B. Case Review System
Item 25: Written Case Plan.
Ohio provides a process that ensures that each child has a written case plan, to be developed jointly with the child, when appropriate, and the child’s parent(s), that included the required provisions.
Policy
ORC § 2151.41.2 requires PCSAs and PCPAs to prepare and maintain a case plan for any child and family who are receiving services from the agency. The only exception to this requirement is when a private child placing agency (PCPA) is providing services to a child who is subject to a voluntary permanent agreement and the child is less than six months of age.
In-Home Voluntary Cases
When PCSAs are providing in-home supportive services without a court order, a case plan is developed when: the case resolution indicates the need for services and the parent, guardian, or custodian has agreed upon the provision of supportive services; or the parent, guardian, or custodian has agreed upon the provision of supportive services. The case plan must be completed no later than sixty days after the case resolution indicates the need for services and when the parent, guardian, or custodian has requested services. The child’s parent, guardian, or custodian and child, if age appropriate, are provided with the opportunity to participate in the joint development, implementation and review of the case plan.
There has to be agreement on the contents of the case plan and signatures obtained on the case plan prior to implementation. All parties receive a copy of the case plan. The case plan is to be amended when there are changes in the conditions of the child and his parent, guardian, or custodian which are affecting the provision of supportive services, the review of the risk assessment has resulted in a change in risk to the child or the child is placed in out-of-home care. The PCSA may implement the amendment once the parent has agreed to the change and attempt to obtain signatures of the parent for amendments. When there is no longer agreement to the provisions contained in the case plan the agency either discontinues services or if the child is an abused, neglected, or dependent child, or is threatened to become an abused, neglected, or dependent requests court intervention. (ORC 5101:2-39-08, 5101:2-38-01)
Case plan goals and objectives are reviewed monthly with the family during worker visits and formal review occurs at the SAR. Upon implementation of CAPMIS, agencies are responsible for conducting case reviews every 90 days. The purpose of the Case Review is to ensure that continued efforts are being made to: assess child safety; evaluate the effectiveness of supportive services offered and provided to the child, his parent, or pre-finalized adoptive parent; identify barriers to the provision of services; and prevent placement, whenever possible, of the child in out-of-home care. At the time of case closure the agency notifies the child’s parents.
Court Involved Cases
Cases that come to the attention of the court require PCSAs and PCPAs to develop case plans under the following circumstances:
• The child and his parent, guardian, or custodian, or if applicable, pre-finalized adoptive parent does not attend a detention or shelter care hearing and the complaint alleged that a child was abused, neglected, or dependent.
• A complaint is filed by the PCSA alleging that the child is an abused, neglected or dependent child.
• The PCSA/PCPA has court ordered temporary or permanent custody of the child.
• The court ordered the PCSA to provide protective supervision for a child living in his own home.
• The court orders the PCSA to place the child in a planned permanent living arrangement.
Under the above mentioned circumstances, the case plan shall be filed with the court either 30 days after the adjudicatory hearing on the complaint or the date of the dispositional hearing on the complaint, whichever occurs first ( ORC § 2151.41.2, 5101:2-39-08.1, 5101:2-38-05). The case plan is based on the
assessment of risk to the child and any other information obtained. Once the court has journalized the case plan all parties are bound by the conditions of the case plan.
The following parties are responsible for working with the agency in developing, implementing and reviewing the case plan: child’s parent, guardian, or custodian; the child’s prefinallized adoptive parent, if applicable; the child’s guardian ad litem and/or court appointed attorney, if one has been appointed; the child, if age appropriate; and the Indian tribe and extended relatives as defined by the child’s tribe, if applicable. The substitute caregiver is also provided with an opportunity to develop, implement, and review the case plan.
The agency or any other party may request a change to the case plan by filing a proposed change with the court. Case plans are reviewed during monthly visits with the family and formal reviews occur during the semiannual administrative review. As PCSAs are implementing CAPMIS case plans will be reviewed during the case review which is to occur every 90 days.
Practice
PCSAs jointly attempt to collaborate with the child’s parent and child (if age appropriate) so that each case plan is unique to the individual family based on their needs. This occurs through both written and verbal communication with the parent and child to extend an invitation to attend meetings to discuss the development to the case plan, identify the families' strengths and weaknesses, and the services that are available to address these areas. This collaborative effort engages both the parent and child in the case planning process. This is a philosophy that a family-centered approach to engaging the family increases the families' readiness and ability to change.
Through the CPOE process, case record reviews have documented disparity amongst the PCSAs in the level of collaboration and attempts to collaborate with the family in the case planning process. This disparity occurred between cases in which the family was receiving in-home or court ordered supportive services. The previous CFSR identified the case plan document did not adequately reflect the activity or level of attempts a PCSA may make in engaging the family in the case planning process. Additionally, the six month time period to review services identified in the case plan for a family was been identified as a barrier.
A collaboration of state staff and PCSAs tackled the issues with the case plan document in an effort to encourage caseworkers to engage the family in the case planning process and to have a document easier for the families to comprehend and ultimately, adhere to.
The CAPMIS pilot counties also identified the Case Review as an opportunity to assist the caseworker in engaging the family in the case planning process. Since more frequent reviews of the progress or lack of progress occurs, caseworkers are more likely to recognize in a shorter time frame the progress the family has made. Furthermore, if the progress is not being made, the caseworker and supervisor are given an opportunity to analyze the barriers towards progress. The barriers may include the unavailability of needed services, the inappropriateness of the provided services, or communication issues between the PCSA and the family. If these issues are examined sooner and more frequently, child safety, permanency and well-being are enhanced. Two of the four CAPMIS pilot counties chose to share and discuss the Case Review directly with the family. This activity demonstrates an increased level of engagement of the family in the case planning process.
Changes in Practice
Many changes have occurred within the State since the last CFSR PIP. CAPMIS is replacing the Family Decision Making Model, which has been implemented in Ohio since January 1998 to assess families that come to the attention of Ohio's child welfare system. CAPMIS is a structured assessment and decision-support model consisting of a series of nine tools utilized at crucial points of a case within the child welfare system. It assists workers in making accurate and effective decisions at key decision-making points throughout the life of a case, promoting child safety, permanence, and well-being. CAPMIS provides a comprehensive assessment of safety and risk. CAPMIS contains the first formal safety assessment protocol which will impact child safety in Ohio. The development and implementation of
CAPMIS was designed to better serve Ohio's children and families while impacting positively on the outcome measures.
OAC rules were developed in order to support the application of CAPMIS. OAC rule enhancements addressed the frequency of worker and parent visits, requirements of where they must meet, and what the meeting will address. A rule is currently under development to address caseworker visits and contacts with children in substitute care. The development of policy to address this area through new performance standards related to the visitation of children in substitute care provides improved direction for caseworkers. These policies are designed to promote child safety and well-being while the child is in substitute care.
Additionally, State and county PCSA staff collaborated in a workgroup from July 2004 until January 2005 to develop an outcome based home visit tool. This tool, known as “Task List,” will be used by workers during home visits with the family while in the field. Use of the “Task List” will enable workers to break down broad case plan objectives into smaller, more easily managed activities; serve as a means to document tasks that are to be completed (by the family or the worker) between home visits; and help track progress towards meeting the case plan objectives. This “Task List” was incorporated into the Child Protection Services Worker Manual which was distributed to PCSA caseworkers and supervisors during CAPMIS readiness training. The manual is also available on the eManuals website. Through the workgroup, revisions to the case plan were made to attempt to make it more family-friendly.
Methods and Supports for Engaging both Parents and Children in Case Planning
As a result of Ohio being a state supervised, county administered system, casework practice and resources differ from county to county. Many PCSAs have embraced the family team decision making philosophy and invite families to participate in case planning meetings where the caseworker and the family, meet to discuss the case plan goals and activities. Many times these meetings also include the family's support system. Other PCSAs have a more informal approach to engaging families in the case planning process.
Nonetheless, OAC rules provide guidance to PCSAs that the parent and children must be given the opportunity to participate in the development of the case plan, to sign the case plan indicating their agreement, and to review the case plan. Rule does not dictate the manner in which this is accomplished nor does it differentiate how the caseworker engages with parents who are receiving in-home services versus substitute care. If a child is in substitute care, the caseworker must also engage the substitute caregiver in case planning. The case planning process is unique for each county.
Although the only review of case plan services the PCSA must invite the family to attend is the SAR, many PCSAs invite families to review the case plan on a more frequent basis. The Case Review Tool has been developed to review a family's case plan services, safety, and risk. Although rule does not specify that this must be done with the family, many PCSAs are discussing the Case Review with the family, either formally, through a meeting, or informally, during home visits with the family. As stated previously, the family, as well as others who are pertinent to the case (e.g., foster parents, service providers) is invited to the SAR. The SAR is held every six months. The parents have the opportunity to sign the SAR and are required to receive a copy of the document.
The caseworker is expected to review the case plan during each face-to-face contact with the family.
Caseworkers are required to have face-to-face contact with the parent and child being serviced through the case plan at least monthly. One contact every two months must be made in the child's home. The purpose of the face-to-face contact is to monitor progress on case plan objectives.
Many agencies have developed internal policies regarding locating and engaging absent parents in the case planning process. At this time, OAC rule does not specifically mandate that absent parents be located and engaged in the case planning process.
Evaluation
The Quality Assurance System for determination of PCSA compliance with ORC and OAC requirements governing case planning is the CPOE Review (Refer to Item # 31 for a detailed description of CPOE). In
addition, for cases which are brought before the court, there is extensive on on-going review of the case plan prior to journalizing the plan. Some courts have requested agencies to make changes to the case plan prior to journalizing the plan.
Measures of Effectiveness
During development of the CFSR PIP, a baseline was established to measure the level of improvement in engaging families and children in the case planning process. The baseline data was based upon 44 CPOE Stage 5 reviews completed and were separated into three (3) categories of ongoing services: in-home supportive services; protective supervision (court-ordered in-in-home services); and substitute care.
The baseline data was reported in the second quarterly PIP report of July 2004.
At that time, the baseline established was as follows:
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan
In-home Supportive 85%
Services
PCSA obtained agreement on the content of the case
plan and provided a copy to the parents and/or child 72%
Protective Supervision
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan and provided each with a copy.
71%
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan
70%
Substitute Care
Documentation that the PCSA provided notice to the substitute caregiver of the opportunity to participate in the development of the case plan
53%
When all 88 PCSAs were reviewed for CPOE Stage 5, the statewide performance percentages for the three (3) categories were as follows:
Documentation that the PCSA provided parents and/or child, the opportunity to participate in the development of the case plan
In-home Supportive 84%
Services
PCSA obtained agreement on the content of the case
plan and provided a copy to the parents and/or child 71%
Protective Supervision
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan and provided each with a copy.
67%
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan
69%
Substitute Care
Documentation that the PCSA provided notice to the substitute caregiver of the opportunity to participate in the development of the case plan
56%
PCSAs achieving less than 90% compliance on the performance measure for CPOE Stage V were required to complete a QIP outlining strategies the agency will implement to improve their compliance rates.
Results of 84 counties reviewed during CPOE Stage 6 are as follows:
Documentation that the PCSA provided parents and/or child, the opportunity to participate in the development of the case plan
87.5%
In-home Supportive Services
PCSA obtained agreement on the content of the case
plan and provided a copy to the parents and/or child 83.8%
Protective Supervision
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan and provided each with a copy.
69.4%
Documentation that the PCSA provided parents and/or child the opportunity to participate in the development of the case plan
70.3%
Substitute Care
Documentation that the PCSA provided notice to the substitute caregiver of the opportunity to participate in the development of the case plan
59.6%
Strengths and Promising Approaches
A collaborative effort with the Supreme Court of Ohio Task Force and a Subcommittee on Responding to Child Abuse, Neglect, and Dependency was established to determine if Ohio’s statutory guidelines for the investigation and prosecution of child abuse and neglect properly serve children and families in need of government intervention; make statutory and administrative recommendations to improve Ohio’s system for accepting and investigating reports of child abuse and neglect; and make recommendations to standardize and make uniform Ohio statutes regarding abuse, neglect, and dependency cases. After an eighteen (18) month study, the Subcommittee made a series of recommendations which include rewriting the language of the ORC that defines categories and dispositions of child abuse and neglect to move to a
“Child in Need of Protective Services” model; and establish an Alternative Response System for responding to reports of suspected child abuse and neglect. The establishment of an Alternative Response system is also intended to influence the type of contact and level of engagement a caseworker has with a family. The focus of an investigation is used on the most serious cases, which are likely to be a collaborative effort between the PCSA and law enforcement as a result of the likelihood of criminal charges. All other cases would be served along a Family Assessment track in which the PCSA would utilize a more friendly approach. A study of the state of Minnesota's Alternative Response system, which Ohio is using as a model in the development and evaluative phase of the initiative, found that a Family Assessment track and the provision of post-assessment services led to increased positive attitudes among families, along with reduced levels of future child abuse and neglect reports. The Family Assessment track and the focus on how a caseworker interacts with the family are likely to result in improvement for Ohio in engaging the family in the case planning process.
The Ohio Child Welfare Training Program (OCWTP) also amended required Caseworker Core training include the following Core Modules to address case planning:
• Caseworker Core Module 2- focuses on engagement in family centered child protective services.
• The Module 2 Learning Lab focuses on skills in engaging families in family assessment and case planning.
• Caseworker Core Module 3- Legal Issues – emphasize father’s rights and working with fathers.
• Caseworker Core Module 4- teaches safety, risk and family assessments.
• Caseworker Core Module 6- addresses engaging fathers.
The court is a critical collaborator in case planning with families and evaluation of progress made by families. Additionally, many PCSAs have collaborated with their local child support office in an effort to locate absent parents. The Ohio Child Welfare Training Program has revised the Family Centered
Casework Core Workshops to incorporate the philosophy of engagement of the family in the case planning process.
Barriers
The turnover of casework staff at the local level continues to be an issue that could be affecting the success of Ohio in achieving an increases rate of parental involvement in the case planning process. Continued staff
The turnover of casework staff at the local level continues to be an issue that could be affecting the success of Ohio in achieving an increases rate of parental involvement in the case planning process. Continued staff