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NORTH CAROLINA’SMULTIPLE RESPONSE SYSTEM
POLICY TRAINING
2006
Note that portions of this slideshow are interactive through the use of hyperlinks.
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Division of Social Services
Family Support and Child Welfare Section
Holly McNeill – MRS Policy Consultant
828.757.5672 Office
R. Patrick Betancourt – MRS Program Coordinator
919.733.4622 Office
North Carolina Department of Health and Human
Services
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MRS is child welfare system reform through the application of family centered principles of
partnership.
During SFY 2004- 2005 the 100 county Departments of Social Services
conducted CPS assessments on 111,581 children
96,938 (about 87%) of these children were reported for neglect or dependency issues
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• Our practice has become inconsistent• We focus on “incidents” and are not able
to see the underlying needs of the family• We need to move from the “We gotcha!”
to the “How can we help?” attitude• “One size does not fit all” in assessing the
needs of 111,581 children• We need to adequately utilize our
resources by spending the most time on the highest risk cases
Why Reform?
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Six Principles of Partnership
1. Everyone desires respect
2. Everyone needs to be heard3. Everyone has strengths4. Judgments can wait5. Partners share power6. Partnership is a process
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Seven Strategies of MRS
1. Collaboration between Child Welfare and Work First
2. A strengths-based structured intake3. Choice of two approaches to reports of child
abuse, neglect, or dependency4. Coordination between law enforcement agencies
and Child Protective Services during the Investigative Assessment
5. Redesign of mandatory CPS In-Home Services6. Child and Family Teams during the provision of
in home services 7. Shared Parenting meetings within the first 7
days of placement out of the home
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approach every call…every interview...every interaction with a child, parent, reporter, collateral contact, foster
parent, and community partner using the six
family centered principles of partnership
EVERYTHING YOU DO…
Starting with Structured Intake all the way through to Permanency is
MRS
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“Stepping Stones” of Family Centered Practice
• Safety of the child is the first concern
• Children have the right to their family
• The family is the fundamental resource for the nurturing of children.
• Parents should be supported in their efforts to care for their children.
• A crisis is an opportunity for change
• Family members are our colleagues
• Families are diverse and have the right to be respected for their special cultural, racial, ethnic, and religious traditions; children can flourish in different types of families
• Inappropriate interventions can do harm
• Families who seem hopeless can grow and change
• It is our job to instill hope
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An easy way to remember it is to always
consider: “how would I want to be treated if this was me
and my family?”
The MRS Golden Rule?
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Legislative History of MRS in North Carolina
Session Law 2001-424 (Senate Bill 1005): effective July 1, 2001…
no fewer than two and no more than ten demonstration counties
selected reports of suspected child neglect data collection processes no state funds
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Session Law 2002-126 (Senate Bill 1115): effective July 1, 2002…
expanded to include suspected reports of dependency,
required a report on the effectiveness of MRS no later than April 1, 2003,
Legislative History of MRS in North Carolina (cont’d.)
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Session Law 2003-284 (House Bill 397):
effective July 1, 2003… no fewer than 10 and no more than 33
demonstration areas exceed max number if a county specifically
requests inclusion and resources are available original pilots continue family-centered approach to CPS continue the evaluation of MRS report by April 1, 2004 recommendations for statewide implementation
must be included in the report
Legislative History of MRS in North Carolina (cont’d.)
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Session Law 2003-304 (Senate Bill 421): effective July 4, 2003 amended…
N.C.G.S. §7B-302 to specify that the director or director’s designee may not enter a private residence for investigation purposes without specific criteria being met
N.C.G.S. § 131D-10.6A(b) to specify that each child welfare social worker must receive training on family centered practices and state and federal law regarding the basic rights of individuals
Legislative History of MRS in North Carolina (cont’d.)
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4 Criteria for Home Entrance
1. The reasonable belief that a juvenile is in imminent danger of death or serious physical injury.
2. The permission of the alleged victim child’s parent or person responsible (adult) for the juvenile’s care.
3. The accompaniment of a law enforcement officer who has legal authority to enter the residence.
4. An order from a court of competent jurisdiction.
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Session Law 2005-55(House Bill 277)
Defines both Family Assessment Response and Investigative Assessment Response.
States that each county of the state shall use either the Family Assessment or Investigative Assessment response in response to reports of abuse, neglect and dependency.
Leaves the assignment of the response to the county DSS Director
Removes the requirement to make a home visit in child care related CPS investigative assessments
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Work First – Child Welfare Collaboration
• ensures that children and adults are protected from abuse, neglect, exploitation
• enables citizens to maintain or achieve maximum self-sufficiency and personal independence through employment if possible
• ensures that every family and individual has sufficient economic resources to obtain the basic necessities of life
• strengthens family life in order to nurture our children so that they may become productive,healthy, and responsible adults
• assists disabled and dependent adults, while ensuring they live in the most independent setting feasible with the least possible intrusion from public agencies
Mutually supporting activities designed to fulfill the Division’s Mission of ensuring safety, permanence, and well-being for North
Carolina’s children and self-sufficiency for North Carolina’s families:
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Enhancing Work First and Child Welfare Collaboration:
• Use one another as collateral contacts• Attend each other’s staff meetings• Make joint home visits• Maintain regular communication• Create complimentary plans• Involve Work First at the point of initial Child
Welfare contact• Consider which is the best service case manager• Check mutual histories at first contact• Cross train staff
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Intake and Screening Reports of Suspected Child Maltreatment
MRS does not change the intake process
Continue using DSS-1402
Consult manual material, forms, laws and policy
Mandates to notify reporters, LEA, DA, DCD, etc. remain
Confidentiality of reporters remains
Limitation on contact with non-reporters (no extended intake)
Agency’s “response clock” begins ticking at time of intake
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Strengths Based Structured Intake does: Focus on family strengths in an effort to ensure the safety of
children Respectfully allows reporters to be heard, supported, and
encouraged Encourage the identification of collaterals and supportive
agencies Improve the quality and consistency of information Screen for DV, substance abuse, medical insurance coverage,
and “medical home” 100% of the time Provides the foundation for the delivery of family centered
services
Intake and Screening Reports of Suspected Child Maltreatment (cont’d.)
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Assignment of Reports for Assessment
That action is to respond using one of two approaches. In both responses (Family Assessment and Investigative Assessment) the DSS:
Codes 210 on Day Sheets (DSS-2203) Initiates contact within mandatory time frames Invokes the jurisdiction of the court if needed the ensure
child safety
If, through structured intake, DSS determines that a valid CPS report has been received it must take action through protective services to ensure the safety of the child
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“Switching Responses”(Investigative Assessment Family Assessment)
• No abuse, abandonment, or “special types” of report that remains as reported throughout the assessment may be completed as a Family Assessment
• An Investigative Assessment may be switched to the Family Assessment response if it becomes obvious that it could have been assigned as such if the true situation was known at intake
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“Switching Responses”(Family Assessment Investigative Assessment)
• Any neglect or dependency report may be assigned initially and initiated as an Investigative Assessment
• Any report initially initiated in the Family Assessment
response may be switched to an Investigative Assessment if it becomes obvious it should have been assigned as such if the true situation was known at intake.
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Key Points about “Switching Responses”
should not be done frequently
should not be done without a thorough discussion of the case between the social worker and the supervisor
must be done with supervisory approval and documentation in the record should also clearly show why such a decision was made, and how it helped ensure the safety of the child
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Reports Appropriate for the Family Assessment Approach
Those reports of:
neglect (except abandonment and other special types of reports)
dependency
that meet the statutory definition of: N.C.G.S.§7B-101
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These include allegations a juvenile …
• does not receive proper care• does not receive proper supervision• does not receive proper discipline• is not provided necessary medical care• is not provided necessary remedial care• lives in an environment injurious to his/her welfare
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Also included are allegations that a juvenile…
• has been placed for care or adoption in violation of law
• lives in a home where another juvenile has been subjected to abuse or neglect by an adult who regularly lives in the home
• is in need of assistance or placement because he/she has no parent, guardian, or custodian responsible for the juvenile's care or supervision
• whose parent, guardian, or custodian is unable to provide for the care or supervision and lacks an appropriate alternative child care arrangement
• is involved in a situation where one DSS is conducting a reciprocal (conflict of interest) assessment on reports of neglect or dependency
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Reports Appropriate for the Investigative Assessment Approach
Those reports of:abuse
abandonment
certain “special types” of reports
that meet the statutory definition of: N.C.G.S.§7B-101
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These include allegations a juvenile …
• has been physically abused• has been sexually abused• has been emotionally abused• has been involved in moral turpitude• “special” types of reports
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“Special” Types of Reportsincludes any report involving:
a child fatality when there are surviving children in the family a child in custody of local DSS, family foster homes, residential
facilities, and child care situations, and reciprocal investigative assessment on abuse reports
a child taken into protective custody by law enforcement officer or a physician, pursuant to N.C.G.S.§7B-308 and N.C.G.S. § 7B-500
the medical neglect of disabled infants with life threatening condition, pursuant to Public Law 98-457 (Baby Doe)
a child hospitalized (admitted to hospital) due to suspected abuse / neglect
abandonment suspicion or actual presence of a methamphetamine lab child under one year of age shaken or subjected to corporal
punishment.
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What’s different in how DSS responds?
First…what does not change is the county department’s mandate to
comply with all laws and administrative codes during the
provision of child protective serves.
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Conducting an Assessment using the Family Assessment Response
• Initiate within mandatory standard times frames (immediately, 24 hours or 72 hours from intake)
• DSS decides with whom to initiate initial contact
• Recommended first contact is with the parents
• Most of the time first face-face contact will be with the parents and child
• Interview children (with permission of parent) in private as necessary to ensure safety
• In DV cases, never force adult victims or children to be interviewed or develop plans in presence of the perpetrator of violence
• Take an MRS brochure and explain the process of the assessment
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Conducting an Assessment using the Family Assessment Response (cont’d.)
• Conduct the Safety Assessment using the DSS-5231 to document findings
• Develop safety responses with the family if “Not Safe” or “Conditionally Safe”
• Allegation is never used to warrant a safety response…only address identified safety issues
• Introduce other structured decision making tools as appropriate to help engage and inform family of the Family Assessment process
• Contact every collateral named by reporter
• Parent chooses level of involvement with professional collaterals
• Protect the safety of non-professional collaterals as needed
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• Ask parents for collaterals and contact them prior to case decision / finding
• Use the CME / CFE (CMHE) programs as outlined in policy
• Involve families in completion of all structured decision making forms as appropriate
• Complete the assessment within 45 days or document inability to do so and notify parents
• Case decision / finding focuses on the level of need for services, not identification of a perpetrator
• Case decision / finding is made by worker and supervisor, or staffing team
• Document findings on DSS-5104
Conducting an Assessment using the Family Assessment Response (cont’d.)
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“Ceasing” the Family Assessment
If the agency responds to a neglect or dependency report using a Family Assessment response and determines that there is clear evidence the allegations do not constitute neglect or dependency as defined in N.C.G.S. §7B-101, the agency can cease conducting that Family Assessment as long as the Safety Assessment (DSS-5231), Risk Assessment (DSS-5230) and Family Strengths and Needs Assessment (DSS-5229) reflect no issues of frequency or severity of maltreatment, no current safety issues and no future risk of harm.
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“In Need of Services” Case Finding
• safety issues and future risk of harm is so great that the agency must provide involuntary services (the safety and risk of harm is so great that you can not “walk away” from this family)
• reported to the Central Registry with no perpetrator information entered
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“Services Provided, No Longer Needed” Case Finding
• safety of a child and future risk of harm are no longer issues because the agency had been successful in “frontloading” necessary services during the family assessment
• continued involuntary CPS supervision is no longer needed to ensure the child’s safety
• reported to the Central Registry with no perpetrator information entered
• document any service referral deemed appropriate to meet the family's non-safety connected need
• use services codes 122 or 330 to provide services under this finding, if this is available
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“Services Recommended” Case Finding:
• safety of a child is not an issue and future risk of harm is not an issue
• not appropriate if agency feels it needs to monitor compliance due to safety and future risk of harm
• DSS may have begun "plugging" services in during the assessment or will make the recommendation for services at the point of the finding for any service referral deemed appropriate to meet the family's non-safety connected need
• use services codes 122 or 330 to provide services under this finding, if this is available
• also used when the agency makes referrals to community partners
• reported to the Central Registry with no perpetrator information entered
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“Services Not Recommended” Case Finding:
• appropriate for cases in which the safety of a child not an issue • there is no concern for the future risk of harm to the child• the family has no need for other non-safety related services • reported to the Central Registry with no perpetrator information
entered
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Family Assessment Cases Key Points:
In all things, at all times, ensure the safety of the child
Make the process as transparent as possible so the family can “see” what is happening to them and their children
Respect the family and partner with them to safely resolve issues of safety, permanence, and well being
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Family Assessment Central Registry Issues:
• No perpetrator name or relationship entered on DSS-5104
• No maltreatment code will be reported
• “In Need of Services” will be reported in Field 21 as 05
• “Services Recommended” as 06
• “Services Not Recommended” as 07
• “Services Provided; No Longer Needed” as 08
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Conducting an Assessment Using the Investigative Assessment Response
• Conducted according to the current CPS investigation process (Sections 1408, 1416, and 1418 in the Division’s current CPS manual)
• Develop a close working relationship with law enforcement• Memorandums of Agreement developed to ensure an effective
working relationship.• Goals are to hold perpetrators accountable for harming
children, reduce the number of interviews for children; and enhance the evidence gathering process for law enforcement
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CPS In-Home Services
• Involuntary CPS for cases “Substantiated” or found to be “In Need of Services”
• Coded 215 on Day Sheets (DSS-2203) (as long as Risk Ratings = Intensive, High, and Moderate)
• Family seen within 7 days of decision to begin service planning
• In cases involving DV never force adult victims of violence or children to meet with, develop plans with, or be in the presence of the perpetrators of violence
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CPS In-Home Family Service Agreements (DSS-5239)
• Serves as the foundation for working with families• Completed within 30 days of case decision• Updated every 3 months, as often as circumstances
warrant a change, or within 30 days of removal• Based upon Strengths / Needs and Risk Assessments
as documented with structured decision making tools
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In-Home Services Foundations for Practice:
• Families are unique and distinctive.• Families have their own culture and set of norms and
all function differently. • Social workers can better address risk, support and
engage families in the process to promote planning and achieve positive change for children and families.
• In using this methodology, the three of the four core outcomes of safety, permanence and well being will be addressed within families with whom we work (self-sufficiency can be achieved through coordination with Work First’s Mutual Responsibility Agreement)
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CPS In-Home Services in NC:
• CPS In-Home ServicesIntensive/High RiskModerate Risk
• Family Support (Low Risk) Voluntary Services provided by the DSS or an agency in the community
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are “reasonable candidates for Foster Care in the absence of
preventive services.”
CPS In-Home Services provided to North Carolina children who…
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Case Contacts in Intensive / High Risk Cases:
• Weekly Face-to-Face Contacts with the Family• All “Substantiated” or “In Need of Services” children and their
caregivers twice per month• Children who were “Unsubstantiated” or found not to need
mandatory services at least once per month • “Off Weeks” with as many significant family members as
necessary to ensure the safety of the children• “Significant family members” are those people in the home who
can ensure the safety of the children• Two contacts with service providers per month (Mental Health,
Educators, Daycare, Work First, Eligibility Services, etc.)• Contacts may be made at the CFT Meetings• SW-SW Supervisor staff frequently enough to ensure safety…
best practice suggests weekly but this is not a requirement
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Case Contacts in Moderate Risk Cases:
• All “Substantiated” or “In Need of Services” children and parents twice per month
• Two contacts with service providers per month (Mental Health, Educators, Daycare, Work First, Eligibility Services, etc.)
• Contacts may be made at the CFT Meetings• SW-SW Supervisor staff enough to ensure safety…best
practice suggests monthly but this is not a requirement
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Child and Family Team Meetings (CFT)
A CFT is a group of persons identified by and with the family who are committed to the child and family and are invested in helping
them change.
It utilizes a team decision making approach to:• improve the agency’s decision making process• encourage the involvement, support and “buy-in” of the family,
extended family, and the community to the agency’s decisions• develop specific, individualized, and appropriate interventions for
children and families. • specific documentation of CFT is critical
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In all cases, at all times, the CFT meeting is WITH the family, not ABOUT the family.
ENGAGE…ENGAGE…ENGAGE!!!
Seek the family’s input and ideas!!!
They are the experts!!!
Child and Family Team Rule #1!
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CFT Membership:(May Change as Case Changes)
ALWAYS includes the family (no family..no CFT) Anyone significant to the family (family decides who this is) The child (if age appropriate) Safety resources Facilitator Social Worker Relevant service providers Foster parents (if child placed)
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CFT FrequencyIntensive / High Risk Cases
Within 30 days after the assessment case decision Quarterly while the case remains open for CPS In-Home Services Intensive /
High Services (or as often as needed to update the service agreement) Critical decision points in the case (removal of a child from the home or a
change in placement) Any time a significant change in the service plan is needed to ensure the
safety of the child Prior to any petition or court action To address the unique characteristics, and possible resolutions, for “stuck
cases” Case closure (when requested by the family or a service provider)
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All Child and Family Team meetings conducted
while the case has a High or Intensive risk rating
will have a facilitator, except those that
involve case closure.
Child and Family Team Rule #2!
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“Facilitator”
Experienced, trained person with no or as little case responsibilities as possible who:
• manages the CFT meetings• builds trust in the partnership process• makes sure everyone is heard• assures common understanding• helps team find common ground• encourages the team to build creative ways to ensure the
child’s safety• assures the meeting is WITH the family NOT ABOUT them
(CFT Rule #1)
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Intensive Family Preservation Services (IFPS) in CPS In-Home Cases
Intensive, in-home crisis intervention services Designed to help families with children at imminent risk of placement Time limited (usually a maximum 6 weeks) Smaller caseloads 24 hour availability of staff IFPS worker becomes a member of CFT as long as IFPS in place Contacts of IFPS worker counted towards weekly CPS In-Home contacts as
long as purpose is documented IFPS workers provides DSS social worker with written documentation Meeting with DSS social worker, IFPS worker, and Family (best practice CFT
meeting) within seven days of IFPS completion
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CFT Frequency Moderate Risk Cases
Within 30 days following the case decision Quarterly while the case remains open for CPS In-Home
Moderate Services (or as often as needed to update the service agreement)
Use of a facilitator decided by the individual agency based upon what is needed to ensure safety of the child.
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No progress made at Child and Family Team Discussion between SW and Supervisor Using the Structured Decision Making tools evaluate:
Safety (other reports? current safety issues?)Future Risk (what exactly are the risks to children?)Strengths / Needs (what issues remain unfilled?)
If Safety and Risk warrant, file a juvenile petition for an adjudication Document all services offered and the family’s responses and progress (if any) if
it is decided to close the case Notify the family in writing of the decision to close the case (indicate their lack of
progress will be considered if future CPS issues arise)
“Stuck Cases” and MRS(Moderate Risk…No Progress or No Cooperation)
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Family Support Services (FSS)Service Code 122
• Community-based services to promote the well-being of children and families
• Designed to increase the family’s strengths and stability to increase parents' confidence and competence in their parenting abilities, to afford children a stable and supportive family environment, and otherwise to enhance child development
• Voluntary services and can be provided by the agency, within the agency outside of CPS or in a community agency
• Low risk (and some moderate) and the agency can "walk away" from this family • Family can refuse or end for any reason at any time with no repercussions
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FSS Guidelines
• Services provided by DSS or any other unit in the agency
• Face to face contact with a family member monthly
• Intra-agency check for services
• DSS decides best agency case manager
• Contact family within seven days to explain services
• Recommended CFT to conduct thorough assessment
• Explanation of client’s rights to end services
• Use Structured Decision Making tools as appropriate with family to plan services
• Family Support Plan to document services
• On-going assessment using Family Strengths & Needs
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MRS and Placement Activities
Child and Family Team Meeting
• CFT when DSS believes a child cannot be maintained safely in the home
• CFT meetings take the place of PPAT throughout the life of the case, until the child has achieved permanency
• If immediate safety threatened, ensure it first then convene the CFT the next business day
Shared Parenting Meeting
• Builds relationship between birth and foster parents
• Held within seven days of placement• Designed to make all parents part of
the “team” and engage them in issues related to the child’s daily life
• Allows birth parents opportunity to teach foster parents about their child
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REMEMBER THAT FAMILY CENTERED PRACTICE IS ABOUT RESPECTING THE FAMILY WHILE
ENGAGING THEM TO ENSURE THE SAFETY OF THEIR CHILDREN
Finally…
