INSTRUCTIONS TO STAFF 340:75-1-151

Revised 5-15-09

1. (a) Referral focus for CHBS.  Form 04MP019E, Referral for 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 prevent a child's removal from the home due to abuse or neglect;

(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) CHBS OCS contract liaison referral guidelines.  Oklahoma Children's Services (OCS) contract liaisons use guidelines outlined in (1) through (11) in determining 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 340:75-3-10.3, and the child is safe to remain in the home if in‑home services are provided; 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 person responsible for the child (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;

(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 existence of risk to the child and does not agree that treatment is necessary;

(iv) the perpetrator returns to the home; or

(v) the PRFC(s)' lifestyle places the child at continued risk of sexual abuse through activities, such as prostitution, extensive involvement with pornography, or association with those who participate in those activities.

(3) Neglect.

(A) A referral is appropriate in a serious neglect case when 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 proper nutrition and feeding techniques;

(iv) there is medical neglect, or failure to follow through on health needs of an ill child.  The child may remain safely in the home if intensive in-home services are provided;

(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 Child Welfare (CW) response; or

(vi) housing conditions pose a threat to the health and safety of the child 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 many 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) when 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 places the child at risk, 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 his or her chemical dependency.

(B) 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 mental or emotional impairment that may be stabilized by appropriate medication or therapy, and the PRFC(s) is willing to comply with recommended treatment, such as:

(i) an impairment is present in the PRFC(s):

(I) but does not significantly impede the PRFC(s)' potential to make necessary changes; or

(II) and 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 mental or emotional impairment when:

(i) it is determined that the PRFC(s) or the child with mental illness requires hospitalization;

(ii) the PRFC(s) is impaired to the extent that the PRFC(s) 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 or public health nurse or family member is available to provide the care; or

(ii) there is no possibility that resources can be obtained to ensure safety and 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 parties deny that 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 removal of the child.  To determine priority for service, the OCS contract liaison may hold or decline a referral to CHBS, particularly when the family has failed to cooperate with CHBS services in the past.

(B) A CHBS referral is not appropriate in a voluntary case when risk to the child is moderate or may be controlled with the use of contingency funds or other community services.

(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 if intensive in-home services are made available, and the PRFC(s) has made or will have made 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 family member 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, Individualized Service Plan (ISP) 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, drug testing 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 address the social behavioral issues that are creating conflict with supportive assistance from CHBS.

(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 is a therapeutic foster family;

(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 post 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 poses a risk of 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 post 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 has threatened family members with physical harm.

(c) 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 for safe reintegration.

(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 six 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 safety services and a court case exists.

(d) CHBS maintain kinship placement referrals.  The child's CW worker consults with the resource specialist when foster parent behavior is the reason the placement is at risk.  Prior to submitting Form 04MP019E, the child's CW worker determines whether another course of action is more appropriate to correct any issues with the foster parent's behavior.  The resource specialist initials Form 04MP019E to signify to the OCS contract liaison that the specialist concurs with the referral decision.

(e) Completion of Form 04MP019E.  Required elements of Form 04MP019E are:

(1) identifying information for CHBS referrals.  Referrals for CHBS require identifying information on the parent(s) or placement provider, as applicable, and oldest child participating in 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 prevent the child's removal from the home, 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) areas of greatest risk;

(D) outcomes expected;

(E) tentative date, for reunification cases, that 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 in 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 required for CHBS referrals.  Current Forms 04KI006E, Family/Child Strengths and Needs Assessment, and Form 04KI012E, Individualized Service Plan (ISP), are attached to Form 04MP019E.  For voluntary Family-Centered Services cases, Form 04MP025E, Voluntary Family Service Agreement, and Form 04MP020E, Safety Assessment, are attached.

2.   (a) Referral for PAS.  Form 04MP019E is accessed via KIDS Service Log.  The referring CW worker selects the services needed as indicated on Form 04MP019E.

(b) Parent Aide Services (PAS) OCS liaison referral guidelines.  A family who receives PAS commonly exhibits issues of parental neglect or a combination of environmental factors that are low to moderate risk.  To determine the levels of service or intervention a family needs, the CW worker uses the Levels of Service protocol per OAC 340:75-4-12.1.  The OCS contract liaison reviews the Levels of Service protocol and determines whether PAS will adequately meet the needs of the family.  Referrals that may not be appropriate for PAS include:

(1) most court-involved cases;

(2) history of previous court involvement;

(3) previous termination of parental rights;

(4) children who reside in out-of-home placements;

(5) serious physical abuse;

(6) out-of-control teens or truancy issues;

(7) sexual abuse; and

(8) ongoing issues involving domestic violence or substance abuse in which treatment was not sought.

(c) Identifying information for PAS referrals.  Referrals for PAS require identifying information on the parent(s) and oldest child participating in services.

(d) Reason for PAS referral.  A request for PAS must identify the specific reason for the referral, such as prevent the child's removal for specific conditions of risk or, in the exceptional circumstance, that a referral is submitted from a court-involved case.

(e) Supporting documentation for PAS referrals.  Voluntary Family-Centered Services cases require Forms 04MP025E and 04MP020E.  For court-involved cases, Form 04KI006E, 04KI012E, or 04KI024E is required.

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 that each referral is complete, with supporting documentation per OAC 340:75-1-151 Instructions to Staff 1(e)(4), and appropriate for referral.  OCS referrals are transmitted via KIDS to the contractor by means of the supervisor's approval.

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.