INSTRUCTIONS TO STAFF 340:75-1-151
1. (a) Referral focus for CHBS. Form OCS-1, Oklahoma Children's Services (OCS) Referral, is accessed via KIDS Service Log. The referring Child Welfare (CW) specialist chooses the focus of service that corresponds to the case plan. Comprehensive Home-Based Services (CHBS) include:
(1) voluntary services to strengthen parental protective capacities to maintain the child safely in the child's own home;
(2) trial adoptive placement maintenance;
(3) kinship placement maintenance;
(4) out-of-home permanent placement maintenance;
(5) reunification; and
(6) post-legal adoption maintenance.
(b) Criteria for CHBS referrals. CHBS referrals are appropriate for:
(1) a voluntary services case when:
(A) at least one child in the family is assessed as unsafe;
(B) the family is cooperative and likely to meet the case plan goals with comprehensive and time-limited services;
(C) the family does not require assistance to meet a singular need; and
(D) no pervasive safety concern exists such as a custodial parent who is habitually unwilling or unable to protect the child; and
(E) other less intensive services within the community are exhausted or it is established that community resources are not sufficient to avert the child's placement in out-of-home care;
(2) a voluntary services case when:
(A) the criteria in (1) are met; and
(B) the child is residing outside of the home as part of the safety plan; however, the CW specialist maintains an open family-centered services case until after the child returns to the parent's home and is considered safe;
(3) reunification services for a family who has an active court case, including cases where the child has been removed, may be removed, or has been returned to the home;
(4) maintenance services for permanent placement in a kinship, adoptive, or trial adoptive home at risk of disruption due to the child's acting-out behavior. When the disruption is due to the caregiver's behavior, the referral is discussed with and approved by the resource specialist responsible for maintaining the resource home; or
(5) foster or adoptive home maintenance when the child has an established connection or attachment to the resource family; however, CHBS is not used to maintain therapeutic placements or to rectify paid placement providers' deficient parenting skills.
(c) Exceptions to CHBS criteria. A formal staffing with the CW supervisor is required for exceptions to the referral criteria. Oklahoma Children's Services (OCS) contract liaisons may request justification for utilizing CHBS and have the authority to reject any referral.
(d) CHBS OCS contract liaison referral guidelines. Contract liaisons are gatekeepers responsible for priority decisions to ensure OCS resources serve the families most in need. When the approved referral is incomplete, or a service other than CHBS is more appropriate for the family, the contract liaison contacts the CW specialist and supervisor for additional information or to recommend a more appropriate intervention. CHBS is not specified as a required service in the Individualized Service Plan. Contract liaisons use guidelines in (1) through (11) to determine appropriate referrals for CHBS.
(1) Physical abuse.
(A) A CHBS referral is appropriate in a physical abuse case when:
(i) the child has been injured but the injury is not serious per OAC 340:75-3-2, and the child is safe to remain in the home with a safety plan until the specified person responsible for child (PRFC) can protect the child; or
(ii) an older child refuses to return home due to a conflict with a parent that escalated to physical injury, and family members agree to work cooperatively with CHBS to resolve the conflict.
(B) A CHBS referral is not appropriate in a physical abuse case when:
(i) physical abuse to the child is considered serious or life-threatening per OAC 340:75-3-2;
(ii) a physical abuse history exists and no PRFC is willing or able to protect the child;
(iii) the person responsible for the injury to the child remains in the home and does not accept responsibility or demonstrate a desire to change the abusive behavior; or
(iv) an infant has been intentionally injured.
(2) Sexual abuse.
(A) A CHBS referral is appropriate in a sexual abuse case when:
(i) the perpetrator has left or no longer frequents the home, in the case of sexual abuse by a household member or frequent visitor, and a safety plan is in place;
(ii) the perpetrator is incarcerated or a court order exists preventing him or her from accessing the child; or
(iii) the non-abusive PRFC verbalizes and demonstrates his or her willingness to protect the child and accepts CHBS.
(B) A CHBS referral is not appropriate in a sexual abuse case when:
(i) the non-offending PRFC places the child at risk of further victimization by allowing a known sexual abuse perpetrator access to the child;
(ii) sexual abuse involves multiple members of the family jointly engaging in sexual activity;
(iii) the PRFC denies the child is unsafe and does not agree that treatment is necessary;
(iv) the perpetrator of the sexual abuse returns to the home without court approval; or
(v) the PRFC's engagement in activities such as prostitution, extensive involvement with pornography, or association with those who participate in such activities places the child in continued danger of further sexual abuse victimization.
(A) A CHBS referral is appropriate in a serious neglect case when a safety plan controls the safety threats and the PRFC or family is willing and able to participate in CHBS. Examples include:
(i) a child younger than 12 years of age is left alone or is left in the care of an inappropriate caregiver on a regular basis;
(ii) the PRFC is overwhelmed and neglects the child's physiological needs;
(iii) the child is diagnosed as underweight or potentially failure to thrive but the condition is not considered serious or life-threatening and is best addressed by educating the PRFC about emotional nurturing, proper nutrition, and feeding techniques;
(iv) the PRFC medically neglects or fails to address the health needs of an ill child and health care education is likely to strengthen the PRFC's protective capacities.
(v) the refuses to allow the child with adolescent acting-out behaviors to stay or return home due to serious parent and child conflict that requires a CW response; or
(vi) housing conditions cause the child to be unsafe and relocation or prompt repairs are likely to prevent the need for the child's removal from the home.
(B) A CHBS referral is not appropriate in a neglect case when:
(i) neglect is long-term, chronic and has not resolved with multiple prior CW intervention services including CHBS;
(ii) the PRFC does not acknowledge a problem exists, does not want assistance, appears to be seriously mentally ill, or exhibits evidence of significant substance abuse; or
(iii) neglect is considered life-threatening.
(4) Substance abuse.
(A) A CHBS referral is appropriate in a substance abuse case when:
(i) the PRFC acknowledges that his or her drug abuse or dependency threatens the child's safety is willing to enter outpatient treatment for the substance abuse problem, and agrees to cooperate with CHBS to address the child's needs;
(ii) a child in the family is chemically dependent and the family is willing to cooperate with CHBS to initiate treatment options for the child and improve family communication and interaction;
(iii) the PRFC gives birth to a drug-exposed infant who does not have significant health problems, the PRFC is willing to participate in a drug abuse treatment program, and cooperate with CHBS to receive parenting education and skills development; or
(iv) the PRFC who completed substance abuse treatment services needs help in reconnecting to a healthy support system and overcoming family issues caused by chemical dependency.
(B) A brief self-assessment of drug and alcohol abuse and dependency is included in the CHBS multi-level assessments but there is no provision for ongoing drug and alcohol treatment services. A CHBS referral is not appropriate in a substance abuse case when the PRFC:
(i) is not available for substance abuse treatment;
(ii) is not willing to enter treatment for a substance abuse problem;
(iii) has a chronic history of failing to enter or successfully complete substance abuse treatment;
(iv) requests that the child with a substance abuse problem be placed outside the home and the PRFC does not verbalize or demonstrate a sense of commitment and responsibility to the child; or
(v) has a behavioral health condition or developmental delays that will likely result in unsuccessful and unachievable treatment and cooperation.
(5) Behavioral health.
(A) A CHBS referral is appropriate when the PRFC or child has a behavioral disorder or emotional disturbance that may be stabilized by appropriate medication or therapy, and the PRFC is willing to comply with recommended treatment when:
(i) the PRFC has a behavioral health impairment that does not significantly impede the PRFC's potential ability to make necessary changes; and
(ii) there is evidence that the child's needs are minimally met; or
(iii) the child has a serious behavioral health condition but recommended treatment is expected to stabilize the child within the family.
(B) A CHBS referral is not appropriate when the PRFC or child has a behavioral disorder or emotional disturbance when the:
(i) the PRFC or child's behavioral disorder or emotional disturbance requires hospitalization;
(ii) PRFC has a significant cognitive impairment that renders the PRFC unable to learn to provide minimal care for the child and no other family member or person is available to provide long-term support or care;
(iii) PRFC has a chronic behavioral health condition with unsuccessful treatment; or
(iv) sole purpose of the referral is to purchase a psychological evaluation of the PRFC.
(6) Physical illness or limitation.
(A) A CHBS referral is appropriate when physical illness or limitation concerns the:
(i) child with a life-threatening illness and the PRFC requires support to learn to provide or obtain the necessary health care to prevent the child's out-of-home placement; or
(ii) PRFC with a severe physical illness or limitation that threatens his or her ability to meet the child's minimal needs but could provide appropriate care if help is available.
(B) A CHBS referral is not appropriate when:
(i) the child has a life-threatening illness;
(ii) the PRFC does not have the intellectual capacity to learn to provide or obtain the necessary health care,; and
(iii) no homemaker, public health nurse, or family member is available to provide the care; or
(iv) there is a low probability that adequate resources can be obtained to supplement or provide proper physical or medical care of the child.
(7) Domestic violence.
(A) A CHBS referral is appropriate when domestic or intimate partner violence has occurred and:
(i) the person responsible for the physical violence has left the home or is willing to participate in a certified batterers' program to address the issue;
(ii) the victim is willing to take action to protect himself or herself and ensure child safety; or
(iii) all parties to the violence acknowledge a problem exists and are willing to engage in services to address the problem.
(B) A CHBS referral is not appropriate when domestic or intimate partner violence exists and:
(i) violence has been a long-term and chronic dynamic in the relationship with a repeated pattern of separation and reconciliation;
(ii) the PRFC denies violence is an issue that is detrimental to the PRFC or the child; or
(iii) violence intervention services were provided in the past, but the violence continues.
(8) Voluntary services.
(A) A family who receives voluntary services commonly exhibits issues of parental neglect or a combination of environmental factors that, if unresolved, are likely to result in serious harm to the child. To determine priority for service, the contract liaison may defer or decline a referral to CHBS or offer a shortened period of service, particularly when the family has failed to cooperate with CHBS in the past.
(B) A CHBS referral is not appropriate in a voluntary case, unless an exception is approved per OAC 340:75-1-151 ITS # 1, when the child is determined to be safe after Form 04KI030E, Assessment of Child Safety, is completed or safety threats may be controlled with the use of contingency funds or other community resources.
(9) Reunification. Refer to OAC 340:75-6-31.
(A) A CHBS referral is appropriate during reunification when:
(i) the child can safely return to the home, the PRFC(s) has made or commits to make the changes that provide the safety and stability prescribed by Form 04KI012E, Individualized Service Plan (ISP); or
(ii) the family is highly motivated to cooperate with CHBS to work through barriers to have the child returned to the home; and
(iii) the family is willing to collaborate with the OCS contract case manager (CCM) to set goals and participate in treatment to affect the child's rapid, safe return to the home; and
(iv) at least one PRFC is available to participate with the CCM.
(B) A CHBS referral is not appropriate to facilitate reunification when:
(i) the permanency plan is not reunification;
(ii) no PRFC is willing to work with the CCM;
(iii) other, less intensive services are sufficient to enable the PRFC to achieve family reunification by completing the requirements prescribed by Form 04KI012E, Individualized Service Plan (ISP); or
(iv) the referral is prompted by a need for a single focus service, such as a mentor, tutor, psychological evaluation of a PRFC, or a similar service.
(10) Permanent placement.
(A) A CHBS referral is appropriate when a child is in a permanent placement when:
(i) the permanent placement is at risk of disruption and the child has established ties to the family that afford the child a permanent connection;
(ii) the kinship, trial adoptive family, or the child needs assistance with learning behavior management techniques; or
(iii) the kinship or trial adoptive family is willing to cooperate with CHBS to address the social or behavioral issues creating conflict.
(B) A CHBS referral is not appropriate when a child is in a permanent placement when:
(i) the resource parent refuses to accept services;
(ii) the resource parent has endangered the child or other children in the resource parent's care;
(iii) the child has not bonded with the resource family, but no other placement is available; or
(iv) CW determines the permanent placement no longer meets the child's needs and the child will be moved.
(11) Adoption disruption.
(A) A CHBS referral is appropriate when a trial adoption disrupts or is at risk of disruption when:
(i) the child is placed in substitute care and the goal is to reunify the child with the adoptive family;
(ii) the child presents emotional or behavioral problems that the adoptive parent believes may result in disruption;
(iii) the child is experiencing grief or loss issues that have not been addressed;
(iv) the adoptive family may benefit from enhanced parenting skills to manage the child's special needs; or
(v) there are situational stressors to the family, such as death, divorce, or the addition of a new family member.
(B) A CHBS referral is not appropriate when a trial adoption disrupts and the:
(i) adoptive parent does not want the child returned to the home;
(ii) adoptive parent refuses to accept services; or
(iii) child, 12 years of age or older, has threatened family members with physical harm.
(c) CHBS reunification referrals.
(1) The CHBS reunification referral is timed to allow the child in out-of-home care to be returned to the home no later than midpoint in the CHBS service period allowing the CCM time to observe family interactions and reinforce safe parenting behaviors.
(2) The CCM and the CW specialist develop the plan for the child's return to the home that includes the tentative return date and a schedule for overnight, unsupervised visitation prior to the actual return. Sibling integration is strategically planned.
(3) When the child is not authorized by the court to return home as anticipated and the permanency plan remains reunification, the CHBS case may be placed in suspended status for up to three months or closed and a new referral made when reunification is imminent.
(4) Reunification is selected as the focus of service if services are required when the court grants custody to a parent who was not previously the custodial parent, or an intact family requires services and a court case exists.
(d) CHBS kinship placement maintenance referrals. The CW specialist consults with the resource specialist when a kinship parent's behavior jeopardizes the placement. Prior to submitting Form 04MP019E, OCS Referral, the CW specialist determines whether another course of action is more appropriate to correct issues with the kinship parent's behavior. The resource specialist initials Form 04MP019E, OCS Referral, to signify to the OCS contract liaison that the specialist concurs with the referral decision.
(e) Completion of Form 04MP019E. Form 04MP019E includes:
(1) identifying information for service participants. The CW specialist prints a copy of the referral to ensure that the address and other populated information is correct before submitting the CHBS referral to the supervisor for approval. CHBS referrals require:
(A) identifying information for the custodial and noncustodial parent or placement provider, as applicable and each child participating in services; and
(B) two referrals when the parents will receive services in separate households listing a different child's name on each referral, when more than one child will receive services.
(2) the reason for the CHBS referral. A request for CHBS identifies the specific reason for the referral such as physical abuse, child's behavior, or environmental conditions.
(3) documentation that CHBS is the most appropriate type of service for the family. The CW specialist documents the:
(A) specific conditions that put the child at risk of:
(i) out-of-home placement; or
(ii) placement disruption;
(B) reasons for the child's placement;
(C) prior history of abuse and neglect, explanation of safety threats, impending or present danger, and the in-home or out-of-home safety plan;
(D) outcomes expected from services including the specific behaviors that must change for the child to be safe;
(E) tentative date the child will be returned to the family home when reunification is the case goal or the date the child was returned. The CW specialist:
(i) selects a date prior to that of the referral to signify the child resides in the home; and
(ii) selects reunification as the service focus when:
(I) the child will be or was returned home from OKDHS custody or supervision; or
(II) services are required after the court grants custody to a parent who was not previously the custodial parent; or
(III) for a supervision only case.
(4) supporting documentation from the court-involved case that includes:
(A) Form 04KI028E, Family Functional Assessment;
(B) Form 04KI030E, Assessment of Child Safety;
(C) Form 04MP046E, Family Team Meeting Report, when applicable; and
(D) Form 04KI012E, Individualized Service Plan (ISP).
(5) supporting documentation for voluntary family-centered services (FCS) cases referred more than 15 business days after Form 04MP025E, Voluntary Family Service Agreement, is signed, includes:
(A) Form 04MP025E, Family Service Agreement;
(B) Form 04KI030E, Assessment of Child Safety;
(C) Form 04MP054E, Immediate Protective Action Plan/ Voluntary Safety Plan;
(D) Form 04MP046E, Family Team Meeting Report, when applicable;
(E) Form 04KI028E, Family Functional Assessment; and
(F) Form 04KI012E, Individualized Service Plan (ISP).
(6) a full description of the safety threats and conditions that must be addressed to make the child safe.
(A) When Child Protective Services (CPS) makes the CHBS referral or immediately after the case transfers to FCS, Forms 04KI028E, Family Functional Assessment, and 04KI012E, Individualized Service Plan (ISP), are not required as the CHBS Family Inventory of Needs Determination (FIND) and Family Intervention Plan (FIP) may substitute for the required CW case planning when the CHBS, FIND, and FIP are entered into the case record within 15 calendar days after Form 04MP025E, Voluntary Family Service Agreement is signed.
(B) A CPS specialist may initiate the referral as soon as CHBS is determined appropriate. If at that time, Form 04KI030E, Assessment of Child Safety, has not been finalized, a referral may be submitted using only Form 04MP054E, Immediate Protective Action Plan/Voluntary Safety Plan, and a full description of the safety threats and conditions that need to be changed to make the child safe. A completed Form 04KI030E, Assessment of Child Safety, is forwarded to the OCS contract liaison within seven business days of the referral date.
2. (a) Referral for Parent Aid Services (PAS). Form OCS-1, OCS Referral, is accessed via KIDS Service Log. The referring CW specialist selects the services needed on Form 04MP019E. Parent aide services are non-therapeutic services provided by trained paraprofessionals to encourage parenting skill development.
(b) Criteria for PAS. PAS is appropriate for the PRFC who:
(1) is new to parenting and unfamiliar with how to access available resources;
(2) received PAS or CHBS and failed to meet goals due to cognitive or developmental delays or a lack of cooperation and was denied service by the OCS contract liaison;
(3) is likely to benefit from time-limited, non-therapeutic services;
(4) does not have a singular need such as transportation;
(5) does not have pervasive safety concerns that require the attention of a CW specialist, such as a PRFC who:
(A) is chronically unwilling or unable to protect his or her young child;
(B) does not acknowledge a problem exists;
(C) appears to be seriously mentally ill; or
(D) exhibits evidence of significant substance abuse.
(6) has an open CW case under the direction of the FCS or permanency planning specialist and would benefit from hands-on parenting, housekeeping, or budgeting instruction, or other basic non-professional activities, while the CW specialist assesses safety.
(c) Exceptions for PAS. A formal staffing with the CW supervisor is required for exceptions to the referral guidelines. OCS contract liaisons may request justification for utilizing PAS outside of the referral guidelines, deny the referral, or suggest that the referral be redirected to CHBS.
(d) PAS OCS liaison referral guidelines.
(1) The CPS specialist may determine that a PRFC requires parenting education or assistance with maintaining a safe home environment even though the child is currently deemed safe and does not require ongoing CW services. PAS may assist the PRFC eliminate safety hazards in the home and learn sufficient parenting skills to avoid re-entry into the CW system.
(2) When the case is transferred to FCS or there is a need for PAS in the court-involved case, a parent aide may be assigned to assist the CW specialist with hands-on parenting education, transportation, budgeting, home management, and other tasks appropriate for the paraprofessional under the guidance of the CW specialist.
(A) In the case with more serious threats to child health or safety, the parent aide assists with monitoring the family's in-home safety plan compliance, but is not assigned sole responsibility for assessing safety or case planning.
(B) The PAS case with complex safety issues requires coordination and guidance from the CW specialist specialist, that includes the CW specialist attending the intake staffing and regular case staffings to ensure services are effectively meeting the family's needs and controlling child safety.
(C) The CW specialist communicates to the parent aide the desired parenting skills and behaviors to model for and practice with the PRFC to enhance the PRFC's protective capacities that address specific conditions that caused the child to be unsafe.
(D) PAS is not responsible for or assigned responsibility for ensuring child safety during supervised visitation.
(E) PAS is appropriate when the parent and child have unsupervised visitation, are in trial reunification, or are reunified.
(e) PAS referrals. PAS referrals contain:
(1) identifying information for each parent and child participating in services and information regarding the non-custodial parent who maintains a relationship with the child participating in services, when applicable.
(2) reason for the PAS referral. The PAS referral identifies the specific services and the type of maltreatment alleged in the initial referral, or for permanency planning cases, the PRFC's remaining court-related requirements or issues.
(3) expected service outcomes. The referring specialist documents the specific behavioral changes that demonstrate improved protective capacities expected as a result of PAS services.
(4) supporting documentation.
(A) The supporting documentation for a PAS referral in a family-centered services case requires:
(i) Form 04MP025E, Family Service Agreement; and
(ii) Form 04KI030E, Assessment of Child Safety, with Form 04KI0129E, Voluntary Safety Plan, when applicable. When the Form 04KI030E is not completed at the time of the PAS referral, the CW specialist may submit the referral with Form 04MP054E, Immediate Protective Action Plan/Voluntary Safety Plan, and provide completed Form 04KI030E within seven business days.
(B) The supporting documentation for a PAS referral in a court-involved case requires:
(i) Form 04KI028E, Family Functional Assessment;
(ii) Form 04KI012E, Individualized Service Plan (ISP);
(iii) Form 04MP043E, Family Team Meeting Guide, when applicable;
(iv) Form 04KI030E, Assessment of Child Safety; and
(v) Form 04MP054E, Immediate Protective Action Plan/Voluntary Safety Plan.
3. Supervisory responsibility for CHBS and PAS referrals. Referrals for CHBS and PAS are approved via KIDS by the CW supervisor after the CW supervisor ensures each referral is complete with supporting documentation appropriate for the referral.
4. Authorizations for CHBS and PAS. The OCS contract liaison authorizes or rejects CHBS and PAS referrals approved by the CW supervisor. An authorized referral is forwarded to the primary contractor for acceptance. A rejected referral is returned by the OCS contract liaison for additional information, suspended, or denied with reasons cited. The CW supervisor and OCS contract liaison determine the priority of referrals based on greatest need.