IV. M. Alternative Response

Effective 7/1/06

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IV. M. Alternative Response

Effective 7/1/06

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PHILOSOPHIC BASE

The process of assessment begins with the first contact with or about a family and continues throughout involvement with the family. Families have the right and responsibility to make their own decisions, as long as doing so does not result in serious harm and/or threats of serious harm to a child.  When a child is reported to be abused or neglected, the law gives priority to child safety and protection.  In order for the response to be effective, family members must be engaged in a respectful manner in both the assessment and planning process.  The family, informal and formal supports, and the community share the responsibility for child safety.  

 

This policy supports the OCFS Practice Model in that it focuses on strengths as well as needs.  It focuses on assessing the signs of safety, risk and danger and assessing for the risk of child abuse and neglect.  This policy promotes family engagement and inclusion in a team approach to planning and intervention.

 

PURPOSE

An Alternative Response includes a timely and time-limited process of gathering critical individual, family, and environmental information in order to determine:

 

1.If a child is at Risk of Child Maltreatment;
2.The impact of the Risk on the child(ren);
3.Signs of safety, signs of risk, and signs of danger;
4.How likely it is for a child to experience maltreatment within the next six months;
5.Caregiver strengths and needs related to child safety;
6.Develop a plan to assist the family in keeping the children safe.

 

OVERVIEW

An Alternative Response includes:

 Engaging the family and support system,  
 Gathering and Analyzing information, within the framework of child abuse and neglect, the current signs of safety, risk, and danger and their impact on child safety, and well-being, and
 Exercising informed judgment to reach and explain decisions.
 Convene a Family Team Meeting—inviting the family, their informal and formal supports, and providers in order to develop a Family Plan.  The Family Plan builds upon family strengths to meet the identified needs.  

 

ALTERNATIVE RESPONSE ASSESSMENT ACTIVITIES

1.Review available history for parent(s)/caregivers(s).
2.Activities to Locate a Family/Child (refer to Appendix Two). Consult with DHHS staff to search for  additional information on current locations where client is likely to be found. When a family cannot be located within 35 days of receipt of the report, the assessment will be closed as Unable to locate.
3.Initial Face to Face Contact or home visit with parent/caregiver within 5 days of receipt of referral. The date of CIP receipt of referral is the date of the Decision "Assign to Contract Agency" in MACWIS.
4.Face to Face contact with all parents/caregivers and children and one home visit to observe the environment within 10 days of report. Exceptions must be documented that demonstrate reasonable diligence.
5.Following initial parent/caregiver and child interviews, the assigned Case Manager makes a decision regarding the safety of each child (refer to Appendix 3). Assessed signs of safety, risk, and danger will be considered. Children are considered safe when there are no apparent signs of danger present. Any signs of danger will be promptly reported to DHHS (refer to Appendix One).
6.It may be possible to close the assessment if there are no child abuse/neglect concerns, no signs of risk, and the child is safe.
7.Make additional face to face contacts and home visits as necessary to complete Assessment and engage the family in participating in an FTM for the purpose of developing a Family Service Plan.
8.The Date of Receipt of Post Assessment Referrals from DHHS is the date of the transfer meeting unless the CIP and DHHS mutually agree that a transfer meeting is not necessary.

 

AREAS TO EXPLORE AND ASSESS

The depth to which these areas are explored will vary at different phases:

 Family history
 Specific reports of child maltreatment
 Signs of Safety, Risk, and Danger
 Decision whether each child is safe
 Consultation with DHHS regarding the presence of Signs of Danger and the need for DHHS follow-up.
 Referral needs (CDS, Case Management, PHN, other services)
 Child(ren)’s needs related to safety, and well being
 Needs of parent/caregiver(s) (physical, emotional, social, cognitive, psychological) as they relate to the child(ren)’s safety, and well-being
 What it is like for each child to live in the home (from the child(ren)’s and parent/caregiver(s)’ perspective)
 Substance Abuse and the impact on the child(ren)
 Domestic Violence and the impact on the child(ren)
 Mental Illness and the impact on the child(ren)
 SBI Check through OCFS Intake when indicated
 Informal and formal support systems
 Family strengths and protection needs for the children
 Child well-being (educational, physical and mental health needs)
 Parent/Caregiver(s)’ readiness to partner with the CIP Agency to meet the identified needs of the family

 

ACTIVITIES FOR DEVELOPING THE FAMILY PLAN:

1.When it is determined the family will participate in CIP Agency Services, the Case Manager will partner with the family to continue assessment activities, prepare for a Family Team Meeting, and to develop a Family Plan.
2.Case Managers will facilitate a Family Team Meeting for further assessment and identification of individual/family strengths and needs.  The team will develop a plan to meet those needs.  These activities must be completed, and documented within 35 days of the report.
 To prepare for the Family Team Meeting, the analysis questions are considered and documented (refer to a-e).  This information will be verbally shared with the parent(s)/caregiver(s) and their supports at the Family Team Meeting.
a)With regard to safety for the children of this family, what signs of safety, and risk, are present?  Level of Safety for each child?  
b)With regard to all the developmental and well being (educational, physical, and mental health) aspects of these children, what are the strengths, and what are the needs?
c)With regard to all the developmental and well being aspects of these children, what are the caregiver’s strengths, and what are the needs?
d)With regard to the permanency and stability aspects of this family, what are the strengths, and what are the needs?
e)With regard to support systems for this family (both formal and informal), what are the strengths, and what are the needs?

 

 The purpose of the Family Team Meeting is to identify, share, and review the current family strengths and needs related to child safety. This team will help to determine how to help the family meet those needs, as well as how progress will be measured.  

 

 A Family Plan will be developed during this meeting to determine what steps are necessary to meet the needs for child safety, who is responsible, and timeframes for meeting the goal.  

 

3.The following Family Plan will be used following the Team Meeting.  The plan should be signed by the parent(s)/caregiver(s) and CIP Agency staff.  Copies of the Family Plan will be made available to the family participants at the Family Team Meeting. Copies of the Family Plan will be provided to other participants as appropriate no later than 7 days after the meeting.

 

Family Plan for meeting the needs of the ___________ family:

1.The strengths of the family related to child safety are:
2.The current needs with respect to child safety, and well being are:
3.The services/supports needed to assist the family in regards to child safety and well being are:
4.Who will do what/when to carry out the plan:
5.Progress and change will be measured by:
6.Possible outcomes in relation to child safety are:
7.Informal and Formal Supports:

I accept the CIP Agency offer to assist me in obtaining needed services and will receive Targeted Case Management services from the CIP Agency in order to gain access to and manage needed medical, nutritional, social, educational, transportation, housing, and other services identified in this plan.

Signature of Parent/Caregiver_____________  Date:____________

Signature of Parent/Caregiver_____________  Date:____________

Signature of Case Manager________________  Date:____________

Name of Supervisor ______________________________

 

4.Family Plans will be completed within 35 days of receipt of referral.

 

5.Timely (within 30 days) provision of and/or arrangement for services outlined in the family plan.

 

6.Case Management Services as developed in the Family Plan

 

ONGOING SERVICE AND ASSESSMENT ACTIVITIES

 

1.Case Managers will have face-to-face contact with all children/family members at least monthly. Exceptions must be documented that show diligence and/or reasonable explanations for this not occurring.

 

2.In cases referred where there is significant risk, the Case Managers will have face to face meetings with the family twice monthly for at least three months.  Significant risk is described as a family in which a child is 5 years or younger and at least one of the following risk factors is present and has an impact on child safety: Domestic Violence, Substance Abuse, Mental Illness (See Appendix Four).

 

3.Case Managers must meet individually with family members and when needed with extended family members and other family supports as well as contacting service providers to assess progress.

 

4.The Case Managers will continue to assess and review whether the family is making progress toward the agreed upon goals of the Family Plan and to identify additional needs and strengths.  The family plan may require modification during Case Management Services.

 

5.As part of the Review process, the following questions will be explored:

 

a)What are the current signs of safety, risk , and danger?

 

b)What changes have been made by parent/caregiver(s) in regards to the needs established in the family plan?

 

c)What additional strengths and needs have been identified since the assessment:
(1)With regard to safety issues:
(2)With regard to developmental and well being issues for the parents/caregivers:
(3)With regard to developmental and well being issues for the child:
(4)With regard to permanency and stability issues:
(5)With regard to support systems:

 

CLOSING

Cases must be closed no later than 6 months from receipt of referral unless an exception is granted by DHHS Supervisory staff.

 

The closing summary will include:

 

 Date of closure;
 Brief summary of the reason and nature of involvement including services that were provided and those that will continue;
 Progress/changes made or not made;
 Family functioning at closing including signs of safety, risk and danger;
 Informal and Formal supports and how they will help the family;
 Resulting level of safety for each child

 

 

APPENDIX ONE

Some Signs of Safety

 

These are positive factors and/or resources within the family and family environment that are capable of promoting and maintaining child safety.

 

1.Caregiver has demonstrated previous restraint from child maltreatment;
2.Caregiver accepts responsibility for child maltreatment;
3.Caregiver understands his/her primary role and responsibility is to protect, nurture and provide for the well being of the child(ren);
4.Demonstrated caregiver affection, attentiveness, concern, nurturance, responsiveness, etc.;
5.Child turns to caregiver for comfort, getting needs met, support;
6.Child is capable of self protection;
7.On target child development;
8.Previous demonstration of protective action;
9.Demonstrated self-awareness/positive self-esteem;
10.Previous appropriate use of informal and/or formal supports;
11.Evidence of functional relationships in and/or out of the home;
12.Safe home environment;
13.Basic child needs being met in a timely, effective and consistent manner;
14.Caregiver demonstrates empathy towards the child;
15.Caregiver demonstrates help seeking behaviors;
16.Caregiver is receptive to Department involvement/intervention;
17.Open communication among family members;
18. Regular functional social/community contacts;
19.Demonstrates the management of stress;
20.Demonstrated ability to solve problems and apply learning to new experiences; and
21.Experienced positive parenting as a child.

 

Some Signs of Risk

These are negative factors and/or the lack of resources within the family and family environment that, because they exist, may be or become challenges to achieve and maintain child safety.  These factors also increase the likelihood of a child experiencing child maltreatment.

 

1.Presence of significant family stress;
2.Social isolation/lacking adequate support;
3.Poor parent/caregiver impulse/self control;
4.Prior reports of child maltreatment;
5.Child developmental delays;
6.Substance/drug misuse, abuse (parent, caregiver or child);
7.Uncontrolled, unmanaged parent/caregiver or child mental health issues;
8.Parental/caregiver inability, unwillingness to accept that child maltreatment has occurred, to accept responsibility for child maltreatment or to assume responsibility for child safety;
9.Unkempt home environment;
10.Significantly vulnerable child;
11.Parent/caregiver’s inattentiveness to child;
12.Marital/adult relationship conflict;
13.Serious poor child physical health;
14.Serious parent/caregiver medical issues;
15.Family finances difficulties;
16.Unresolved prior parent victimization as a child;
17.Many transient people frequenting the child’s home;
18.Parental disability;
19.Excessive, rigid, and/or ineffective parental discipline;
20.Diminished parent/caregiver protective capacities;
21.Excessive school absences/school performance issues;
22.Criminal activity (parent, caregiver or child);
23.Seriously acting out child;
24.Prior removal of child custody;
25.Many service providers working with the family and little or no apparent change in circumstances, behaviors;
26.Poor problem identification and resolution skills;
27.Unrealistic expectations of child; and
28.Child is scapegoated;
29.Caregiver avoids contact with service providers; and
30.Animal abuse.

 

Signs of Danger

 

These are very serious parental behaviors, conditions, and child or family circumstances that either have caused or very soon could cause high severity child abuse and neglect. When they are present, signs of danger require safety planning.

 

1.A parent/caregiver behavior IS violent and/or out of control and this behavior causes or threatens serious harm to a child.

 

 Violent shaking and/or choking of an infant or young child.
 Use of any extreme physical treatment of a child which causes or is likely to cause an injury. (e.g. torture, extensive bruises, multiple serious abrasions, broken bone/s, significant hair loss from being pulled, inflicted serious and or multiple burns, internal injuries which may result from kicking, pushing, throwing or slamming)
 Brutal or bizarre behaviors directed at a child and/or adult.
 Use or threatened use of guns, knives or any other weapon or implement which causes or threatens serious harm to a child and/or adult.
 A parent/caregiver expresses bizarre and/or irrational thoughts (demonstrates impaired judgment, sees or hears things that are not there, sees child as "evil"), and these behaviors cause or threaten serious harm to a child.
 Any behavior that indicates a significant lack of self-control (e.g. reckless, unstable, raving, explosive, suicidal and/or homicidal behavior).

 

 

2.A parent/caregiver describes or acts towards a child in predominantly negative terms or has extremely unrealistic expectations of the child.
 Pervasively demeaning, degrading, humiliating, and/or scapegoating a child.
 Expects a child to perform or act in a way that is impossible or improbable for the child’s age (e.g. babies and toddlers not expected to cry, child expected to be still for extended periods of time, to be toilet trained, or to eat neatly).

 

3.A parent/caregiver caused high severity child abuse and/or neglect AND is communicating a plausible threat of high severity child abuse and/or neglect to a child.
 Manipulation/retaliation (e.g. threats of having to go into a foster home, not being able to see a parent any more, a parent/caregiver having to go to jail, etc.) for a child’s contact, communication, or disclosure resulting in CPS involvement.
 Terrorizing with threats to kill or seriously harm the child, a loved one, animal, or valued possession.

 

4.There are serious maltreatment allegations or there are high severity maltreatment findings, and there is reason to believe the family is about to flee or to refuse access to a child.
 Family has previously fled in response to serious CPS involvement.
 Parent/caregiver says they may flee or it appears as if they are planning to flee.
 Parents are isolating the child in response to CPS intervention.

 

5.A parent/caregiver is unwilling or unable to provide sufficient supervision to protect a child from high severity child abuse and/or neglect.
 Parent/Caregiver is unable to recognize threats of serious harm; and therefore, cannot adequately provide supervision to protect the child from the threat(s).
 Even after being made aware of a plausible threat of serious harm, a parent/caregiver’s response indicates he or she will not, even in light of this knowledge, adequately protect and supervise the child from the threat(s) of serious harm.

 

6.A parent/caregiver has not or is unable to meet a child’s medical needs that may result in serious health care problems if left untreated.
 Parent/caregiver does not seek treatment for a child’s serious medical condition.
 Parent/caregiver does not follow prescribed treatment for a serious condition.
 A parent/caregiver has removed child from a hospital against medical advice.

 

7.A parent/caregiver has previously abused or neglected a child, and the high severity of the child maltreatment or the parent/caregiver’s response suggests that a child’s safety is of serious concern.
 A parent/caregiver has previously lost custody of a child as result of a child protection proceeding.
 There is a chronic and/or an escalating pattern of maltreatment.
 Parent/caregiver does not acknowledge or take responsibility for prior serious harm to a child.

 

8.A child is fearful of people living in or frequenting the home, and there are serious allegations or high severity child maltreatment.
 A child cries, cowers, cringes, trembles or otherwise exhibits fear in the presence of certain individuals or verbalizes such fear.
 Child exhibits severe anxiety (e.g. nightmares, insomnia) related to a situation associated with a person(s) living in or frequenting the home.
 Child reasonably expects retribution or retaliation from parent/caregiver.

 

9.A parent/caregiver is unwilling or unable to meet the child’s immediate safety needs for food, clothing, and/or shelter, which causes or threatens serious harm.
 A child is deprived of food and/or drink for prolonged periods of time and/or a child appears to be malnourished.
 Lack of parental response to identified threat(s) which fail to protect from unsafe, hazardous, and/or no housing (in dangerous weather/environment)
 Dangerous substances or objects within reach of a vulnerable child.

 

10.There is reason to believe that child sexual abuse has occurred AND current circumstances suggest that the child’s safety may be of immediate concern.
 Alleged abuser has continued access.
 A parent/caregiver has not demonstrated the ability or willingness to believe and/or protect a child from sexual abuse.

 

11.A parent/caregiver’s reported and/or observed drug or alcohol abuse seriously affects his/her ability to supervise, protect, or care for a vulnerable child.
 A parent/caregiver has misused drugs and/or alcohol to the extent that judgment and actions are seriously impaired.
 A parent/caregiver’s active use of substances that result in impulsive, dangerous behaviors.
 Co-sleeping in combination with substance abuse.

 

12.A parent/caregiver’s reported or observed behaviors are indicative of serious physical, mental illness or developmental disability, which has or may soon seriously effect his/her ability to supervise, protect, or safely care for a vulnerable child.

 

 A parent/caregiver refuses supports and/or services that would enable the parent/caregiver to safely care for and protect a child, given the parent/caregiver’s serious physical or mental limitations (i.e. medication).

 

13.A batterer of domestic violence affects the ability of the adult victim of the domestic violence to care for and/or protect a child from high severity maltreatment.
 A parent/caretaker is unable to provide basic care and/or supervision for the child because of injury, incapacitation, forced isolation, or other controlling behavior of the alleged or observed domestic violence abuser.
 A parent/caregiver is forced, under threats of serious harm, to participate in or witness abuse of a child, and/or a child is forced, under threat of harm, to witness or participate in the abuse of a parent/caretaker.
 A batterer has caused unexplained injuries, and the adult victim’s explanations are inconsistent or contrary to credible information (from a child, neighbors, previous police reports, etc.)

 

14. A child’s behavior triggers a parent/caregiver’s inappropriate response that caused or is likely to cause serious harm to a child.
 A parent/caregiver cannot tolerate a crying infant who cannot be soothed.
 A parent/caregiver has unrealistic expectations and an inability to tolerate a child who cannot meet his or her expectations.
 A child demonstrates uncontrolled, rageful, or aggressive behavior.

 

15.A parent/caregiver’s explanations for serious maltreatment and/or serious unexplained child injuries are inconsistent with credible supporting evidence or change over time.
 A serious injury that is inconsistent with the explanation given by the parent/caregiver.
 A child who has a serious injury, and everyone who has had access and opportunity denies responsibility for the injury.

 

16.There is evidence of and/or a report of abuse/neglect related to a child’s death or an unexplained child’s death.
 More than one "SIDS" death in the family.
 A parent/caregiver was present when a child died and he/she has no explanation for the cause of death.
 A parent/caregiver uses a child care provider whose actions contributed to a child’s death.

 

 

APPENDIX TWO

 

Activities to Locate a Family and/or Child:

 

If the family cannot be located within 5 days of the receipt of the report the Case Manager will determine which resources are likely to have current information on the location of the family.

 

1.Prior to attempting subsequent visits with the family and/or child, the Case Manager will ascertain whether the address appears to be accurate.  The Case Manager will utilize other resources in the following priority:

 

A. Contact the Department of Health and Human Services, Office of Child and Family Services to review records, open or closed.
B.Contact Department of Health and Human Services Central Intake Supervisor to review other DHHS electronic records (TANF, SSI, Food Stamps).
C.Other public sources such as: Division of Motor Vehicles.or Internet based address searches.
D. Other providers who appear to have had contact with the family/child (e.g., persons involved in making report to DHHS, Law Enforcement, etc. );

 

2.Telephone calls may be made, registered letters may be sent, and/or notes to contact the Case Manager may be left at the home or other places the family may frequent, if it appears such activities would enhance the likelihood of locating the family.  Careful consideration should be given to whether any of these activities would create a threat of harm to the child or another person.

 

3.The Case Manager will maintain confidentiality and will disclose only as much information as necessary.  In some instances, the Case Manager may need only identify himself/herself as an employee or social worker with a Social Services agency.

 

 

APPENDIX THREE

DHHS SAFETY DEFINITIONS:

 

Safety is the degree to which a child is secure from harm and/or serious harm now or in the near future.  That decision is reached by considering the presence or absence of child abuse and neglect, the severity of the abuse and neglect, imminence, and the overall the signs of safety, risk, and danger present.

 

The level of safety is determined when leaving the home, following initial contacts, and whenever making assessment/case decisions.

 

A child is safe when there is no evidence of child abuse and neglect or child abuse and neglect has occurred, but is unlikely to reoccur, and there are no signs of danger present. Signs of risk may be present.

 

A child is safety compromised when there is evidence of child abuse and neglect, but there are signs of safety present, and any signs of danger can be controlled or managed by a family safety plan.

 

A child is unsafe when there is evidence of child abuse and neglect and signs of danger (threats of serious harm) are present that cannot be controlled or managed by a family safety plan.  

 

A child is very unsafe when there is evidence of child abuse and neglect, and the signs of danger present an immediate threat of serious harm that cannot be controlled or managed by a family safety plan.

 

Severity:  The degree of impact (Low/Moderate or High) or threatened impact of the most severe type/s of child abuse and/or neglect upon the child.

 

Imminence:  The likelihood of a child experiencing or re-experiencing abuse and neglect in the very near future, by looking at the combination of existing safety, risk, and danger signs.

 

Risk:  The presence of parent, caregiver, and/or child behaviors or any conditions that may increase the likelihood that child abuse or neglect will occur at some point in the future.

 

Threat:  The presence of parent/caregiver and/or child behaviors or any conditions that by a preponderance are very likely to result in high severity child maltreatment in the very near future.

 

Signs of Safety:  These are positive factors and/or resources within the family and family environment that are capable of promoting and maintaining child safety (See Appendix 1).

 

Signs of Risk:  These are negative factors and/or the lack of resources within the family and family environment that, because they exist, may be or become challenges to achieve and maintain child safety.  These factors also increase the likelihood of a child experiencing child maltreatment (See Appendix 1).

 

Signs of Danger:  These are very serious parental behaviors, conditions, and child or family circumstances that either have caused or very soon could cause high severity child abuse and neglect. When they are present, signs of danger require safety planning. (See Appendix 1.)

 

Safety Planning:  A timely process which involves family members and their informal and formal supports when possible, that is designed to create, increase, or support signs of safety, in order to control and manage present signs of danger and threats of serious harm.  

 

Family in Need of Child Protective Services: A family who has experienced child abuse and neglect to the degree that without Child Protective intervention the children are at risk of entering foster care.

 

Working/Closing Recommendations:  A plan made by actively involving parent(s)/caregiver(s) and the Department when concerns for child well-being exist, but there are no present signs of danger and threats of serious harm.  This may be used when maltreatment is found.  The Department may or may not complete a full assessment.

 

Informal supports:  These are family friends, neighbors, extended family members, and community members who are able to help identify family strengths and needs and who are able to help sustain efforts to provide and maintain child safety.

 

Formal supports:  These are service providers and other professionals who are able to help identify family strengths and needs and who are able to help sustain efforts to provide and maintain child safety.

 

Full disclosure:  As we work with children, families, and their teams, we will clearly share our purpose, role, concerns, responsibilities, and decisions.

 

Family Stability: Parents are able to meet the requirements of parenting while assuring the safety and well-being of all family members.

 

 

APPENDIX FOUR

Domestic Violence

A pattern of coercive behavior that is used by a person against family or household members to establish and maintain power or control over the other party in the relationship and in which the child/ren is/are affected as demonstrated by the child/ren’s statements or behavior that indicate stress, fear, involvement in the incident(s) or injury due to domestic violence.  This behavior may include physical violence, sexual abuse, emotional and psychological intimidation, verbal abuse and threats, stalking, isolation from friends and family, economic control and destruction of personal property.

 

Substance Abuse

Substance use that significantly impairs a parent/caregiver’s ability to meet essential needs, including residential stability and constancy of caregiving figure, of a child in their care.

 

Mental Illness

The parent/caregiver manifests symptoms of mental illness that significantly impair a parent/caregiver’s ability to meet the essential needs of a child in their care.  Examples include:

         depression and/or psychosis that results in caregiving impairment,

 misperception of a child’s abilities due to mental illness that impact the child’s safety,
 misperception of a child’s intentions/behavior in a way that the parent/caregiver has harmed, or is at risk of harming, the child