INSTRUCTIONS TO STAFF 340:75-1-151
Revised 3-26-10
1. (a) Referral focus for CHBS. Form 04MP032E, Referral for Contracted Service, is accessed via KIDS Service Log. The referring Child Welfare (CW) worker 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 so that children can be safely maintained in their own homes;
(2) maintenance of trial adoptive placement;
(3) maintenance of kinship placement;
(4) maintenance of out-of-home permanent placement;
(5) reunification; and
(6) maintenance of post legal adoption.
(b) Criteria for CHBS referrals. CHBS referrals are appropriate for:
(1) voluntary services case when:
(A) at least one child in the family is assessed as being unsafe;
(B) the family is cooperative and likely to meet goals with comprehensive and time-limited services and does not require assistance to meet a singular need and there is no pervasive safety concern such as parents who are chronically unwilling or unable to protect their children; and
(C) other less intensive services within the community are exhausted or it is established that community resources are not sufficient to avert placement of the child in out-of-home care;
(2) 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 worker maintains an open FCS 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 a 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 acting out behavior of the child; however, if the disruption is due to a caregiver's behavior, the referral is discussed with and approved by the CW worker responsible for maintaining the resource home; or
(5) maintenance of foster or adoptive home when a child has an established connection or attachment to the resource family; however, CHBS is not used to maintain therapeutic placements or to rectify deficient parenting skills of paid placement providers.
(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 who are 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 worker and supervisor for additional information or to recommend a more appropriate intervention. CHBS is not to be 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 referral is appropriate in a physical abuse case when:
(i) a 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 person(s) responsible for child (PRFC(s)) can protect the child; or
(ii) an older child refuses to return home due to a conflict with a parent(s) that escalated to physical injury, and family members agree to work together with CHBS to resolve the issues of conflict.
(B) A referral is not appropriate in a physical abuse case when:
(i) physical abuse to a child is considered serious or life-threatening per OAC 340:75-3-2;
(ii) there is a history of physical abuse and no PRFC has been 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) there is any intentional injury to an infant.
(2) Sexual abuse.
(A) A referral is appropriate in a sexual abuse case when:
(i) the perpetrator has left the home, in the case of sexual abuse by a family member, and a safety plan is in place;
(ii) the perpetrator does not have access to the child either through incarceration or court order; or
(iii) the non-abusive PRFC verbalizes and demonstrates his or her willingness to protect the child and accepts CHBS.
(B) A referral is not appropriate in a sexual abuse case when:
(i) the PRFC(s) continually puts the child at risk of sexual abuse by allowing access by a known perpetrator;
(ii) sexual abuse involves multiple members of the family jointly engaging in sexual activity;
(iii) the PRFC(s) denies the child is unsafe and does not agree that treatment is necessary;
(iv) the perpetrator returns to the home; or
(v) the PRFC(s)' lifestyle places the child in impending danger of sexual abuse through activities, such as prostitution, extensive involvement with pornography, or association with those who participate in such activities.
(3) Neglect.
(A) A referral is appropriate in a serious neglect case when a safety plan is controlling the threat and the PRFC(s) or family is willing and able to participate in CHBS. Examples include:
(i) a child younger than 12 years of age is left alone to care for self or in the care of an inappropriate caregiver on a regular basis;
(ii) the PRFC(s) 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(s) about emotional nurturing, proper nutrition, and feeding techniques;
(iv) there is medical neglect, or failure to follow through on health needs of an ill child and health care education is likely to strengthen the protective capacities of the PRFC.
(v) the PRFC(s) refuses to allow a child with adolescent acting-out behaviors to stay or return home due to serious parent and child conflict that required a CW response; or
(vi) housing conditions cause the child to be unsafe and relocation or prompt repairs are needed to avoid removal of the child.
(B) A referral is not appropriate in a neglect case when:
(i) neglect is long-term and chronic, and CW has provided multiple intervention services including CHBS, but the situation has not been resolved;
(ii) the PRFC(s) does not acknowledge there is a problem, 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 referral is appropriate in a substance abuse case when:
(i) the PRFC(s) acknowledges that his or her drug abuse or dependency has threatened the child’s safety, and is willing to enter outpatient treatment for the substance abuse problem and work with CHBS to address the child's needs;
(ii) a child in a family is chemically dependent and the family is willing to work with CHBS to initiate treatment options for the child and improve family communication and interaction;
(iii) a PRFC gives birth to a drug-exposed infant who does not have significant health problems and the PRFC is willing to participate in a drug abuse treatment program and work with CHBS to receive parenting education and skills development; or
(iv) a PRFC who has 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 referral is not appropriate in a substance abuse case when the PRFC(s):
(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 not following through with substance abuse treatment;
(iv) requests that his or her child with a substance abuse problem be placed outside the home and the PRFC(s) does not verbalize a sense of commitment and responsibility to the child; or
(v) has mental health issues or developmental delays that make treatment and cooperation impossible.
(5) Mental health.
(A) A referral is appropriate in a case where the PRFC(s) or child has a behavioral disorder or emotional disturbance that may be stabilized by appropriate medication or therapy, and the PRFC(s) is willing to comply with recommended treatment when:
(i) an impairment is present in the PRFC(s):
(I) but does not significantly impede the PRFC(s)' potential to make necessary changes; and
(II) there is evidence that the child's needs are minimally met; or
(ii) a child has a serious mental illness but treatment is expected to stabilize the child within the family.
(B) A referral is not appropriate in a case where the PRFC(s) or child has a behavioral disorder or emotional disturbance when:
(i) it is determined that the PRFC(s) or the child with a behavioral disorder or emotional disturbance requires hospitalization;
(ii) the PRFC(s) is impaired to the extent that he or she is 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) the PRFC(s) has a history of chronic mental illness with little treatment success; or
(iv) the sole purpose of the referral is to purchase a psychological evaluation of the PRFC(s).
(6) Physical illness or limitation.
(A) A referral is appropriate in a case involving physical illness or limitation of the PRFC(s) or child when the:
(i) child has a life-threatening illness and the PRFC(s) needs support to learn to provide the necessary health care to prevent out-of-home placement; or
(ii) the PRFC(s) has a severe physical illness or limitation that threatens his or her ability to meet minimal needs of the child but could provide such care if help were available.
(B) A referral is not appropriate in a case involving physical illness or limitation of the PRFC(s) or child when:
(i) the child has a life-threatening illness, the PRFC(s) does not have the intellectual capacity to learn to provide necessary health care, and no homemaker, public health nurse, or family member is available to provide the care; or
(ii) there is no possibility that resources can be obtained to supplement or provide proper physical or medical care of the child.
(7) Domestic violence.
(A) A referral is appropriate in a case involving domestic or intimate partner violence when:
(i) the person responsible for physical violence has left the home or is willing to participate in all services to address the issue;
(ii) the victim is willing to take action to protect himself or herself and ensure safety of the child; or
(iii) all parties to the violence acknowledge there is a problem and are willing to engage in services to address the problem.
(B) A referral is not appropriate in a case involving domestic or intimate partner violence when:
(i) violence has been a long-term and chronic dynamic in the relationship with a repeated pattern of separation and reconciliation;
(ii) the PRFC(s) deny violence is an issue that is detrimental to them 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 hold 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 when the child is determined to be safe after completion of Form 04KI030E, Assessment of Child Safety, 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 referral is appropriate in a case of reunification when:
(i) the child can safely return to the home e and the PRFC(s) has made or will make the changes that provide the safety and stability prescribed on Form 04KI012E, Individualized Service Plan (ISP); or
(ii) the family is highly motivated to work through numerous barriers to have the child returned and willing to work intensively with CHBS; and
(iii) the family is willing to collaborate in goal setting and treatment with the OCS contract case manager (CCM) to affect the rapid, safe return of the child; and
(iv) at least one PRFC is available to participate with the CCM.
(B) A referral is not appropriate in a case of reunification when:
(i) the permanency plan is something other than reunification;
(ii) no PRFC is willing to work with the CCM;
(iii) other, less intensive services are sufficient to enable the PRFC(s) to complete the requirements set forth on Form 04KI012E, and achieve family reunification; or
(iv) the referral is prompted by a need for a single focus service, such as a mentor, tutor, psychological evaluation of a PRFC(s), or a similar service.
(10) Permanent placement.
(A) A referral is appropriate in a case involving a child 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, or trial adoptive family, or the child needs assistance in learning behavior management techniques; or
(iii) the kinship or trial adoptive family is willing to work with CHBS to address the social or behavioral issues creating conflict.
(B) A referral is not appropriate in a case involving a child in a permanent placement when:
(i) the resource family refuses to accept services;
(ii) the resource family has endangered the child or other children in its care;
(iii) the child has not bonded with the resource family, but no other placement is available; or
(iv) CW determines that the permanent placement no longer meets the child's needs and the child will be moved.
(11) Adoption disruption.
(A) A referral is appropriate in a case involving a trial adoption 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(s) 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 deal with 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 referral is not appropriate in a case involving a trial adoption disruption when the:
(i) adoptive family does not want the child returned to the home;
(ii) adoptive family refuses to accept services; or
(iii) child aged 12 or older has threatened family members with physical harm.
(e) CHBS reunification referrals.
(1) Timing of the referral is important. The referral is timed in order that the child in out-of-home care will be returned no later than midpoint in the CHBS service period to allow time for the CCM to observe family interactions and reinforce safe parenting behaviors.
(2) The CCM develops the plan for return in conjunction with the CW worker, including the tentative date of return and a schedule for overnight, unsupervised visitation prior to the actual return. Reintegration of siblings is strategically planned.
(3) If, at the court hearing, the child is not returned home as anticipated, and the permanency plan is reunification, the CHBS case may be put 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.
(f) CHBS maintain kinship placement referrals. The child's CW worker consults with the resource specialist when a kinship parent's behavior is the reason the placement is at risk. Prior to submitting Form 04MP032E, the child's CW worker determines whether another course of action is more appropriate to correct any issues with the kinship parent's behavior. The resource specialist initials Form 04MP032E, Referral for Contracted Services, to signify to the OCS contract liaison that the specialist concurs with the referral decision.
(g) Completion of Form 04MP032E. Required elements of Form 04MP032E include:
(1) identifying information for CHBS referrals. Referrals for CHBS require identifying information of the custodial and noncustodial parent(s) or placement provider(s), as applicable, and all children participating in services. Two referrals are made when parents will receive services in separate households and a different child’s name is listed on each referral, if there is more than one child who will receive services. The CW worker prints a copy of the referral before submitting to the supervisor for approval to ensure that the address and other populated information is correct.
(2) reason for the CHBS referral. A request for CHBS must identify 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 worker documents the:
(A) specific conditions that put the child at risk of:
(i) out-of-home placement; or
(ii) potential disruption of the placement;
(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(ren) to be safe;
(E) tentative date, for reunification cases, the child will be returned to the family or the date the child was returned. The CW worker selects a date prior to that of the referral to signify the child resides in the home. Reunification is selected as the focus of service when:
(i) the child will be or was returned home from OKDHS custody or supervision; or
(ii) services are required when the court grants custody to a parent who was not previously the custodial parent or for a court supervision case.
(4) supporting documentation for CHBS referrals of court-involved cases, including:
(A) Form 04KI028E, Family Functional Assessment;
(B) Form 04KI030E, Assessment of Child Safety;
(C) Form 04MP043E, Family Team Meeting Guide, if applicable; and
(D) Form 04KI012E, Individualized Service Plan (ISP).
(5) supporting documentation for voluntary Family-Centered Services (FCS) cases referred more than 15 days after Form 04MP025E, Voluntary Family Service Agreement, is signed, includes:
(A) Form 04MP025E, Voluntary Family Service Agreement;
(B) Form 04KI030E, Assessment of Child Safety;
(C) Form 04KI029E, Voluntary Safety Plan;
(D) Form 04MP043E, Family Team Meeting Guide, if 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 change to make the child safe. If the referral is made from Child Protective Services (CPS) 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, may substitute for the case planning required of CW if entered into the case record within 15 days following the signing of Form 04MP025E, Voluntary Family Service Agreement. A CPS worker can initiate the referral as soon as it has been determined CHBS is appropriate. If at that time, Form 04KI030E, Assessment of Child Safety, has not been finalized, a referral may be submitted using only Form 04KI029E, 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 04MP032E is accessed via KIDS Service Log. The referring CW worker selects the services needed as indicated on Form 04MP032E.
(b) Criteria for PAS. PAS is appropriate for families who:
(1) are new to parenting and unfamiliar with how to access available resources;
(2) received PAS and failed to meet goals due to lack of cooperation but who are likely to benefit from a shortened service period or were denied service by the OCS contract liaison;
(3) are likely to benefit from time-limited, non-therapeutic services;
(4) do not have a singular need, such as transportation;
(5) do not have pervasive safety concerns that require the attention of a CW worker, such as a PRFC who:
(A) is chronically unwilling or unable to protect his or her young child;
(B) does not acknowledge there is a problem;
(C) appears to be seriously mentally ill; or
(D) exhibits evidence of significant substance abuse.
(6) have open CW cases under the direction of the worker assigned to the FCS or Permanency case, and would benefit from hands-on parenting, housekeeping, or budgeting instruction, or other basic non-professional activities, while the CW worker assumes responsibility for assessing 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 it be redirected to CHBS.
(d) PAS OCS liaison referral guidelines. CPS workers may determine that a family needs parenting education or assistance with maintaining a safe home environment even though the child(ren) is currently deemed safe and does not require ongoing CW services. Such families may re-enter the CW system without additional assistance in addressing issues of parental neglect or a combination of environmental factors that may not constitute a safety threat to the child(ren). To determine the levels of service or intervention a family needs, the CPS worker uses the Levels of Service protocol per OAC 340:75-4-12.1. PAS is appropriate for families at Level 2 if the family will not have continuing oversight from a CW worker. If the case is transferred to FCS or there is a need for PAS in a court-involved case, a parent aide may be assigned to assist the CW worker with hands-on parenting education, transportation, budgeting, home management, and other tasks that are appropriate for a paraprofessional under the guidance of the CW worker. In a case with more serious threats to a child’s health or safety, the parent aide can assist in monitoring the family’s compliance with the in-home safety plan, but is not assigned sole responsibility for assessing safety or case planning. PAS cases with complex safety issues require coordination and guidance from the CW worker, including attendance at the intake staffing and regular staffing of the case to ensure services are effectively meeting the needs of the family and safety is assured. PAS is not given responsibility for ensuring the safety of children during supervised visitation. PAS is appropriate in cases where the parents and children are having unsupervised visitation, are in trial reunification, or have been reunified.
(e) Identifying information for PAS referrals. Referrals for PAS require identifying information of the parent(s) and child(ren) participating in services.
(f) Reason for PAS referral. A request for PAS must identify the specific services and the type of maltreatment alleged in the initial referral, or for permanency cases, remaining issues of families involved with the court.
(g) Expected outcomes of service. The referring worker documents the specific behavioral changes expected, as a result of PAS services that demonstrate improved parental capacity.
(h) Supporting documentation for PAS referrals.
(1) Voluntary Family-Centered Services cases require Forms 04MP025E, Voluntary Family Service Agreement, and 04KI030E, Assessment of Child Safety, with Form 04KI0129E, Voluntary Safety Plan, when needed. If the Assessment of Child Safety is not completed at the time of referral, the worker may submit the referral with Form 04KI029E, Voluntary Safety Plan, and provide the completed Form 04KI030E within seven business days.
(2) Court involved cases require, Form 04KI006E, Family/Child Strengths and Needs Assessment, or Form 04KI028E, Family Functional Assessment, Form 04KI012E, Individualized Service Plan (ISP), and if pertinent, Form 04MP043E, Family Team Meeting Guide, Form 04KI030E, Assessment of Child Safety, and Form 04KI029E, 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 per OAC 340:75-1-151 Instructions to Staff 1(e)(4) or 2(e) and appropriate for 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. CW supervisors and OCS contract liaisons determine the priority of referrals based on greatest need.