Instructions to Staff 340:75-18-1
Issued 12-15-11
1. Child and Family Service Review (CFSR) protocol.
(1) CFSR review team. The CFSR is conducted by two to four teams of CW staff and community stakeholders in the designated county or counties. Prior to participation in reviews, staff and stakeholders complete training regarding the CFSR process. Stakeholders sign commitments agreeing to keep confidential the information made available to them during the CFSR. Each team consists of:
(A) a Children and Family Services Division (CFSD) Continuous Quality Improvement (CQI) Section representative, who serves as the leader of the site review;
(B) a CW specialist or supervisor who is not affiliated with a site under review;
(C) a third party identified by the respective Field Operations Division (FOD) area director; and
(D) at least one volunteer stakeholder, not employed or contracted by OKDHS.
(i) The participating county director or designee ensures that a background check is completed on each stakeholder, unless the stakeholder is employed in law enforcement, prior to the stakeholder's involvement in the CFSR.
(ii) The background check includes a criminal records check through Oklahoma State Bureau of Investigation (OSBI) and review of Child Abuse and Neglect Information System.
(2) CFSR schedule.
(A) Prior to the beginning of each calendar year, Continuous Quality Improvement (CQI) CFSR team members produce an annual schedule that projects the date for a CFSR at each site in the state for the year.
(B) CFSRs occur quarterly within each FOD area, allowing each site to participate in a review at least once per year, except in rare instances when an exception is granted.
(i) When exceptional circumstances exist, the county director contacts the area director to request permission to obtain an adjustment in the schedule.
(ii) When the county director is granted permission to obtain an adjustment, the county director convenes a meeting or conference call with the Area CQI coordinator and CQI programs manager to discuss rescheduling options.
(iii) The CFSD CQI CFSR team makes efforts to honor the request without compromising the CFSR yearly review schedule.
(iv) When the CFSR review cannot be rescheduled within the same quarter, the current year's review is cancelled and the CFSR schedule resumes the next year.
(3) Stratified random sample. Each CFSR includes a stratified random sample of approximately six children in each of the three-to-four participating counties.
(A) CFSD CQI CFSR team members notify county staff of each child identified for inclusion in a CFSR at least one month prior to the CFSR.
(B) The OKDHS site coordinator, identified by the county director, contacts the person responsible for the child (PRFC) for each child and discusses the opportunity to participate in the CFSR.
(4) Preparation for CFSR.
(A) At least one CFSD CQI CFSR team member is assigned to each area to:
(i) assist in planning for quality improvement;
(ii) facilitate staff and stakeholder participation; and
(iii) approximately one month before the CFSR, train designated area staff and stakeholders in CFSR interview, record review, and standard application procedures.
(B) Each CFSR site leader visits with the participating county director or designee at the initiation of the CFSR to:
(i) explain procedures;
(ii) confirm arrangements; and
(iii) schedule an exit conference.
(5) CFSR assessment procedures.
(A) Outcome performance is assessed on-site through:
(i) review of CW case records; and
(ii) observations and interviews with:
(I) school-age children;
(II) parents or PRFCs;
(III) CW staff;
(IV) placement providers; and
(V) other persons with a significant role in a child's life.
(B) CFSD CQI CFSR team members collaborate with each team member daily during the CFSR to assure the findings made by the team member is consistent with performance criteria for each outcome and systemic factor;
(C) Systemic factors performance is assessed through individual and group interviews of internal and external stakeholders arranged by county staff.
(6) CFSR results.
(A) Findings are generated for each child indicating whether each outcome is:
(i) substantially achieved;
(ii) partially achieved;
(iii) not achieved; or
(iv) not applicable.
(B) Findings for systemic factors are aggregated to achieve findings of:
(i) strength;
(ii) partially achieved; or
(iii) area needing improvement.
(C) The CFSD CQI CFSR team:
(i) shares the CFSR findings with designated CW staff at each site that describe performance related to each outcome and systemic factor, and the significant or ongoing departures from service quality expectations;
(ii) recognizes and commends the site's areas of strength:
(I) with the participating county director during the county exit conference at the conclusion of the county review; and
(II) with the area director or designee during the area exit; and
(iii) reports immediately to relevant authorities, including the county director, area director, CFSD director, findings of significant non-compliance with civil rights, rules, or laws.
(7) Continuous quality improvement plan. The CFSR team assists each human services center (HSC), when requested, develop a plan to address the HSC's most critical challenges in CW service delivery identified during the CFSR.