Case Planning Basics Version 3.0

Case Planning Basics Version 3.0
7/10/2015

Introduction Case and service planning is the heart of the work we do with families in the child welfare system. We are charged with partnering to develop plans that will help families keep their children safe, or finding permanency for children who cannot safely be maintained or reunified with their families. This eLearning module will focus on case planning basics and provides foundational information for the in-person classes on developing case objectives and plans for families and case planning in a team setting. 7/10/2015

Learning Objectives K1.The trainee will be able to identify the difference between case plan goals, objectives, and services. K2. The trainee will be able to define Minimum Sufficient Level of Care (MSLC) as the primary consideration for addressing child and youth safety in case planning. K3. The trainee will be able to identify the role of standardized assessment in case plan development. K4. The trainee will recognize reasonable efforts and active efforts as the minimum standard to support families in meeting case plan goals. K5. The trainee will be able to recognize how the impact of trauma may affect the case planning process. K6. The trainee will be able to recognize S.M.A.R.T. objectives. Values V1. The trainee will value prioritizing child, youth, and family needs in case plan objectives. V2. The trainee will value embedding safety linked behaviors and protective capacities in case plan objectives. V3. The trainee will value the case plan as a mutually agreed upon document that contains the obligations and roles of the department and the family. Please review the following objectives for this course. 7/10/2015

Agenda Section 1: Components of the Case Plan
Define the case plan process Minimum Sufficient Level of Care (MSLC) and the case plan Case plan goals, service objectives, and client responsibilities Timelines Section 2: Developing the Case Plan How the assessment drives the case plan Factors and practices that impact the case planning process Writing S.M.A.R.T. objectives Section 3: Implementing the Case Plan Reasonable vs active efforts Prioritization of activities Section 4: Additional Case Plan Requirements Legal Requirements Other case plan activities Section 5: Case Scenario The agenda for this course includes four sections and a case scenario. Section 1: The Components of the Case Plan. Information on defining the case process, defining the Minimum Sufficient Level of Care and its importance in case planning, defining case plan goals, service objectives and client responsibilities and timelines in case planning. Section 2: Developing the Case Plan. Information on how the assessment drives the case plan, factors and practices that impact the planning process and writing SMART objectives Section 3: Implementing the Case Plan. Information on providing reasonable vs active efforts with a family and prioritizing services and activities with the family. Section 4: Additional Case Plan Requirements. Information on additional legal requirements and other case plan activities. Section 5: Case Scenario. A case scenario that illustrates the practices of case planning specific to the needs of the family. A post test concludes the course on Case Planning Basics. 7/10/2015

The Art of Case Planning
Highly structured Meets specific requirements Individually tailored Engages participants The social worker’s role in helping the family plan for changes in their lives is critical to outcomes that ensure the safety, permanency and well being of children. Case planning , like ballroom dancing requires strict adherence to key rules, a specific format and compulsory content; but within this highly defined structure, each case plan must be engaging, individually tailored and original. While the case plan has to fit into a very specific format within the CWS/CMS it also has to be tailored to meet individual needs and must be completed within the context of purposefully and effectively engaging families. It is the level of planning that most social workers and families do not do in their day to day lives. 7/10/2015

Section 1: Components of a Case Plan
Case Plan Definitions Minimum Sufficient Level of Care (MSLC) Case Plan Requirements We will first cover the components of a case plan. These components include definition of terms, ensuring that a Minimum Sufficient Level of Care is consistently applied throughout the time a family is within the child welfare system and case plan requirements. 7/10/2015

Case Plan Definitions Engagement Permanence Case Plan Case Plan Update
Concurrent Services Participatory Case Planning Let’s review definitions for the following terms: Engagement is a process in which family member(s) are active in the child welfare intervention. Ideally this includes being receptive to receiving help, acknowledging the existing safety and risk concerns, believing in the likelihood of a positive outcome, taking the initiative in making positive changes and having a positive relationship with the social worker (Yatchmenoff, 2005) Effective engagement includes the worker (with cultural humility and sensitivity to possible historic trauma and unresolved grief and loss) carefully explaining his/her role in the case planning process. The family or individual is given the opportunity to tell their view of their family, guided by thoughtful and empathetic questions from the worker, through a process known as appreciative inquiry. The worker may give information that emphasize how he/she will respectfully respond to the participant’s view of the family. This exchange of information is the foundation of the relationship and sets the tone to work in partnership and support the participant and his/her family in reaching the goal of safety, permanency and well being for the child. (CDSS, Office of Child Abuse Prevention, 2011). Permanence: A primary outcome for child welfare services whereby all children and youth have stable and nurturing legal relationships with adult caregivers that create a shared sense of belonging and emotional security that endures over time. Case Plan: The written document which is developed based on an assessment of the circumstances which required child welfare services intervention; and which the social worker in partnership with the family, identifies the case plan goal, the objectives to be achieved, the specific services to be provided and case management activities to be performed. Case planning involves county staff and the child and/or his/her family working together to mutually identify a specific goal, specific interventions which address the behaviors that lead to the safety and risk concerns and service delivery methods ( CDSS, 2003b) Case Plan Update : The written document which contains any changes regarding the information in the case plan and includes specific information about the current status of the family and their progress (CDSS 2003b). More information on case plan updates will be given in the monitoring and adapting trainings. Concurrent Services: While the primary goal is reunification, concurrent services refers to portion of the case plan for a child who is receiving family reunification services. The services include identifying the child’s permanency alternative(s) and the interventions needed to achieve permanency if the family does not succeed in reunifying ( CDSS, 2003b and ICWA). Participatory Case Planning: Is a strategy encompassing several formal models and informal philosophies aimed at working together with the family and others (such as relatives, service providers, community members and tribal ICWA social workers) to develop strength based case plans that are tailored to meet the specific needs of the family. 7/10/2015

Minimum Sufficient Level of Care (MSLC)
The social standard for the minimum of parent behavior below which a home is inadequate for the care of a child As previously noted in the eLearning in Assessment Procedures Part 1, the Minimum Sufficient Level of Care is the social standard for the minimum parent behavior below which a home is considered inadequate for the care of a child. The MSLC is family specific with no fixed criteria. It incorporates family strengths and needs, community standards and cultural values. It is important that the expectation of the MSLC remain constant throughout the life of a family’s time in the child welfare system, so that all parties know what to expect. Structured Decision Making (SDM) tools guide us in formulating and maintaining the MSLC throughout the time a child and family are in the child welfare system. The MSLC is the primary consideration when addressing child and youth safety in case planning. Please download the Handout 1 Minimum Sufficient Level of Care and review. The importance of “community standards” is explicitly identified in the Indian Child Welfare Act (ICWA) which mandates that the standards applied to a given Native American child reflect his tribe’s standards. 7/10/2015

Case Plan Requirements
Engagement, Assessment Goal for Permanency Service Objectives Client Responsibilities Timeline Case Plan requirements include: Engagement, Assessment, Goal for Permanency, formulating objectives to ensure the family has met the minimum sufficient level of care, service objectives activities, and the timeframes to complete the plan. Engagement and assessment are found in other trainings. In this training we will focus on establishing the goal for permanency, service objectives, parent responsibilities (also referred to as Client Responsibilities in CWS/CMS) and timelines in the case planning process. When the assessment is completed, you will work with the family to set the least intrusive goal, based on the safety and risk factors. Parents must be offered an opportunity to participate in adoption and relinquishment planning as the permanency goal is set (CDSS 1998b, CDSS, 2000). The CWS/CMS system offers 9 permanency goals for the social worker to choose from. 7/10/2015

Case Plan Goals There are 9 possible goals Remain home (FM)
Return home (FR) Adoption with siblings (PP) Adoption (PP) Maintain in legal guardianship (PP) Legal guardianship (PP) *Tribal Customary Adoption (PP) The nine potential permanency goals in the CWS/CMS System are: The child can remain at home, which is considered Family Maintenance or FM, while objectives are being worked on and interventions provided; return home, which is considered Family Reunification or FR, adoption with siblings, adoption, maintaining a current legal guardianship or establishing a new legal guardianship are all considered permanent placement services or PP. Tribal Customary Adoption is an adoption arranged following the customs, laws and traditions of the Native American child’s tribe. Tribal customary adoption does not require termination of parental rights; rather the tribe makes the determination about the roles of the biological parents and adoptive parents in the child’s life. Tribal involvement is required and the permanency goal is set by the tribe. It is critical to consult a child’s tribe to understand how the tribe may prioritize these goals. Some tribes may prefer guardianship as a concurrent plan rather than adoption or tribal customary adoption. 7/10/2015

Case Plan Goals (continued)
Long term foster care with relative caregiver Long term foster care Stable foster care with emancipation Non Minor Dependent Youth Additionally, there are three case plan goals included but do not represent true permanency. They are: long term care with a relative caregiver, long term foster care and long term foster care with the goal of the child emancipating from the child welfare system. Non –Minor Dependent Youth are those adults ages who remain in foster care while working towards independence. These youth are legal adults, and are provided support and interventions during this transition time. There are a number of options for the non-minor youth including remaining in the care with whom they were with prior to the age of 18, or different planned living arrangements (college dorm, own apartment, etc.). Check with your supervisor on coding of case plan goals in CWS/CMS when working with non minor dependent youth. While goals are selected initially, family progress and circumstances may require changing the case plan goal. For example: A family may have a reunification goal, but it becomes clear the child will not be reunifying. Another case plan goal is then selected, and for this example, the case plan goal is now adoption. With a new case plan goal, there will be other service objectives and client responsibilities formulated to meet the needs of the child and family. 7/10/2015

Concurrent Planning A plan of reunification and an alternate permanent plan Concurrent planning is a plan of reunification and a simultaneous alternate permanent plan that is enacted if reunification does not occur. An example: Amelia age 8, has been placed with a maternal aunt, while Amelia’s father works towards reunifying with Amelia. The alternate plan will be that Amelia will be adopted by the maternal aunt if the father cannot successfully reunify with Amelia. More information on concurrent planning is provided in the eLearning module “Concurrent Planning”. Concurrent Planning is also a requirement for ICWA compliance. K1 7/10/2015

You will also be documenting the concurrent plan into the CWS/CMS system. This is an example of the screen in the system on where you would input the information about the concurrent plan. You will find more information on the CWS/CMS system in the training module “Introduction to CWS/CMS”. 7/10/2015

Permanency Poorer outcomes for youth who do not achieve permanency
Legal Permanency Life Long Connections and Emotional Permanency “Youth who exit care without a permanent family are at risk for a number of negative outcomes. The Midwest Evaluation on Adult Functioning of Former Foster Youth compared individuals who had aged out of foster care with individuals of the same age in the general population. At age 26, individuals who transitioned out of foster care experienced more unemployment, lower incomes, more economic hardships (e.g., not being able to pay rent or utilities), poorer health, and higher arrest rates than youth of the same age in the general population. (Courtney, Dworsky, Brown, Cary, Love, & Vorhies, 2011). Additionally, individuals formerly in foster care were more likely to not have a high school diploma or GED, not have health insurance, and receive government benefits (Courtney et al., 2011). “ We look for permanency for youth who remain in relative or foster care when guardianships have not been established. While obtaining legal permanency may be challenging, we continue to look for legal permanency as well as seek out opportunities for emotional and life long connections for the child/youth to have as they transition from adolescents into adults. We continue to assist young adults, the non minor dependents, to establish, maintain and in some cases reconnect with life long connections to strengthen life long emotional permanency. For tribal children emotional permanency should include connections to their extended family tribe, culture and community. (Child Welfare Information Gateway, 2013) 7/10/2015

Knowledge Check The process of establishing an alternate permanency path should the primary case plan of reunification fail is known as developing a: Case goal Service objective Concurrent plan Client responsibility 7/10/2015

Case Plan Requirements (continued)
Service Objectives in CWS/CMS – you document behavioral objectives Once the goal has been selected, working with the parents and/or youth on developing the objectives is the next step in the case planning process. The term “service objectives” is the title listed in CWS/CMS and where you will document the concrete behavioral changes that describe what needs to happen to achieve one or more goals of safety, permanency and well being. These objectives must be measurable and time limited, based on the problems and family strengths found in the assessment. Any objectives that can be quickly accomplished to give parents successful experiences helps to keep the family engaged and motivated. Behavioral objectives that are entered into the “service objectives” screen of CMS/CWS should be framed in positive language – what the family member will do differently, rather than what the family member will stop doing. The following example is a behavior objective that meets the goal of safety: “ David agrees to stay free from drugs and alcohol and to show his ability to be free from drug and alcohol dependency. He agrees to complete all drug testing.” 7/10/2015

Case Plan Requirements (cont)
Client Responsibilities Client responsibilities are the action steps for the activities or services to support the service objective. The best case plans are: Tailored to meet the individual’s needs Tailored to address the intervention reasons Culturally relevant Built on strengths Prioritized Specific Available Behavior objectives can be seen as the “destination or end result”. Client responsibilities are the route to getting to the destination/end result. Let’s take a moment to provide an example of a two client responsibilities to the previous service objective: “David agrees to stay free from drugs and alcohol and to show his ability to be free from drug and alcohol dependency. He agrees to complete all drug testing.” Client responsibility: 1) David will discuss with the social worker which step of his 12 Step program he is working on during each visit. 2) David will enroll in drug treatment and fully participate in the program within 30 days. Later in this course we will spend more time developing behavior objectives and client responsibilities within the context of the CWS/CMS system. 7/10/2015

Case Plan Requirements (cont)
Timelines in Meeting the Goals As a social worker, you will become familiar with different requirements and timelines in documenting and completing case plan activities. We will briefly review the following time lines: Juvenile Dependency Court Timelines (with more information being found in the Legal Procedures eLearning module) and Case planning timelines (Welfare and Institutions Code) Completing SDM tools within time frames 7/10/2015

Juvenile Dependency Process
Disposition Hearing Review Hearings hearing Please click on the Handout 2 The Juvenile Court Dependency Process to follow along. The case plan is ordered at the Disposition Hearing and progress, modifying or changing the case plan occurs at review hearings. By statute the disposition hearing is held no more than 10 days after the Jurisdiction hearing if the child is out of home, and no more than 30 days if the child remains home or if the department seeks to deny reunification services. Changes to the case plan can be made either through a scheduled review hearing or ex-parte. Review hearings may be scheduled at anytime, but are generally scheduled at 6 month intervals. Modifications to the case plans include returning a child home, or removing a child from a home, and these can be made through scheduled review hearing. The hearing also known as the Selection and implementation hearing, occurs within 120 days from the date of the order terminating or denying reunification services. A new case plan is required that reflects the new goal, as well as services and activities to achieve the goal. Consult your local policy and procedure manual and your supervisor about changing a case plan and court hearings. If reunification services are terminated at the hearing, then a modification of case plan is required, based on the new case plan goal. 7/10/2015

Knowledge Check The 336.26 hearing is known as the:
Dispositional Hearing Selection and Implementation Hearing Permanency Hearing Jurisdictional Hearing 7/10/2015

Case Planning Timelines
60 days from first face to face contact Within six months and every six months thereafter The social worker has 60 days to complete the initial case plan with the family. The time clock on the 60 days starts on the date of the first face to face contact with any agency social worker and includes weekends and holidays. If the date of the dispositional or “dispo” hearing is held prior to the 60 day time line, the social worker and family must complete the case plan for the dispositional hearing and provide it to the court 48 hours prior to the dispositional hearing. The case plan must be signed by the parent(s), social worker and social worker’s supervisor. The social worker must provide a copy of the case plan to the parent(s). A non minor dependent is also required to sign their case plan. The social worker and family must update the plan within six months of completing the initial plan and every six months thereafter. Case plans may be updated more frequently if needed to assist the child and family to achieve the permanency goal. The case plan must have the same signatures as the initial case plan. A copy must be provided to the parents or non minor dependent. 7/10/2015

Structured Decision Making Tools
Family Strengths and Needs Assessment (FSNA) Reunification Assessment Risk Reassessment Safety Assessment The Structured Decision Making Tools also have timelines for completion. Please download the Handout 3 “California Structured Decision Making Overview.” The overview comes from the SDM Policy and Procedure manual and covers all the tools. For the purposes of this course, please note the deadlines for the following tools: The Family Strengths and Needs Assessment (FSNA) tool is to be completed by the worker responsible for the case plan. If it is a voluntary case plan, the FSNA is to be filled out prior to the completion of the initial case plan. Reviewing and/or modifying the FSNA is to be done within 30 days prior to completing an updated case plan in voluntary cases, and 65 days prior to updating a case plan for a court hearing. The Reunification Assessment tool is to be completed every six months with no more than 65 calendar days prior to the case plan completion or permanency plan change. This tool can be completed sooner if new circumstances or information emerges that affects the risk and/or safety of the child. The Risk Reassessment tool and Safety Assessment tools must be reviewed every six months. In voluntary cases, these tools are to be completed no more than 30 days prior to case plan completion or case closure recommendation. In court cases, the tools are to be completed no more than 65 calendar days prior to the case plan completion or case closure recommendation. This tool can also be completed sooner if new circumstances or information emerges that affect the risk and/or safety of the child. 7/10/2015

Section 2: Developing the Case Plan
Using the standardized assessment Being trauma informed when engaging the family Include a cultural perspective of the family Working towards mutual agreement of the case plan Writing S.M.A.R.T objectives The next section will cover the development of the case plan. The importance of the standardized assessment, how trauma impacts the family and the need to engage the family, including the family’s culture when developing a plan, working with a family towards a mutual agreement of the case plan and writing objectives when developing the case plan. 7/10/2015

Using the Standardized Assessment
The risk and safety assessments as well as the Family Strengths and Needs Assessment inform the case planning process. The assessments help the family to understand the reasons for the need for child welfare intervention. Additionally it assists the social worker and family to determine the behavior objectives and client responsibilities to meet the case plan goal. According to state and federal regulations, the assessment must include: Relevant social, cultural and physical factors Apparent problems requiring intervention, and possible causes of those problems Family strengths Whether the child may safely remain at home if pre-preventative services are provided Any known social services previously offered and/or delivered to the child or family and the result of those services If family reunification services is recommended, relatives or others who could provide or assist with legal permanency – adoption, guardianship, or preparation for independence- should family reunification fail The need, if known for any health/medical care Structured Decision Making Tools provide an organized and standardized method of gathering information and formulating the assessment. The case planning activities are focused based on the assessment. More information on developing and formulating assessments can be found in the eLearning modules “Assessment Procedures 1 and 2.” 7/10/2015

Trauma Informed Case Planning
Past and Current Trauma in Children Trauma Histories in Birth Parents We often can more readily recognize behaviors in children who have experienced trauma in their lives. We understand that when a child has been abused or neglected, this results in trauma and can manifest in many different ways. We understand that when a child is removed from his/her parents and placed in a home that may be unfamiliar to him or her, that a child may exhibit behaviors such as crying, lack of appetite, or depression. For additional information on the impact and symptoms of trauma and what social workers can do, please download the Handout 4 The Impact of Trauma on Children. Additionally, it is important to be aware, that most parents of the children that are in the child welfare system, have also had past and current trauma in their lives. When developing a case plan, a recognition and use of skills on how to work with parents who may have unresolved trauma is essential. Please download the Handout 5 Birth Parents with Trauma History for information. Please note a few of these tips here: “Understand that parents’ anger, fear, or avoidance may be a reaction to their own past traumatic experiences, not to the caseworker him/herself. Assess a parent’s history to understand how past traumatic experiences may inform current functioning and parenting. Build on parents’ desires to be effective in keeping their children safe and reducing their children’s challenging behaviors. Help parents understand the impact of past trauma on current functioning and parenting, while still holding them accountable for the abuse and/or neglect that led to involvement in the system. For many parents, understanding that there is a connection between their past experiences and their present reactions and behavior can empower and motivate them. Pay attention to ways trauma can play out during case conferences, home visits, visits to children in foster care, court hearings, and so forth. Help parents anticipate their possible reactions and develop different ways to respond to stressors and trauma triggers Refer parents to trauma-informed services whenever possible. Parents will be more likely to attend services that address their needs. Generic interventions that do not take into account parents’ underlying trauma issues—such as parenting classes, anger management classes, counseling, or substance abuse groups—may not be effective. Become knowledgeable about evidence-supported trauma interventions to include in service planning. Linkages with programs that deliver trauma-informed services can support caseworkers in developing a plan that meets their clients’ needs.” For ICWA cases, active efforts are required as a remedy for past historic traumas imposed upon American Indians through government policies. Be sure to document your active efforts to ensure ICWA compliance. 7/10/2015

Partnering with the Family
Engagement Practices Engaging and partnering with families in the development of the case plan is critical. Many current practices can be found throughout the state in engaging and working with families. Team Decision Making, Family Group Conferencing, Safety Mapping, Child and Family Team Meetings are a few of the formal ways in partnering with families. Social workers engage and partner with families informally everyday. Let’s take a look at a model that helps us understand where our agency may be on the continuum of engagement and partnership. 7/10/2015

Family Partnership Model
Family Engagement Goal: Engage family in services and improve service utilization Family Involvement: Goal: Involve families at every step of the service delivery and evaluation process Family Partners Goal: Partner with Families by valuing and utlizing their input on par with the providers within agencies. Families have equal voice and input into processes that may continue after they have left services Examples of Family Engagement Strategies: Clarify the helping process for the family Focus on immediate and practical concerns Problem solve potential barriers to services (McKay, Stoewe, McCadam & Gonzales, 1998). Examples of family involvement strategies: Families participate in service planning Families complete satisfaction surveys Families are involved in program evaluation Examples of Family Partner ship: Families serve as equal partners in service planning Families consult on projects Families have genuine participation on advisory boards Please download the Handout 7 Family Partnership Model and follow along. Engagement is defined as helping families to address immediate needs, problem solve and remove barriers, and clarify the child welfare process, so that families will obtain services, and show progress towards the case plan goal. Family involvement is define as the family being actively involved in the service planning, and help evaluate services to best meet their needs in order to meet the case plan goal. Family partnerships is defined as families having an equal voice and input into agency processes, after the family has completed the case plan goal. Ideally, family involvement at all phases of the case planning process enhances chances for successful outcomes. And, families present their unique strengths and challenges, including unresolved trauma which makes family involvement challenging for the worker. Additionally, agency culture, relationships with stakeholders and the courts, and resource availability (including the social worker’s time for the family) play a significant role in engaging and partnering with families. Please talk with your supervisor about strategies and practices of family engagement and partnering within your agency setting. National Child Stress Traumatic Network, Adapted from Chadwick Center for Children and Families, 2009 p.3 7/10/2015

Partnering with the Family
From a cultural humility perspective Tailoring the case plan to the family’s unique culture and addressing one’s own bias is critical as well. Research indicates that African American and Native American children continue to be removed at higher rates, remain in care longer, and reunify with parents at lower rates than the general population. We can note, however, that the trends have been moving in more positive directions. Continued efforts to address systemic and institutional racism, involving community and cultural leaders, as well as professional growth in working with families of different cultures, will provide us with the knowledge, skills and supports to effectively keep children safe in culturally sensitive ways. Knowledge and skill development in ethnographic interviewing, working with families from a cultural humility perspective and continuing to assess for personal bias are but a few of the ways to work in a culturally responsive manner with families. (Needell, 2013) 7/10/2015

Working towards mutual agreement of the case plan
Barriers that may interfere with getting to a mutual agreement Strategies that may enhance getting to a mutual agreement Mix and Match Activity The Engagement modules provided detailed information on engagement and working with families. A brief review on barriers and strategies are below. Match the barrier or strategies in the right column Barriers: Systemic oppression related to ethnic minority status, reduced income and/lower educational attainment Mismatch of needs and services Disagreement about goals of treatment Negative expectations Substance abuse problems Intimate Partner Violence Mental Health problems Basic needs not being met Strategies Solution Focused Interviewing Giving choices Keeping agreements Share all available information with the family Acknowledging all possible outcomes Diffusing anger Valuing family voice Explicitly stating family strengths Focusing on obtainment of skills rather than change in attitude Actively seeking feedback Matching needs to services 7/10/2015

Behavior Objectives and Client Responsibilities
CWS/CMS Developing the case plan with mutual respect and commitment is the heart of the work for the family and the social worker. Ensuring in clear language, what needs to happen, and how it will be done provides the social worker and the family the roadmap for succeeding in meeting the case plan goal. We will begin by focusing on writing clear and behavioral specific behavior objectives, followed by client responsibilities to meet the objectives. Please note that child welfare practice has evolved in such a way, that documenting good behavior objectives and client responsibilities are challenging in the current CWS/CMS system. In order to write and enter these objectives and responsibilities in the system, we recommend utilizing certain screens to customize a family’s case plan. When you are documenting behavior objectives and client responsibilities, please work with your supervisor, for the county specific practice in this area. 7/10/2015

S.M.A.R.T. OBJECTIVES Specific Measurable Achievable Result Focused
Time Limited Using the mnemonic SMART, objectives can be written to clearly convey what needs to happen by when. Let’s review: S- Objectives are Specific – The objective describes a behavior that must occur, or stop occurring before a case is successfully closed. They are statements of the person’s actions. M – Measurable – writing measurable objective is one of the most difficult parts of the case planning process. Some expected outcomes do not lend themselves to easy, precise quantification. Some criteria may be easy to observe but difficult to measure. For example, “ increasing home cleanliness” would not be specific enough, but “the floor be cleared of garbage, debris, food and dirty diapers” provides the measurement for what a clean home may look like. A – Achievable – The objective must be realistic for the family to accomplish them R – Result Focused – The objective should reflect the context of the factors that have put the child/children at risk T – Time Limited – A timeframe within the objective can reasonably be expected to be completed should be included in the objective statement, however time frames may be written into the client responsibilities and charted in the CWS/CMS system. The assignment of a timeframe provides the additional criterion by which the achievement of the objective can be measured. 7/10/2015

Writing Objectives within CWS/CMS
Child Welfare System/Case Management System As previously noted, the current Child Welfare System/Case Management System (CWS/CMS) provides template language for writing service objectives. This can be challenging at times when writing a strength-based service objective. There are ways in which you can personalize the objective to be strength based and family focused. Here are a few examples of “ drop down” language and a reworking of the service objective: Drop Down: Prepare for Independent Living – Alternate – Juan will work closely with the social worker to ensure he will obtain needed skills to live independently. Provide care for child’s special needs – Alternate – Teresa and Tom agree to meet Sally’s special needs. Support placement with potential guardian. – Alternate – The social worker and Henry (the father) will work closely to support Willard’s ( Henry’s son) placement with Jack (Henry’s brother) as the plan is for Jack to become Willard’s guardian. Acquire basic skills to seek employment – Alternate – Geena agrees to work with the Self Sufficiency worker to complete an assessment and develop a training plan to obtain employment. 7/10/2015

SMART Objective Wendy agrees to stay free from drugs and alcohol and show her ability to live free from drug and alcohol dependency. She agrees to comply with all drug tests. The children and extended family will report that they have not seen Wendy high or drunk Wendy agrees to random drug testing and that her drug test will be negative Wendy agrees to discuss what step in her recovery she is working on at each visit with her social worker. Wendy agrees to find a female sponsor who has a minimum of one year sober in a 12 step program The date of completion is the six month date from the signing of the case plan. Let’s look at this objective and illustrate the parts that indicate each part of SMART. S- the objective is specific in the actions Wendy is to do M – the objective is measurable. For example, we can obtain the result of the drug tests A – These are steps than can be completed within a 6 month time frame R – If the steps are taken, these will show that she has the ability to live free from drugs and alcohol T – The activities are to be completed or ongoing during the six month period. 7/10/2015

Here is an example of a CWS/CMS page where you would use the “drop down” feature of the service objective. Please note where the Service Objective Detail is located. That is box in which you would write your detailed, strength based service objective. You will also use the “Additional Description for Participant” box to detail the behaviors that will met the objective. In the previous example: Wendy agrees to stay free from drugs and alcohol and show her ability to live free from drug and alcohol dependency. She agrees to comply with all drug tests, is entered into the Service Objective Box. The activities are entered into the “Additional Description to Participant” box The children and extended family will report that they have not seen Wendy high or drunk Wendy agrees to random drug testing and that her drug test will be negative Wendy agrees to discuss what step in her recovery she is working on at each visit with her social worker. Wendy agrees to find a female sponsor who has a minimum of one year sober in a 12 step program The date of completion is entered into the projected completion box. 7/10/2015

Client Responsibilities
Wendy agrees to stay free from drugs and alcohol and show her ability to live free from drug and alcohol dependency. She agrees to comply with all drug tests. The children and extended family will report that they have not seen Wendy high or drunk Wendy agrees to random drug testing and that her drug test will be negative Wendy agrees to discuss what step in her recovery she is working on at each visit with her social worker. Wendy agrees to find a female sponsor who has a minimum of one year sober in a 12 step program The date of completion is the six month date from the signing of the case plan. Once the objective has been written, then the client responsibilities are formulated. Client responsibilities are how the objective will be done. Client responsibilities are also SMART. There may be one or more client responsibility per service objective. Let’s look at Wendy’s behavioral objective: Wendy agrees to stay free from drugs and alcohol and show her ability to live free from drug and alcohol dependency. She agrees to comply with all drug tests, then more specifically at: Wendy agrees to discuss what step in her recovery she is working on at each visit with her social worker. The client responsibility then is to attend a 12 step recovery program with a description of how the social worker and Wendy will work together on identifying progress in her program. As with service objectives, strength based language in framing the client responsibility is important – what will the desired behavior look like rather than a focus on “stopping” an undesirable behavior. Case Plan Filed Tool (2014) 7/10/2015

In the CWS/CMS screen you identify the “what and how” the objective will be accomplished. Going back to Wendy’s client responsibility, you enter the service in the Category box (Substance Abuse) the Type of service ( 12 step program) , the start and end date, and add the objective from the Behavioral Objective in the “Description/Responsibility for Service”. If known, the provider’s name or program is entered in the “Provider’s” name box. Remember that the CWS/CMS is structured in such a way that it is not as “user friendly” in customizing case plans. Your training region, county and/or supervisor will provide further training on case plan data entry into CWS/CMS. Efforts are currently underway to eventually replace the current system, with a new and innovative system in the next several years. 7/10/2015

Section 3: Implementing the Case Plan
Reasonable vs Active Efforts The social worker must provide reasonable and active efforts to assist the family to achieve the case plan goal. Let us review the concepts and legal basis for reasonable and active efforts. According to the U.S. Department of Health and Human Services Administration for Children and Families: “The concept of reasonable efforts does not have a standard definition because reasonable efforts are to be determined on a case by case basis by the court. Section 471 (e)(15) of the Social Security Act notes that the child’s health and safety are paramount concerns in the determination of active efforts.” While “reasonable” is not defined, it means the social worker and child welfare agency must make concerted efforts to engage the family and help them access relevant services that will help the family make a safer home for their children in order to prevent placement or, if placement occurs, to reunify. “Reasonable” may be different for different families or youth ( e.g., parents with developmental disabilities, minor parents). 7/10/2015

Reasonable vs active efforts
ICWA The Indian Child Welfare Act of 1978 require active efforts on the part of the social worker in working with Native American children and families. Like reasonable efforts, the definition of "active efforts" is left open in the Indian Child Welfare Act to accommodate individual case decisions. The ICWA mandate that active efforts be made in two areas. “ Provide services to the family to prevent removal of an Indian child from his or her parent or Indian custodian and Reunify an Indian child with his or her parent or Indian custodian after removal A cornerstone in the application of active efforts is active and early participation and consultation with the child’s tribe in all case planning decisions. Additionally, active efforts is more intensive than ‘reasonable efforts.’ The Bureau of Indian Affairs has released updated guidelines on examples active efforts on 2/25/ Please download Handout 6 “Active Efforts” for more detail. Let’s look at a couple of examples. Reasonable efforts might be only a referral for services, but active efforts would be to arrange for the best-fitting services and help families engage in those services. Another example of reasonable vs active efforts: Reasonable efforts – providing bus tokens for transportation for a mother to attend a school meeting regarding her son who is in placement. Active efforts – ensuring the mother has transportation via a relative, or providing a social service aide to transport mother to a school meeting regarding her son. Remember, active efforts are required as a remedy for past historic traumas imposed upon American Indians through government policies. Be sure to document your active efforts to ensure ICWA compliance. 7/10/2015

Reasonable vs active efforts
Documentation You must document the reasonable and/or active efforts have been made to prevent placement, whenever placement is recommended and when working towards reunification. These efforts are documented in CWS/CMS. If you recommend to the court that a child should not reunify with his/her family and are asking to implement the alternate plan, the court will examine closely your efforts and documentation and will determine if reasonable or active efforts have been made. 7/10/2015

Knowledge check Reasonable vs active efforts
Interpretation of what constitutes reasonable vs active efforts can be challenging, because the law allows for efforts to be applied on a case by case basis. We can however, look at approximations of what would constitute reasonable vs active efforts. It is good practice to deliver active efforts to all families. Match the following social work activities to the approximation of reasonable or active efforts. Mailing a list of agencies for a mother to contact regarding child care (reasonable) Offering to contact three child care providers on behalf of a parent who is hard of hearing (active) Setting up visitation at an office (reasonable) Observing and providing feedback to a parent during a visitation session (active) Giving bus tokens to a youth to attend a ILS class (reasonable) Providing transportation for a youth to attend ILS class (active) Having care providers arrange sibling visits among themselves (reasonable) Engaging care providers in a visitation plan with activities for siblings (active) 7/10/2015

Implementing the Case Plan
Prioritizing It is important when developing service objectives and client responsibilities, that the plan be reasonable and doable. Having too many objectives and/or client responsibilities can overwhelm a family and could potentially set them up for failure. Achieving the minimum sufficient level of care for returning a child home, requires a focused and reasonable case plan. Even with a reasonable case plan, parents and youth may feel overwhelmed with the number of activities to address within a set timeframe. Partnering with parents and youth to identify high priority needs and what can be worked on first, will be important to discuss in the initial and ongoing visits. Generally, those activities addressing basic needs would be prioritized first. Does the family have basics needs such as food, clothing and shelter? Acute medical, mental health and needs for safety may need to be prioritized first. Does the child have pain from lack of dental care? Does the victim of interpersonal violence need to go to a shelter? Is the father suffering from suicidal thoughts? Look to prioritize case plan activities that will increase safety of the child and build protective capacities of the parent. Activities such as substance abuse treatment, parenting classes and trauma focused treatment may be important to address the parents underlying needs to better build protective capacities. 7/10/2015

Implementing the Case Plan
Additional Legal Requirements ICWA ILP Child Well-being Efforts Face to face visits There are other requirements to be aware of when developing and implementing a case plan. If the family is eligible for services under the Indian Child Welfare Act, there are additional case planning requirements you must address. One such requirement is noticing and working with the child’s tribe on the case plan. More information may be found in the Indian Child Welfare Act eLearning and classroom modules. Youth ages 16 to 18 are required as part of their case plan, and Independent Living services to assist emerging young adults towards living independently as adults. Services must be documented in the case plan and in the Transitional Independent Living Plan (TILP). The TILP is a required pat of the case plan for all youth over age 15 ½ in out of home care. We have previously focused on service objectives and client responsibilities as it relates the goal of safety. Service objectives, client responsibilities and updates on child well being are also important in development and implementation of the case plan. If the child needs mental or behavioral health services, medical needs, specialized services for disabilities, these would be identified and addressed within the case plan. You can also incorporate activities that may enhance a child’s gifts or talents. Check with your supervisor and local policy and procedure in providing services for enhancement activities. Face to face visits must be documented in CMS/CWS. During reunification monthly visits are required with the child and parent with whom the child is to be reunified. Please check with your supervisor for any exceptions to monthly visits. 7/10/2015

Legal Requirements Educational Stability Requirements
In 2003, Assembly Bill 490 established Educational Rights for children and youth in out of home care. For detailed information please download the Handout 8 Overview of AB 490 for Case Workers. While many requirements pertain to a youth or child entering into care, other aspects of the law will need to be addressed during the development and implementation of the case plan. The guiding principles are: a duty to foster educational progress of children and youth in out of home care and to work with all stakeholders, families and children to ensure stable school placements and a meaningful opportunity for youth in out-of-home care to meet the same academic achievements to which all students in California are held. Efforts that help children and youth meet academic achievement include but are not limited to: Considering placement options in proximity of the child or youth’s current school That children and youth in out-of-home care have the same opportunities and resources as their counterparts Allowing the child to remain in the school of origin during a school calendar year if a child has been removed and placed outside of the boundaries. Immediate enrollment of a child who has been placed in out of home care, even when specific records or requirements are not immediately available for processing the enrollment Ensuring that there is a responsible adult to address the child’s educational plan Attending educational team meetings Assist in the Individual Education Plan (IEP) of a child or youth. Please consult with your supervisor on local policy and procedure as well as resources to help children and youth attain academic stability and achievement. 7/10/2015

Legal Requirements Behavioral Health Needs
The US District Court established that children and youth are entitled to mental health services when entering the child welfare system. Known as the “Katie A. vs Bonta”, the lawsuit “was first filed in July of 2002 as a class action suit on behalf of children who were not given proper services by both the child protective system and the mental health system in California.” (1)The plaintiff, Katie A., was a 14-year old Caucasian girl in She was removed from her home at age four and had been in foster care for 10 years. At age five, assessments of Katie indicated that she was a victim of trauma and needed intensive trauma treatment and supportive services for her caregiver. From the age of eight, Katie was placed almost solely in congregate care facilities despite the fact that multiple assessments and recommendations from mental health professionals showed that she responded best to one-on-one attention, and had difficulty with peer relations. She was moved through 37 different placements, including four group homes, 19 different stays at psychiatric hospitals, a two-year stay at Metropolitan State Hospital, and seven different stays at MacLaren Children’s Center. She never received trauma treatment or other individualized outpatient mental health services. The lawsuit alleged that these experiences led to her emotional and educational deterioration. A group of public interest law firms filed on behalf of a class of children in California who were: (1) in foster care or were at imminent risk of foster care placement, (2) had a mental illness or condition documented through assessments, and (3) needed individualized mental health services.” (1) Los Angeles County settled the lawsuit in 2003 and the State of California settled in 2011. (1) (California Social Work Education Center Retrieved 8/26/2014) 7/10/2015

Legal Requirements Behavioral Health Needs
As of 2011, counties have planned and implemented policies, procedures, programs and practices to address the behavioral health needs of children and youth entering into the child welfare system. Efforts continue to evolve at the state and local county level on how best to serve the needs of these children and their families. A partial list is included here, however, it is important to speak with your supervisor about the local policies and practices in meeting the behavioral health needs of children and youth. Please seek out additional training on this important change in child welfare practice. Partnering with local Mental and Behavioral Health programs and staff – County child welfare and behavioral health departments have been collaborating to provide comprehensive and coordinated services to families. Child and Family Teams (CFT) –the formation of a team, inclusive of the child and family to develop a comprehensive plan to address behavioral health needs. The family and child voice and choice are sought and central in planning and implementation of needed behavioral health services to address the well being. The child and family teams may include professionals, family members, friends, community members, etc. CFTs are staffed and run according to local county policy and resources. Mental and Behavioral Health Screening – Counties have developed policy and procedures for screening children and youth who are entering the child welfare system for behavioral health needs. Providing trauma informed, evidenced based behavioral health services – A recognition that children and youth entering into the child welfare system have most likely been traumatized and that services should be delivered with this in mind. 7/10/2015

Section 4: Other Case Plan Requirements
Assessment of placement needs Visitation and Family Time Social Work contact with Substitute Caregiver Child well-being information Explanation and progress of special placement circumstances When there is a child or children who are place out of the home, other case plan requirements need to be completed and documented. This includes: Assessing the child’s placement needs. Does the child have special needs requiring special care? For example, a medically fragile child may require a specialized foster care placement, until the child is stabilized. Visitation and family time. A scheduled time of visitation and family time between the child and family will need to be planned for and implemented. More information on visitation and family time can be found in the eLearning module, Visitation and Family Time. A plan to work with the caregiver on the permanency plan for the child. Is it reunification? Does the caregiver understand and support the goal? How does the caregiver support the goal? Child well being information. We have previously reviewed educational and behavioral health needs. Additionally, information on medical needs and other activities and achievements ( sports, music, art, etc) should be documented in CWS/CMS as well as in review reports to the court. Explanation and progress in special placements. Is the child needing group home care? Why does the child need this care? What is the plan for moving to a lower level of care, or towards reunification? 7/10/2015

Case Plan Updates CMS/CWS
Case plan updates are recorded in CMS/CWS and summarized in court review hearing documents. More information and detail on monitoring, adapting and updating a case plan may be found in “Monitoring and Adapting Case Plans” eLearning module. 7/10/2015

Section 5: Case Scenario
Marcus and Marissa Please download the Handout 9 Case Scenario: Marcus and Marissa, review the scenario and answer the following questions: 7/10/2015

What is missing from the following objective: S. M. A. R. or T ?
The social worker will work with Marcus, Kelly and Sharon Henderson and Jenna Madsen to make sure the Marcus is both physically and psychologically safe during visitation. The Hendersons and Ms. Madsen will meet within 10 days to develop a visitation and family time plan, including dates, locations and hours. The Hendersons will supervise the family time visits until the social worker has evaluated the visits. The social worker will observe Jenna and Marcus on 2 visitation and family times and provide feedback to Jenna on strengths and areas of concern on her parenting. The social worker will have face to face contact with Marcus and the Henderson’s on a monthly basis to address Marcus’s feelings and concerns about visitation and family time with his mother. E is the correct answer. There is no information on when the objective is to be completed. Specific Measurable Achievable Result Focused Timely 7/10/2015

What legal requirement still needs to be addressed in this family
What legal requirement still needs to be addressed in this family? Check all that apply Independent Living Skills Educational Stability Indian Child Welfare Act Concurrent Plan Contact and a plan with Marissa’s father C and E. Marcus is too young for Independent Living Skills, and his educational stability is being addressed as he is attending the same elementary school that he had previously attended prior to being placed with the Hendersons. A specific plan to either reunify Marissa with her father or relinquishment of his legal rights needs to be explored. A concurrent plan is a practice that is cited as helping children achieve permanency, and is addressed in this case scenario. Marcus’s father is identified as belonging to the San Miguel Band of Indians. Marcus may come under the Indian Child Welfare Act (ICWA) and this would need to be researched by notifying the San Miguel Band of Indians to determine if Marcus is a member of the tribe. If Marcus is ICWA eligible, all ICWA legal requirements will need to be followed. Please note that with the Bureau of Indian Affairs (BIA) guidelines established on 2/25/2015, ICWA must be applied until it is determined that the child is not eligible under the Act. If Marcus is ineligible, the “spirit” of ICWA is that his current caregivers provide opportunities for Marcus to learn and participate in Native American activities to learn about his heritage. 7/10/2015

What statement below best fits the definition of a client responsibility for Marissa’s negative behaviors? The social worker will work with the caregivers to help them partner with biological parent. The caregivers will work with Marissa on managing her negative behaviors. The social worker will work with the therapist to decrease Marissa’s negative behaviors. The parent and caregiver will attend 8 sessions of parenting coaching at the South Bay Service Center. D is correct. This activity specifies the “how” of learning parenting skills for Marissa’s current negative behaviors. 7/10/2015

What is the best fit of the following activities to meet the following behavioral objective? The social worker will work with the caregivers to help them partner with biological parent. Within 30 days, the social worker will have a meeting with the caregiver and biological parent. Within 30 days, the social worker will have a biological parent/caregiver meeting to develop a visitation plan. Within 30 days, the social worker will have a meeting to discuss the concurrent plan with the biological parent. Within 30 days, the social worker will have a meeting with the caregivers about their concerns with the biological parent. The correct answer is B. A joint meeting to discuss a specific service that impacts the parent, child and caregiver, with input from all sides, helps foster a partnership between the caregiver and biological parent. 7/10/2015

Summary This course has covered the basics of case planning. Legal requirements, components of a case plan and writing service objectives and client responsibilities have been reviewed. Information on developing case plans from an assessment as well as ensuring that case plans help families meet the minimum sufficient level of care to safely care for their children have been presented. Factors that impact effective case planning including engagement, being trauma informed, developing culturally congruent plans and prioritizing the case plan activities have been presented. To ensure that you are meeting your local county case planning policy and procedure, please consult with your supervisor. For a copy of the bibliography for this course please download Handout 10 Bibliography. 7/10/2015

Resources California Child Welfare Indicators Project Child Welfare Information Gateway – Child-centered Casework Practice National Center for Permanency and Family Connections National Child Traumatic Stress Network –Child Welfare System 7/10/2015

Question 1 Case plans must be formulate no later than ___ days from the first face to face contact. 30 45 60 75 C is the correct answer 7/10/2015

Question 2 The social standard for the minimum of parent behavior below which a home is inadequate for the care of a child is called: Minimum Standard Level of Care Minimum Statewide Level of Care Minimum Sufficient Level of Care Minimum Community Level of Care 7/10/2015

Question 3 Of the following goals, which is considered to not be a true permanency goal? Guardianship Adoption Long Term Care Reunification 7/10/2015

Question 4 What factor(s) impact the case planning process? Check all that apply: Culture of the family Past trauma Substance abuse Family supports The response is that all apply 7/10/2015

Question 5 The 366.26 hearing in Juvenile Court is also known as the:
Dispositional Hearing Selection and Implementation Hearing Jurisdictional Hearing Post Permanency Hearing 7/10/2015

Question 6 Arranging the case plan activities to best meet the family’s circumstances is known as ______. Prioritizing Selecting Sequencing Planning 7/10/2015

Question 7 The “how” of the case plan – what families will do to meet the sufficient level of care for children is known as: Case objectives Service responsibilities Service objectives Client responsibilities 7/10/2015

Question 8 Legal Requirements in that need to be addressed in the case plan. (Check all that apply). ICWA Educational Stability Parent’s History Independent Living Skills 7/10/2015

Question 9 Paul agrees to take steps to find and keep a legal source of income, is considered part of a: Case plan goal Service objective Client responsibility Planned service 7/10/2015

Question 10 The A in SMART objectives refers to: Accessible Accurate
Achievable Aptly 7/10/2015

Case Planning Basics Version 3.0

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Case Planning Basics Version 3.0

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