Children's Behavioral Health Services
Children's Assessment Program
Children and adolescents 6 years through 18 years with behavioral,
developmental, and/or autism related challenges who are recipients
of Targeted Case Management Services or Section 24 Children’s
Habilitation Services (CHS) (Mental Retardation /Autism).
Summary and Procedures
Assessment Program Section 24 Children’s Habilitation Service
Target Population(s)
Children and adolescents 6 years through 18 years with behavioral,
developmental, and/or autism related challenges who are recipients
of Targeted Case Management Services or Section 24 Children’s
Habilitation Services (CHS) (Mental Retardation /Autism). If a child
is in school beyond age 18, check with BDS, Office of Quality Improvement
for appropriate use of the tools in this situation. (Children birth
through 5 years are covered under separate summary and procedures,
which are pending.)
Purpose
- Measure and document child and family progress in identified
functional and strength areas;
- Guide and inform caseload and resource planning activities;
- Evaluate the effectiveness of services and supports provided to
children and families; and
- Guide statewide program and service system planning and development
activities.
Description of the Tools:
Two assessment tools have been adopted
for use with this population:
Children’s Habilitation Services Assessment Tool (CHAT). This
tool was developed to assess the degree of behavioral and functional
challenges specifically in children and adolescents with Mental Retardation/Autism.
The tool measures the level of challenge in three domains: Behavioral,
Social Skills, and Life Skills. All items are rated using a five-point
scale from 0 (Never) to 4 (Most of the Time, in Most Situations).
Separate functional domain scores are obtained by summing the item
ratings for each domain. A Total Functional Score is also generated
by taking the sum of all item ratings. The CHAT is completed by the
Case Manager,DHHS CBHS QIS staff via interview
with the child/adolescent’s primary caregiver.
Child and Adolescent Level of Care Utilization System (CALOCUS).
was developed by the American Association of Community Psychiatrists
(ACCP- Klaehn, O’Malley, Vaughn and Kroeger, 1999). This instrument
is used to derive the level of resource intensity appropriate to
the child and family’s needs and includes two primary components
1) an assessment of the child/adolescent and family along 6 dimensions
(i.e. Risk of Harm; Functional status; Co-Morbidity or Co-Existing
conditions; Recovery Environment–environmental stress and
support; Resiliency; and Treatment, Acceptance and Engagement) and
2) a structured decision making guide that uses assessment results
to determine an appropriate level of resource intensity. The CALOCUS
specifies six levels of resource intensity. Each assessment dimension
is rated from least to most severe using a five-point scale. The
assessment is completed by the designated service provider based
on their knowledge of the child and family. A total CALOCUS Composite
Score is also derived by summing the individual scale ratings.
Family Empowerment Scale (FES). This 34-item instrument was developed
by the Research and Training Center (Koren, DeChillo, and Friesen,
1992) on Family support and Children’s Mental Health at Portland
State University. Its purpose is to assess parent/caregiver perceptions
about their roles and responsibilities within their local service
systems and their ability to advocate on behalf of their child. The
FES is a self-report instrument that is completed by the child/adolescent’s
primary caregiver. Each scale item is rated along a five-point scale
from 1 (Never True) to 5(Almost Always True). The FES scoring procedure
is based on a simple, un-weighted sum of the items, resulting in scores
in each of the following areas: Parent/Caregiver Empowerment: Family,
Service System Empowerment, and Community/Political Empowerment. A
Total Empowerment Score is also derived by taking the sum of all 34
Items.
Who Completes the Assessment Tools?
The CALOCUS and CHAT DHHS CBHS Staff
based on their knowledge of, and experience with the child/family
situation.
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The CALOCUS is completed based on an intake interview/psycho-social
assessment by a qualified professional designated service provider.
It is expected that service providers will use existing intake/assessment
tool and procedures to gather the information necessary to complete
the CALOCUS. The CALOCUS is completed by the designated service provider
after the necessary information has been obtained from the child and
family and other informants. The CALOCUS was not designed to be used
as an interview and should not be administered in this way. Only individuals
who have been trained and have met the established CALOCUS reliability
criteria are permitted to use this tool.
The CHAT is designed to be completed by the designated service provider
through an interview with the child/adolescent’s primary caregiver.
The FES is completed by the child or adolescent’s primary caregiver
(i.e., parent, relatives, foster parents, or other caregiver) who
lives with and knows the child/adolescent. The questionnaire is completed
via pencil and paper. The designated service provider should be present
to answer questions and address any concerns that the
parent/caregiver may have. (Refer to Rev. April 2003 FES Administration
Procedures for further information).
Administration and Procedural Guidelines
Children/Adolescents Receiving Targeted Case Management Services
Case Manager obtains and completes with parent/guardian all required
release of information forms.
Case Manager (CM) completes Initial/Baseline assessments (i.e., CHAT,
CALOCUS, and FES, in conjunction with other relevant information).
If Habilitation Services is warranted by the assessment results, review
of other relevant information, and consultation with Habilitation
Services Provider, the CM insures that the need for Section 24 Habilitation
Services is appropriately documented in the child’s Individualized Support
Plan (ISP).
The Case Manager forwards a copy of completed assessments (CALOCUS,
CHAT, & FES) recommendation, and other relevant documentation
to Section 24 provider.
Section 24 Provider coordinates a planning meeting for Children’s
Habilitation Services. The meeting should include, at a minimum, the
parents/guardian(s), Section 24 Provider, and Case Manager. The purpose
of the meeting is to discuss and reach a common understanding of the
intended goals and objectives of Children’s Habilitation Services;
review assessment information and other child and family documentation;
facilitate discussion of the intensity of Habilitation Services needed,
and ensure coordination with the child and family Individualized Support
Plan. If Children’s Habilitation Services is determined to be
warranted by the assessment results, review of other relevant information,
and consultation with the Section 24 Provider and Child and Family
Team (C&F Team), the Case Manager is responsible for appropriately
documenting the need for Section 24 Services in the child’s
Individualized Support Plan (ISP).
Based on review of all supporting documentation, including Child
and Family Team recommendations, the Section 24 Provider determines
actual number of Habilitation Service hours to be provided.
Annual Assessment Updates
The Case Manager completes all annual assessment (CALOCUS, CHAT & FES)
updates and forwards completed assessments and other relevant
documentation to Section 24 provider for re-appraisal and, if necessary,
adjustment to the intensity of habilitation services provided. Follow-up
assessments are completed every 12 months as long as the child/adolescent
remains enrolled in services and upon exit from service. Follow-up
assessments should be scheduled 12 months, 24 months, etc., from the
date of the initial/baseline assessment.
Based on review of annual update documentation, including: annual
assessment results (i.e., CALOCUS, CHAT, FES), other supporting documentation,
and consultation with
C&F Team, the Section 24 provider assesses current intensity of
supports and, if warranted, makes adjustments to the intensity of
service provided.
Children/Adolescents Receiving Section 24 Habilitation Services without
a Case Manager
DHHS CBHS staff Quality Improvement Specialist (QIS) staff obtains
and completes with parent/guardian all required release of information
forms.
DHHS CBHS staff (QIS) staff conduct initial/baseline assessments,
including: CALOCUS, CHAT, and FES. The completed
assessments, and other
relevant documentation is then forwarded to the Section 24 provider.
Based on review of all relevant documentation, and consultation with
C&F Team, Section 24 provider determines the recommended number
of hours of habilitation services provided.
Annual Assessment Updates
Child/Adolescent on Waiting List for Children’s Habilitation
Services Without Case Manager
DHHS CBHS (QIS) staff are responsible for completing all initial/baseline
assessment tools, including: CALOCUS, CHAT, and FES and completes
the Children’s Habilitation Summary & Service Intensity
Guide. In the event that a child/adolescent continues to be on a waiting
list for Habilitation Services for 12 months or longer, DHHS CBHS
(QIS) staff is responsible for completing all follow-up assessments.
The completed assessments, intensity of habilitation services recommendation,
and other relevant documentation is then used to support the referral
process to Section 24 Services.
Change in Primary Rater
When a child/adolescent’s case is transferred to another Case
Manager within the same provider agency,
the new Case Manager assumes responsibility for conducting the follow-up
assessments. At the point of transfer, an assessment summary, including
all of the assessments completed up to the point of transfer and the
date of the next scheduled follow-up should be provided to the new
habilitation services worker.
Change in Provider Agency
In the event that a child/adolescent and family transfers to another
Targeted Case Management or Habilitation Services Provider Agency,
this should be considered a new entry into service and all applicable
assessment procedures should be followed as outlined in the annual
assessment update section above.
Exit and Re-Entry into Habilitation Services
In the event that a child/adolescent formally exits Habilitation
Services (case is closed) at a Provider Agency and later returns and
is re-enrolled into service, the following procedure applies. Upon
a child/adolescent’s re-entry into habilitation services, regardless
of the time spent away from service, the assessment process would
be reinitiated as if the child/adolescent was a new entry into service
as outlined in the annual assessment update section above.
Assessment Exemption Form.
In some cases it may not be possible or appropriate to complete one
or all of the assessment tools (CALOCUS, CHAT and FES) with a particular
child and family. In these instances, the rater is required to complete
a Children’s Screening and Assessment Exemption Form (parents
signature is required on form) and send it to the Department along
with those assessment tool(s) that were completed. The Assessment
Exemption Form also needs to be completed when a child/adolescent
is exiting from services and a previously administered tool is to
be used as the exit interview, if the assessment was completed within
the last three (3) months.
Training Requirements for Children’s Habilitation Services
Assessment
Training is required on all of the above assessment instruments.
The DHHS Office of Quality Improvement provides trainings on a monthly
basis for identified provider agency representatives on the use of
these assessment tools. For more information on trainings or to sign-up
for training contact Children's Quality Improvement Office by phone:
287-4202
Transmission of Information to BDS
All initial and follow-up assessments are forwarded to DHHS QI Office
for quality review and tracking purposes.
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Preparation
and Transmission of Screening Data to DHHS
CALOCUS, CAFAS and FES Summary Form Descriptive Definitions |
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Client ID: Unique identifier of child/adolescent being
assessed. The 8 character unique identifier is composed of the
first letter of the child/adolescent's last name, the first
letter of the child/adolescent's first name and date of birth.
The unique identification number must be placed in the space
provided on each CALOCUS, CHAT & FES Scoring Sheet.
For example: Sara Jones who has a birth date of 07/28/92 would
be: JS072892 |
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Date Assessed: Date screening tools completed whether initial
screening or update; |
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Service Start Date: Date child/adolescent began receiving Level
II case management services or Section 24 services; |
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Case Number: Agency assigned case number (If applicable); |
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MaineCare Number: Child/Adolescent's MaineCare ID number (if
not applicable, indicate with N/A or pending in space provided) |
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DOB: Child/Adolescent's Date of Birth; |
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Gender (M/F): Child/Adolescent's gender; |
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Child's Residence (County): Refers to the county in which the
child/adolescent currently resides; |
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BDS Region: Refers to the region where the child is receiving
services. |
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Rater Name & ID#: Name of person completing the Assessmnet
and Rater Identification Number; |
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Agency/Program Name: Name of agency providing services; |
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Administration: Refers to the scheduled assessment period in
which tools are being completed
Baseline or Entry into Services
(1st administration)
Annually
(every 12-months from initial assessment)
Exit from Service
Other (use only if assessed date occurs outside designated follow-up
interval time period)
Crisis Services (only use Entry into Service interval) |
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Service/Program: Refers to the service/program (i.e., MH Case
Management; MR Case Management & Crisis Services 65H-BHS;
Section 24-CHS) the child/adolescent is currently receiving
and the program responsible for completing assessments.
Age:Refers to the age of child/adolescent receiving services
(School age or Birth to 5yrs)
Disability Group: Refers to primarydiagnosis category (MH, MR,
MH/MR, Autism, MR/Developmental Disabilities, Developmental
Delays) child/adolescent has been at the time of the assessment.
Refers to family or caregiver (Parent, Guardian, Foster Parent,
Other). |
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Frequency of Transmission: |
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Copies of completed CALOCUS Scoring Sheet, CHAT Summary Sheet
and FES should be mailed to Veronica Dumont (see address below)
at the end of every week. Required information may be faxed
to the Department if desired. Make sure that individual names
are crossed-out on all transmitted copies and use the unique
child ID# as described below:
Send Forms To: Veronica Dumont
#11 SHS, Marquardt Bldg.
Augusta, ME. 04333
(telephone: 287-4202 or fax: 287-9915)
Training inquiries can also be made to Cindy McPherson,
Assessment Training Coordinator (287-4319) or fax: 287-7571 |
CALOCUS -Child and Adolescent
Level of Care Utilization System
CAFAS - Child and Adolescent Functional
Assessment Scale
FES - Family Empowerment System
Services for Children with PDD Disorders
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