Base, and during the sixteen (16) cases reviewed as part of the DCF Regional QA Model for Case Management Side-by-Side. RFA’s were not issued during 15 the forty-seven (47) cases reviewed for Council on Accreditation (COA). RFA’s were issued for the following reasons: Missing court order/ratification orders accepting case plans Missing physical health and dental care documentation Missing mental health documentation Missing ICWA eligibility form 5323 Missing updated educational / school records Supervisory reviews not completed quarterly and/or lack of follow-through Missing initial and/or six-month updated family assessments Expired case plans Missing completed exit interviews Lack of monthly contacts with parents when goal was reunification Lack of accurate documentation in FSFN regarding psychotropic medication Summary and Recommendations The overall performance in achieving safety 67.8%, permanency 74.9% and well-being 75.3% are below the 90%, which should be raised to meet the current projected CFSR performance range of 95%. More specifically the following areas under each should be carefully evaluated and strengthened to raise ChildNet’s overall performance achievements. Safety: • Initial and updated family assessments must be completed timely, focusing on the immediate and prospective safety of the child, as well as any changes and implications in the family’s situation related to emerging concerns and services needs. Permanency: • The CA and the family need to develop an aftercare plan in advance of case closing that outlines specific services needed or desired and steps for obtaining those services. Also, a check-in system should be developed that allows the child advocate to check on the family every quarter for the first year of case closure to ensure ChildNet meets contract Measure 3 (The percentage of children reunified who re-entered Out-of-home care within 12 months shall not exceed 10.5%) • The CA must file case plans timely, and ensure each case plan filed is accompanied by a legal request having the case plan heard before the goal date expires. Once the court accepts the case plan, the case file must be updated with the actual case plan and court order accepting the current (not expired) case plan. • Continue to strengthen documentation of all inquiries to determine if the child was of Native American or Alaskan Native heritage by the completion of the ICWA 5323 form. Well-being: • Ensure CA updates the Normalcy Plan quarterly, and strengthen documentation of how children are afforded opportunities to participate in normal life skills activities in the foster homes and communities that are appropriate for the youth’s respective age or special needs. 16 • Ensure all pre-independent living assessments are completed timely and are maintained in the case file. Also strengthening documentation of services being provided based on the needs identified from the assessment. • Ensuring all cases involving a child 13 years of age or older and in licensed foster, receive guidance and assistance in developing an educational and career path that is based on the child’s individual abilities and interests, which is currently being addressed with the revision of the new Independent Living Transitional Action Plan due to roll out shortly. • Strengthen case file documentation on each youth’s, 15 years of age but not yet 18, progress towards successfully transitioning from foster care to independence for the following: IL staffings, permanency staffings, Casey Roundtable forums and thirty-day home visitations. • In reference to the goal of APPLA, case file documentation needs to be strengthen to show concerted efforts were made to ensure the child is adequately prepared to transition into independent living and is living in a “permanent” arrangement, based on the commitment on the part of the caregiver, until he/she reaches the age of majority. • Ensure documentation is maintained in the case file of updated child’s physical health, dental and mental / behavioral health assessment(s) and appropriate services are being provided to address identified needs. Federal Child and Family Services Review: • Strengthen timeliness and documentation of all quarterly supervisory reviews by considering all aspects of the child's safety, well-being and permanency; and ensuring follow through on guidance and direction and/or documented the reasons the guidance and direction were no longer necessary. 17 List of Standards and Data Roll-Up for FY 2010/2011 Q2 % of Yes No % of No NA Total 1 No child living in the home was re-abused or neglected. (applicable to in-home cases) 2 The focus child was not re-abused or re-neglected. (applicable to out-of-home care cases) 24 77.4% 7 22.6% 49 31 60 88.2% 8 11.8% 12 68 3 If a child was re-abused or re-neglected, immediate and ameliorative interventions were initiated on behalf of the child. (applicable to all cases) 15 100.0% 0 0.0% 65 15 4 Concerted efforts were made to provide or arrange for appropriate services for the family to protect the child and prevent the child's entry into out-of-home care. (applicable to in-home cases) 23 79.3% 6 20.7% 51 29 17 68.0% 8 32.0% 55 25 19 76.0% 6 24.0% 55 25 18 20 18 11 69.2% 83.3% 78.3% 61.1% 8 4 5 7 30.8% 16.7% 21.7% 38.9% 54 56 57 62 26 24 23 18 6 22.2% 21 77.8% 53 27 73 97.3% 2 2.7% 5 75 40 59.7% 27 40.3% 13 67 40 59.7% 27 40.3% 13 67 38 56.7% 29 43.3% 13 67 5 A thorough initial family assessment was conducted following the investigative safety assessment that sufficiently addressed child safety factors and emerging risks. (applicable to all cases) 5.1 Caregivers' (if removed from)/parents' capacity to protect and nurture the child; 5.2 Observations of interactions between the child and siblings and household members 5.3 Emerging risk factors 5.4 Actions needed to address emerging risk factors 5.5 Implementation of a safety plan when needed 5.6 The initial family assessment was completed within 15 working days of ESI staffing/case transfer. 6 Completed service referrals were consistent with the needs identified through investigative assessment(s), and other assessments related to safety. (applicable to all cases) 7 The updated family assessment was focused on the immediate and prospective safety of the child, as well as any changes and implications in the family's situation related to emerging concerns and service needs. (applicable to all cases) 7.1 A review of changes in the family’s condition or circumstances since the initial assessment that positively or negatively impacted the child’s safety 7.2 A review of the short and long-term implication of any changes in individual or family factors affecting family resources, strengths and/or protective capacities 7.3 An evaluation of signs of emerging danger and a plan to address them 18 Yes 36 57.1% 27 42.9% 17 63 7.4 A review of the case plan goals met and are remaining, and the plan to address any barriers that exist to fully meet the case plan goals. 37 55.2% 30 44.8% 13 67 7.5 The family assessment was completed at least every six months and/or at critical changes in circumstances of the family unit. 16 23.9% 51 76.1% 13 67 8 All immediate and emerging safety concerns were addressed and additional needed interventions were provided to protect the child. (applicable to all cases) 40 90.9% 4 9.1% 36 44 9 A thorough safety assessment of the home was completed prior to reunification or placement of the child in an unlicensed out-of-home care setting. (Applies to cases involving post placement supervision, and where a child will be placed in an unlicensed [relative/non-relative] setting.) 26 92.9% 2 7.1% 52 28 Yes % of Yes No % of No NA Total 11 91.7% 1 8.3% 68 12 2 40.0% 3 60.0% 75 5 22 78.6% 6 21.4% 52 28 50 84.7% 9 15.3% 21 59 54 87.1% 8 12.9% 18 62 55 83.3% 11 16.7% 14 66 7 63.6% 4 36.4% 69 11 5 45.5% 6 54.5% 69 11 5 45.5% 6 54.5% 69 11 1 33.3% 2 66.7% 77 3 19 79.2% 5 20.8% 56 24 28 30 28 90.3% 96.8% 90.3% 3 1 3 9.7% 3.2% 9.7% 49 49 49 31 31 31 46 38 57.5% 48.1% 34 41 42.5% 51.9% 0 1 80 79 69 86.3% 11 13.8% 0 80 51 64.6% 28 35.4% 1 79 48 64.0% 27 36.0% 5 75 10 Concerted efforts were made during post-placement supervision to manage the risks following reunification and prevent re-entry into out-of-home care. (applicable to inhome post-reunification cases) 11 The child remained safe in his/her home after being discharged from out-of-home care and did not re-enter outof-home care at least 12 months following discharge. (applicable to out-of-home cases) 12 A multi-disciplinary staffing/assessment for placement planning was conducted before each placement to ensure the placement or move was unavoidable. (applicable to out-of-home care cases) 13 The child's current placement is stable and appropriate to meet the child's needs with no apparent or significant risks or projections of disruption. (applicable to out-ofhome care cases) 14 Concerted efforts were made to identify, locate and evaluate other potential relatives and possible permanent placements for the child 15 The child experienced no more than two out-of-home care placement settings during the period under review. 16 If No was entered for #15, all placement changes were planned in an effort to achieve the child's case goals or to meet the needs of the child. 17 In cases involving a child in a licensed placement setting, an exit interview was conducted with the child when moved from one placement to another, and appropriate action was taken if the exit interview documented a concern. 17.1 An exit interview was conducted with the child when he/she was moved from one placement to another to discuss the previous placement experience. 17.2 Appropriate action was taken if the exit interview documented a concern. 18 The parents were notified of all the child's placement changes. (applicable to out-of-home care cases) 19 The court was informed of the child's placements and reasons for changes in placement 19.1 Number and type of placement 19.2 Reason for the change in placement. 20 Qualitative supervisory reviews and follow through were conducted as needed and required. 20.1 Reviews were completed quarterly 20.2 Supervisor considered all aspects of the child's safety, well-being and permanency 20.3 Supervisor ensured follow through on guidance and direction or documented the reasons the guidance and direction were no longer necessary. 21 The case record contained a current (not expired) case plan. (applicable to court ordered in-home and out- 19 of-home care cases) 22 The current case plan goal was appropriate based on the child's, and family's circumstances. 23 The case plan specifically addressed visitation and other contact plans with all case participants. 23.1 Mother 23.2 Father 23.3 Caregiver (removed from) 23.4 Between siblings 24 The case is designed to achieve permanency (out-ofhome care cases) and safety and stability (in-home cases) through appropriate tasks for the case participants. 24.1 Mother 24.2 Father 24.3 Child (if developmentally or age appropriate) 24.4 Caregiver (removed from) 25 The services worker communicated with service providers about the effectiveness of services for involved case participants. (applicable to all cases) 25.1 Mother 25.2 Father 25.3 Child 25.4 Out of Home Care Provider (includes relative/nonrelative) 26 The child's current placement was in close proximity to the parents to facilitate face-to-face contact between the child and parents while the child was in out-of-home care. (applicable to out-of-home care cases) 26.1 Mother 26.2 Father 27 If No was entered for #26, the location of the child's current placement was based on the child's needs and achieving the case plan goal. (applicable to out-of-home) 28 The child was placed with siblings who were also in licensed and/or non-licensed out-of-home care. (applicable to out-of-home care cases) 29 If No was entered for #28, there was clear evidence separation was necessary to meet the child's needs. (applicable to out-of-home care cases) 30 Concerted efforts were made to ensure visitation (or other contact) was sufficient between the child and parents to maintain or promote the continuity of the relationship between them. (applicable to out-of-home care cases) 30.1 Mother 30.2 Father 31 Concerted efforts were made to ensure visitation (or other forms of contact if visitation was not possible) between the child and his or her siblings and it was of sufficient frequency to maintain or promote the continuity of the relationship. (applicable to out-of-home care cases) 32 Concerted efforts were made to maintain the child's important connections. (applicable to out-of-home care) 20 47 97.9% 1 2.1% 32 48 33 32 94.3% 100.0% 2 0 5.7% 0.0% 45 48 35 32 Yes % of Yes No % of No NA Total 23 4 11 100.0% 100.0% 68.8% 0 0 5 0.0% 0.0% 31.3% 57 76 64 23 4 16 45 41 29 11 9 95.7% 100.0% 93.5% 73.3% 100.0% 2 0 2 4 0 4.3% 0.0% 6.5% 26.7% 0.0% 33 39 49 65 71 47 41 31 15 9 53 40 29 28 73.6% 71.4% 69.0% 62.2% 19 16 13 17 26.4% 28.6% 31.0% 37.8% 8 24 38 34 72 56 42 45 34 87.2% 5 12.8% 41 39 47 44 26 90.4% 86.3% 89.7% 5 7 3 9.6% 13.7% 10.3% 28 29 51 52 51 29 5 100.0% 0 0.0% 75 5 16 44.4% 20 55.6% 44 36 12 60.0% 8 40.0% 60 20 46 44 28 85.2% 84.6% 80.0% 8 8 7 14.8% 15.4% 20.0% 26 28 45 54 52 35 21 75.0% 7 25.0% 52 28 51 78.5% 14 21.5% 15 65 33 An inquiry was made to determine if the child was of Native American or Alaskan Native heritage. (Life of Case - applicable to out-of-home care and court ordered supervision cases) 34 If the child is of Native American or Alaskan Native heritage, the tribe was provided timely notification of its right to intervene in any state court proceedings seeking court ordered supervision, an involuntary out-of-home care placement or termination of parental rights. (Life of Case - applicable to out-of-home care and court ordered in-home supervision cases) 35 Concerted efforts were made to place the child in outof-home care in accordance with the Indian Child Welfare Act placement preferences if the child was of Native American or Alaskan Native heritage. (Life of Case applicable to out-of-home care cases) 36 The mother was encouraged and supported to participate in making decisions about her child's needs and activities. 37 The father was encouraged and supported to participate in making decisions about his child's needs and activities. 38 For cases in which an out-of-state placement was, or is being, explored for the focus child, a complete Interstate Compact for the Placement of Children (ICPC) packet requesting a non-priority home study was submitted within the required timeframe. (applicable to out-of-home cases) 39 The information provided in the ICPC packet regarding the focus child was sufficient to enable the receiving state to make an appropriate decision concerning approval of the proposed placement for the focus child. 40 If the child was in out-of-home care for at least 12 of the most recent 22 months or met other ASFA criteria for TPR, a TPR petition was filed or joined - Life of Case 41 If a Termination of Parental Rights petition was not filed, there were compelling reasons and an exception for not filing the petition was documented. 42 Appropriate steps were taken to identify and recruit an adoptive family that matched the child's needs. 42.1 If TPR has occurred, appropriate steps have been taken to identify and recruit an adoptive family. 42.2 If TPR has not occurred, there is evidence recruitment efforts have been initiated. 43 Appropriate steps were taken to process and approve an adoptive family that matched the child's needs. 44 If the case involves a youth who has reached 13 but not yet 15 years of age and he/she is living in a licensed, out-of-home care placement, a pre-independent living assessment was completed that identified service needs and services were provided. 45 If the child is 13 years of age or older and in licensed foster care, the case management agency provided guidance and assistance in developing an educational and career path that is based on the child's individual abilities and interests. 46 The teen-aged focus child is afforded opportunities to participate in normal life skills activities in the foster home and community that are reasonable and appropriate for his/her respective age or special needs. 21 22 28.2% 56 71.8% 2 78 0 0.0% 5 100.0% 75 5 Yes % of Yes No % of No NA Total 0 0.0% 3 100.0% 77 3 38 73.1% 14 26.9% 28 52 20 58.8% 14 41.2% 46 34 2 66.7% 1 33.3% 77 3 3 100.0% 0 0.0% 77 3 22 59.5% 15 40.5% 43 37 11 73.3% 4 26.7% 65 15 14 93.3% 1 6.7% 65 15 11 91.7% 1 8.3% 68 12 3 75.0% 1 25.0% 76 4 15 93.8% 1 6.3% 64 16 3 50.0% 3 50.0% 74 6 8 57.1% 6 42.9% 66 14 5 35.7% 9 64.3% 66 14 47 For youth 15 years of age but not yet 18, the agency appropriately monitored his/her progress towards successfully transitioning from foster care to independence through regular informative staffings. 48 An ongoing assessment of the child(ren)'s needs was conducted to provide updated information for case planning purposes. (applicable to all cases) 49 An assessment for residential group care was completed when required. 50 An ongoing assessment of the mother's needs was conducted to provide updated information for case planning purposes. (applicable to all cases) 51 Concerted efforts were made to support the mother's engagement with services. (applicable to all cases) 52 An ongoing assessment of the father's needs was conducted to provide updated information for case planning purposes. (applicable to all cases) 53 Concerted efforts were made to support the father's engagement in services. (applicable to all cases) 54 An ongoing assessment of the out-of-home care providers or pre-adoptive parent's service needs was conducted in order to ensure appropriate care for the child. (applicable to out-of-home care cases) 55 Concerted efforts were made to actively involve all case participants in the case planning process: 55.1 Mother 55.2 Father 55.3 Child (if developmentally appropriate) 55.4 Out of Home Providers 56 The frequency of the services worker's visits with all case participants was sufficient to address issues pertaining to the safety, permanency goal, and well-being of the child. (applicable to all cases) 56.1 Mother 56.2 Father 56.3 Child 56.4 Caregiver (out-of-home) 57 The quality of the services worker's visits with case participants was sufficient to address issues pertaining to the child's safety, permanency and well-being. 57.1 Mother 57.2 Father 57.3 Child 57.4 Caregiver (out-of-home) 58 Concerted efforts were made to assess the child’s educational needs during out-of-home placement. 59 If educational needs were identified, necessary educational services were engaged. (applicable to out-ofhome care cases and in-home cases if relevant) 60 Services effectively reduced or resolved the issues that interfered with the child's education. (applicable to out-ofhome care cases and in-home cases if relevant) 61 Concerted efforts were made to assess the child’s physical health care needs. (Applies to all out-of-home care cases. Applies to in-home cases when relevant to why the child and family are involved with the dependency 22 4 40.0% 6 60.0% 70 10 71 88.8% 9 11.3% 0 80 3 60.0% 2 40.0% 75 5 Yes % of Yes No % of No NA Total 58 89.2% 7 10.8% 15 65 55 88.7% 7 11.3% 18 62 35 77.8% 10 22.2% 35 45 34 77.3% 10 22.7% 36 44 56 91.8% 5 8.2% 19 61 64 52 30 22 50 82.1% 80.0% 65.2% 91.7% 73.5% 14 13 16 2 18 17.9% 20.0% 34.8% 8.3% 26.5% 2 15 34 56 12 78 65 46 24 68 59 21 11 64 56 73.8% 33.3% 28.9% 80.0% 82.4% 21 42 27 16 12 26.3% 66.7% 71.1% 20.0% 17.6% 0 17 42 0 12 80 63 38 80 68 74 41 27 74 63 92.5% 68.3% 67.5% 93.7% 92.6% 6 19 13 5 5 7.5% 31.7% 32.5% 6.3% 7.4% 0 20 40 1 12 80 60 40 79 68 30 73.2% 11 26.8% 39 41 16 84.2% 3 15.8% 61 19 12 80.0% 3 20.0% 65 15 45 65.2% 24 34.8% 11 69 system) 61.1 If the child was removed during the period under review, or if not removed but brought into the into the dependency system due to health related issues, he/she received an EPSDT screening within 72 hours. 61.2 After the removal episode or health issues that resulted in interventions by the dependency system, and the EPSDT screening was not done within 72 hours, a medical screening was completed within a week. 61.3 Documentation reflects that the services agency complied with the periodicity schedule pertinent to the child's age and needs. 62 Concerted efforts were made to provide appropriate services to address the child’s identified physical health needs. (applicable to out-of-home care cases and in-home cases if relevant to the reason the agency is involved) 62.1 The diagnoses from physical health care screenings are documented in the case file. 62.2 Documentation reflects that the services agency followed-up on treatment plans that the doctor ordered. 63 Concerted efforts were made to assess the child's dental health care needs. 63.1 Documentation reflects that the child's dental health care needs were assessed 63.2 Documentation reflects that the services agency complied with the periodicity schedule pertinent to the child's age and needs. 64 Appropriate services were provided to address the child's identified dental health needs. 65 An assessment(s) of the child's mental/behavioral health needs was conducted. 66 Appropriate services were provided to address the child's mental/behavioral health needs. 66.1 Documentation reflects that the services agency matched the needed services specific to the child's mental/behavioral concerns. 66.2 Documentation reflects that the services agency followed-up on all treatment plans that the doctor ordered. 67. Express and Informed consent or court authorization was obtained for the use of each psychotropic medication deemed necessary by a physician to address the child’s mental/behavioral health needs. 67.1 The case management organization involved the child and the parents/legal guardian in the decision making process by facilitating contacts with physicians for treatment planning. 67.2 Prior to seeking a medical evaluation to determine the need to initiate or continue a psychotropic medication, the case manager provided the Prescribing Practitioner all pertinent medical information known to the agency at the time. 67.3 The case manager documented communication with the child's parent or guardian to ensure parental awareness of the need to provide express and informed consent for the prescription of each psychotropic 23 15 71.4% 6 28.6% 59 21 1 16.7% 5 83.3% 74 6 Yes % of Yes No % of No NA Total 42 61.8% 26 38.2% 12 68 25 62.5% 15 37.5% 40 40 23 63.9% 13 36.1% 44 36 18 62.1% 11 37.9% 51 29 20 46.5% 23 53.5% 37 43 19 47.5% 21 52.5% 40 40 15 36.6% 26 63.4% 39 41 13 56.5% 10 43.5% 57 23 47 82.5% 10 17.5% 23 57 28 80.0% 7 20.0% 45 35 28 82.4% 6 17.6% 46 34 22 81.5% 5 18.5% 53 27 7 100.0% 0 0.0% 73 7 3 75.0% 1 25.0% 76 4 7 100.0% 0 0.0% 73 7 2 66.7% 1 33.3% 77 3 medication. 67.4 When express and informed consent could not be obtained from the child's parents, the case management organization submitted a request for court authorization to Children's Legal Services. 67.5 When there was a need for a court order, one was obtained. 68 All data fields in the Florida Safe Families Network related to psychotropic medications appropriately and accurately documented the child's prescribed medications 68.1 Name of medication and dosages prescribed 68.2 If the medication is for psychotropic purposes 4 100.0% 0 0.0% 76 4 5 100.0% 0 0.0% 75 5 6 6 7 85.7% 85.7% 100.0% 1 1 0 14.3% 14.3% 0.0% 73 73 73 7 7 7 Yes % of Yes No % of No NA Total 7 100.0% 0 0.0% 73 7 7 7 6 100.0% 100.0% 85.7% 0 0 1 0.0% 0.0% 14.3% 73 73 73 7 7 7 60 84.5% 11 15.5% 9 71 72 91.1% 7 8.9% 1 79 1 25.0% 3 75.0% 76 4 1 25.0% 3 75.0% 76 4 1 25.0% 3 75.0% 76 4 1 25.0% 3 75.0% 76 4 Yes % Yes No % No NA Total Safety Outcome 1 99 86.8% 15 13.2% 126 114 Safety Outcome 2 Overall Safety Total 489 588 64.9% 67.7% 265 280 35.1% 32.3% 686 812 754 868 Permanency Outcome 1 332 77.4% 97 22.6% 1251 429 Permanency Outcome 2 Overall Permanency Total 530 862 73.4% 74.9% 192 289 26.6% 25.1% 1038 2289 722 1151 Well-Being Outcome 1 1355 78.3% 375 21.7% 1069 1730 Well-Being Outcome 2 58 77.3% 17 22.7% 165 75 68.3 Prescription begin and end dates 68.4 Dates of expressed and informed parental consent or court order 68.5 Name of prescribing practitioner 68.6 Reason the medication was prescribed 69 Judicial Reviews were held in a timely manner and Judicial Review Social Study Report's (JRSSR's) provided a thorough investigation and social study concerning all pertinent details relating to the child. 70 Based on all of the information reviewed, it is likely the child will live in a safe and nurturing environment with his/her needs being met on a permanent basis during the next 12 months. 71 For children with the goal of "Another Planned Permanent Living Arrangement", the agency made concerted efforts to ensure the child is adequately prepared to transition into independent living and is living in a "permanent" arrangement until he/she reaches the age of majority. (applicable to Another Planned Permanent Living Arrangement [APPLA] cases) 71.1 The agency has made or is making concerted efforts to adequately prepare the child to transition from foster care into independent living upon being emancipated or reaching the age of majority. 71.2 The living arrangement is deemed "permanent" based on a commitment on the part of the foster parent, relative or non-relative caregiver. 71.3 The child is in long-term facility and will remain in that facility until transition into an adult care facility. Summary Totals: 24 25 Well-Being Outcome 3 Overall Well-Being Total 435 1848 67.1% 75.3% 213 605 32.9% 24.7% 1592 2826 648 2453 Federal Child and Family Services Review 415 72.3% 159 27.7% 306 574