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Deliverables: Contractual Requirements for FPS Providers

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Title: Deliverables: Contractual Requirements for FPS Providers


1
Deliverables Contractual Requirementsfor FPS
Providers
2
A training module for FPS therapists created
byCheri Johnson, MSWCentral Washington
University for Childrens AdministrationOlympia
, Washington
3
Introduction
  • Every part of the FPS Client Service Contract is
    IMPORTANT!
  • Signing a contract signifies your intent to
    comply with all requirements, no matter how
    seemingly small or obscure.

4
Before beginning this training.
  • It will be especially helpful for you to have
    read the FPS Client Service Contract thoroughly.
  • Some level of familiarity with the contract will
    ensure that the topics addressed in the training
    make more sense!

5
  • Please have the following items handy
  • Your copy of the FPS Client Service Contract
  • Copies of handouts (some are referred to as
    cheat sheets)
  • Highlighter
  • Note-taking implements (pen and paper, sticky
    notes)

6
  • Whenever you see this symbol,

we will be turning to the handout indicated on
the slidethis is your cue to pull out the
appropriate handout to follow along.
7
Suggestion
  • Highlight every item in the contract that details
    a contractual requirement.
  • Take notes regarding any questions that arise as
    you go through the contract or the training
    module.
  • Direct questions to your supervisor, your
    regional CA program consultant, the FPS Program
    Manager in Olympia, or a CA-designated trainer.

8
A special note to providers using subcontractors
  • Provide a copy of the Client Service Contract to
    each subcontractor, and require they read it
    thoroughly.
  • Provide subcontractors with administrative as
    well as clinical supervision.
  • Know that you are responsible for errors or
    oversights made by subcontractors who dont know
    the contract!

9
This training module will focus primarily on
Exhibit A, Statement of Work
  • but you still need to be aware of all
    aspectsbusiness, legal, and clinicalof the FPS
    Client Service Contract.

10
Are you ready?
  • Well now begin a step-by-step exploration of
    deliverables outlined in the FPS Client Service
    Contract.

11
Exhibit A Statement of Work
12
FPS Purpose and Goals
  • Family Preservation Services are committed to
    reinforcing the strengths of the family to
    prevent the out-of-home placement of a child or
    to expedite the earlier return of children from
    out-of-home care
  • i.e, to preserve the family unit.

13
  • Services focus on empowering families to
  • Solve problems,
  • Become self-sufficient, and
  • Strengthen relationships with community resources.

14
  • Helping to improve family functioning is critical
    in order to enhance the health, safety, and
    welfare of children
  • allowing them to remain at home, and the family
    to remain intact.

15
FPS Values and Beliefs
  • Children need their families and should be raised
    by their own families whenever possible.
  • Interventions should focus on family strengths,
    and must be responsive to the familys needs and
    to their cultural values.

16
  • Child safety is our first priority.
  • Participation should be voluntary.
  • All families have the ability to learn, grow, and
    change.
  • FPS works in partnership with families,
    respecting their expertise and inviting their
    collaboration.

17
Service Outcomes
  • RCW 74.14C.030 lists 5 expected outcomes of FPS
  • Connection to community resources
  • No new referrals to CPS or FRS within one year of
    FPS case closure
  • Consumer satisfaction
  • For reunification cases, reduction in length of
    stay in out-of-home placement and
  • Reduction in level of risk factors identified
    at time of referral.

18
as translated into a contractual requirement
  • Providers must demonstrate at the conclusion of
    services
  • Improved child safety/harm reduction,
  • Improved family functioning,
  • Connection to community resources, and
  • Client satisfaction.

19
  • So how do we demonstrate that weve helped our
    clients achieve the required outcomes?

20
The NCFAS
  • Administer the NCFAS (North Carolina Family
    Assessment Scales) to assess family functioning
    at both intake and exit from services.
  • Compare intake and exit scores in each domain.
  • Progress is indicated by improvement in scores
    from intake to exit.

21
Consumer Satisfaction Survey
  • Provide each family with a Consumer Satisfaction
    Survey at the conclusion of services.
  • Surveys are confidential, and are mailed directly
    to DSHS in Olympia.
  • Results are not linked to specific families data
    is compiled to provide insight into overall
    consumer satisfaction with FPS as a service.

22
Connections to Community Resources
  • Document in client file all referrals made to
    community resourcesalso include this information
    in weekly updates to social worker and in Monthly
    Status Report.
  • Summarize community referrals under the
    appropriate goal(s) in the narrative portion of
    the Exit Summary.

23
Document, document, DOCUMENT!
  • Provide information related to required outcomes
    in Exit Summaries and Quarterly Reports.

24
  • The FPS Program Manager compiles data from Exit
    Summaries, Quarterly Reports, and Consumer
    Satisfaction Surveys into a report which is
    submitted to the Washington State Legislature.
  • This data helps determine whether FPS will
    continue to be fundedthus, your cooperation in
    supplying the information is critical!

25
  • Furthermore.provider success in achieving
    desired outcomes is one way Childrens
    Administration evaluates provider performance.
  • and may help determine whether you continue to
    receive a Client Service Contract.

26
Availability of Services
  • FPS clients must have access to their therapist
    or designated backup 24 hours a day, 7 days a
    week, including holidays.
  • From the contract the therapist and
    paraprofessional if utilized, or designated
    back-up, assigned to the family shall be
    accessiblefor all emergent situations.

27
  • From contract The Contractor shall ensure
    consistency of services for the family by
    assigning a single designated therapist to
    provide services for the family. The Contractor
    shall identify a back-up therapist to assist each
    family as needed.

28
What this means is
  • Each newly-referred FPS family is assigned a
    specific FPS therapist, as well as a back-up
    therapist.
  • The FPS therapist, as well as the parapro (if one
    is being used) and/or back-up therapist, must be
    available to the family in case of emergencies.

29
  • Family crises do not always occur during business
    hours
  • so make sure your agency is able to comply with
    this crucial requirement!

30
  • FPS meetings take place at the clients
    convenience, not at the therapists or referring
    social workers convenience.
  • The FPS therapist must be available during those
    hours when problems can be seen and addressedas
    long as the family agrees to meet at those times.

31
  • Please note The contract DOES NOT support
    the use of unannounced, surprise visits by the
    therapist! While this may be necessary in cases
    where the client has no phone, drop-in visits
    should be avoided whenever possible (leave these
    up to the social worker, if they feel the need
    for such methods).

32
  • Of course, if youve asked the client for
    permission to make unannounced visits and they
    agree,
  • dropping in without an appointment is
    completely acceptable.

33
  • Meetings with families take place in their own
    homes, unless the family requests an alternate
    location.
  • Potential exceptions to this expectation
    safety, need to access equipment located
    elsewhere, etc.

34
Caseload
  • Average caseload must not exceed 10 cases per
    full-time FPS therapist.
  • Caseload size may be adjusted when parapros are
    used or therapist is hired to provide FPS less
    than 40 hours/week.
  • Any adjustments in caseload size must be
    addressed in the contractors Operating
    Procedures.

35
  • Caseload size must also be adjusted to take into
    consideration a therapists other
    responsibilities (e.g., carrying cases under
    other service contracts, such as FRS Phase II or
    BRS providing clinical supervision to other
    staff, etc.).

36
  • An FPS therapist may always carry fewer than 10
    cases (as long as their agency agrees! ?), but
    the contract prohibits going above an average of
    10 unless this is approved by CA and incorporated
    into the contractors Operating Procedures.

37
Duration of Services
  • Each FPS referral is limited to a maximum of 6
    months, or until the funds allotted for that case
    have been exhausted (whichever comes first).

38
  • Occasionally, families may be re-referred, if
    substantial risk of placement continues to exist
    and the regional program consultant approves the
    re-referral.
  • Written approval from the referring social worker
    and regional program consultant must be retained
    in the client file for any extension of services.

39
Please note...
  • When a case has been referred for reunification,
    the child MUST be returned to the home within 30
    days of the referral, or the FPS therapist is
    required to terminate services.
  • The FPS Client Service Contract does not provide
    for exceptions to this requirement.

40
Authorization of Services and Referrals
  • All referrals must be initiated in writing by a
    CA social worker.
  • All referrals must be made using the referral
    form designated by CA for FPS (if referring
    social worker is not sure how to access this, the
    CA Regional Program Consultant will advise them).

41
  • The referring social worker must indicate on the
    referral form whether the child(ren) is/are at
    risk of placement or in need of reunification.

42
Important!
  • The Contractor shall not accept a case without
    a complete written referral on the
    CA-designated referral form.
  • Complete means
  • Uses the designated referral form (as opposed to
    an obsolete form)
  • Is signed by the supervisor and
  • Includes all required documentation.

43
Please keep in mind
  • CA Social Workers have large caseloads and many
    service contracts with which to workthey cant
    be expected to remember the ins and outs of the
    FPS referral process!
  • YOU need to be the expert in this area so we
    have a cheat sheet to help.

44
Referral/Intake Process
45
Step-by-Step Referral Process
  • Social worker meets with family, gathers info,
    suggests FPS, family agrees.
  • Social worker completes referral form, obtains
    supervisors approval and signature, attaches
    Safety Plan, etc.
  • Social worker/supervisor select provider and
    contact them by phone to determine providers
    ability to take case.
  • Referral packet faxed to provider.

46
When you receive the referral
  • Make sure its on the correct form.
  • Check for supervisors signature.
  • Check whether referring social worker has
    indicated At risk of placement or In need
    of reunification for each child.
  • Check whether social worker has checked yes
    or no to indicate completion of CA Documents
    (Safety Plan, etc.), and that they have attached
    the appropriate forms.

47
  • If any one of these items is missing or
    incomplete, the FPS therapist must
    contact the referring social worker
    immediately to explain he/she may not
    begin working with the family until the
    referral is complete.

48
Delivery of Services
  • Every FPS intervention will differ, depending
    on the individual familys strengths, challenges,
    situations, needs, and goals.

49
  • The effective therapist utilizes his/her
    experience, clinical skills, and unique
    individual strengths and abilities to determine
    the best way to proceed with each individual and
    each family.
  • Childrens Administration also provides
    specialized trainings to ensure the consistency
    and effectiveness of Family Preservation Services.

50
For example
  • All FPS therapists and paraprofessionals receive
    training in Motivational Interviewing (MI)
  • a client-centered, directive intervention that
    focuses on enhancing intrinsic motivation by
    exploring and resolving client ambivalence.

51
Evidence-Based Practice (EBP)
  • In addition to Motivational Interviewing, other
    EBPs are being explored and practice
    applications developed for FPS.
  • One example is Positive Parenting Program (Triple
    P). This model, as well as others designed to
    meet the needs of FPS families, will be included
    in a menu of potential service models.

52
  • When EBPs are incorporated into the service
    contract, FPS therapists will be required to use
    these models with all families whose presenting
    problems fit the model.
  • CA will provide training on all EBPs included in
    the service contract, to ensure fidelity to the
    model.

53
Regardless of practice model or clinical approach
  • there are a number of steps which must be
    taken and tasks to complete with each family with
    whom you work.
  • We will now take a look at the variety of
    tasks that play a part in each FPS intervention.

54
Initial Face-to-Face Contact
  • As previously described, first face-to- face
    contact must take place within 48 hours of
    receipt of referral.
  • If first meeting cannot occur within 48 hours,
    therapist must notify referring social worker,
    (as per Notifications, later in this
    training).
  • At least one primary caregiver must sign a
    voluntary consent form, provided by the FPS
    therapist.

55
Voluntary Consent
  • There is no state-required Voluntary Consent Form
    (aka Voluntary Service Agreement) currently in
    use each contractor provides their own format.
  • While Voluntary Consent Forms may contain
    additional information at the contractors
    discretion, they must include an acknowledgement
    that FPS is voluntary and that the client is
    choosing to participate in services.

56
Safety Plan
  • If the referring social worker has completed a CA
    Safety Plan, a copy must be attached to the
    CA-designated referral form for FPS.
  • During the initial meeting, the therapist must
    review the CA Safety Plan with the family.

57
  • If no Safety Plan was completed by the social
    worker but the therapist becomes aware of safety
    concerns during the initial meeting, he or she
    must contact the referring social worker
    immediately (and report to CPS intake as well if
    these are CPS concerns).
  • Written notification must follow within 24 hours.

58
  • The CA Safety Plan must be reviewed with the
    family at least every 2 weeks results documented
    in the client file.
  • Any new safety concerns must be immediately
    reported to the referring social worker and
    followed up in writing (as noted previously).
  • Safety plan status is reported to the social
    worker during weekly case updates.

59
Please Note!
  • Remember that this requirement is related to
    CA-generated safety plans.
  • As an FPS therapist you may choose to develop a
    different kind of safety plan with your clients,
    but doing so is not contractually required
  • and doesnt impact the requirement for reviewing
    and utilizing the CA Safety Plan!

60
Frequency of Client Meetings
  • There is no requirement as to how frequently
    meetings with FPS clients should occur.
  • However, a good rule of thumb is to have at least
    one face-to-face meeting each weekmore
    frequently for crisis intervention and when
    developing the Family Assessment and Service Plan.

61
  • The frequency of meetings with any family will
    generally vary according to
  • Family need and the specifics of their Service
    Plan
  • Where you are in the intervention (typically,
    increased frequency at the beginning, decreased
    near the end) and
  • The amount of allotted funds remaining for each
    case.

62
Case Meetings
  • The FPS therapist will attend any case-related
    meeting requested by CA staff.
  • If unable to attend, the therapist will provide a
    written report, if requested to do so by CA staff.

63
  • Meetings may include (but are not limited to
  • Child Protective Team (CPT) meetings
  • Prognostic staffings
  • LICWAC meetings
  • Case Review staffings
  • Family Unity meetings
  • Family Team Decision-Making (FTDMs)

64
  • On occasion, FPS therapists may be asked to
    testify in court as to what is happening with a
    family.
  • Therapists may also be asked to provide a court
    report or other documents.
  • It is the therapists responsibility to comply
    with any and all such requests.

65
Child and Family Team Meetings
  • Gathers everyone involved with a particular
    family to discuss that familys needs and
    progress.
  • The CFT meeting includes
  • FPS therapist
  • Referring social worker
  • Family members, as appropriate and
  • Representatives from other agencies working with
    the family.

66
  • May be convened if the FPS therapist feels a CFT
    would be beneficialits not required, but is
    often clinically indicated and extremely helpful
    in ensuring the family and all treaters are
    following the same game plan.
  • If the referring social worker decides such a
    meeting should be convened, he or she may
    delegate this responsibility to the FPS
    therapist, and the therapist must comply.

67
Family Assessment
  • The FPS therapist is required to conduct a
    thorough Family Assessment with each family
    referred for services.
  • The North Carolina Family Assessment Scale
    (NCFAS) is the state-designated tool that must be
    utilized with every family.

68
  • The NCFAS, used in Placement Prevention cases,
    contains 5 domains
  • Environment
  • Parental Capabilities
  • Family Interactions
  • Family Safety
  • Child Well-being
  • Each domain contains various items that are
    scored individually an overall score is obtained
    for each domain.

69
  • The NCFAS-R, used only in Reunification cases,
    contains the five domains of the NCFAS plus two
    additional domains
  • Caregiver/Child Ambivalence
  • Readiness for Reunification
  • As with the NCFAS, the therapist scores each item
    and then determines an overall score for each
    domain.

70
  • During the first 20 days following the initial
    meeting with the family, the therapist
    familiarizes him/herself with the familys
    strengths and challenges in each domain.
  • When the therapist has sufficient information to
    complete the Family Assessment, he/she scores the
    family on each NCFAS/NCFAS-R scale and determines
    overall scores for each domain.

71
  • There is no minimum or maximum number of hours
    the therapist must spend on the Family
    Assessment, either with the family or scoring the
    NCFAS/NCFAS-R.
  • After scoring all scales, the therapist completes
    a narrative report and submits it to the
    referring social worker within 20 calendar days
    of the first face-to-face contact.

72
  • Currently, each contractor may decide what form
    their completed Family Assessments will
    takethere is no state-generated document
    required.
  • However, the narrative report submitted to the
    referring social worker must either incorporate
    the NCFAS/NCFAS-R scores or have a copy of the
    scales attached.

73
  • The NCFAS/NCFAS-R and the written Family
    Assessment, in conjunction with the FPS referral,
    is used as the basis for the Service Plan and
    outcome measures for services provided to the
    family.

74
  • The FPS therapist completes the NCFAS/NCFAS-R
    again when the case is being closed. By
    comparing exit scores to the ones obtained at
    intake, the therapist may determine the amount
    of progress made by the family in each domain
    during the intervention.
  • This information is reported in the Exit Summary.

75
Other uses of the NCFAS
  • The NCFAS/NCFAS-R must be reviewed in clinical
    supervision when a specific case is being
    discussed this must be documented in the client
    file.
  • The NCFAS/NCFAS-R must also be reviewed when a
    case is transferred from one therapist to
    another the review must be documented in the
    client file.

76
Important Note
  • All FPS therapists must complete specialized
    training in the use of the NCFAS/NCFAS-R before
    working with families. Please refer to the
    Program Requirements section of this training
    module for more information.

77
Service Plan
  • Developed during the same time frame as the
    Family Assessmentcompleted Service Plan due to
    referring social worker by 20 calendar days from
    the first face-to-face contact.
  • Service Plan addresses needs and builds
    on strengths identified in the Family Assessment.

78
  • Always developed with the family, not for them,
    with their unique strengths and challenges, risk
    factors, needs, and culture in mind
  • Pre-packaged, one-size-fits-all service plans
    are never used in FPS! Each Service Plan is
    uniquely tailored to fit each individual family
    receiving preservation services.

79
  • Include input from referring social worker (and
    other sources, if applicable) when developing the
    Service Planfamilies may not agree with the
    reason for referral, but the Service Plan must be
    consistent with/supportive of the Case Plan
    developed by the social worker.

80
  • Each adult/adolescent family member addressed in
    the Service Plan should sign and date the
    completed plan.
  • Younger children may sign if they wishwhile not
    required, this can help them feel as though
    they are playing a significant part in the
    treatment process.
  • The therapist should also sign, before forwarding
    the plan to the social worker for approval.

81
A good Service Plan
  • Clearly identifies goals of service, as related
    to concerns noted in referral.
  • Outlines objectives (action steps) for achieving
    each goaldefines who will do what, when it will
    be done, etc.
  • Is realistic, achievable, and something the
    family wants to accomplish!

82
  • At the first family meeting following
    completion of the Service Plan, each adult
    and adolescent family
    member receives
    his/her own copy
    of the Plan.

83
A final note on Service Plans...
  • The Service Plan is a dynamic documentit should
    change as the familys situation changes, and
    reflect the flow of the intervention.
  • When a goal is accomplished, document it,
    celebrate it, and move on to a new goal.

84
  • If no progress is happening on a specific goal,
    discuss with the family and consider another
    approach.
  • When goals are accomplished, amended, or
    discarded, be sure to note this in weekly
    contacts with the social worker, as well as in
    the Monthly Status Report.

85
Community Connections
  • One of the primary functions of FPS is to help
    enhance families connections to the communities
    in which they live and work.

86
  • To achieve this desired outcome, the FPS
    therapist will explore a number of issues,
    including
  • What are the familys needs?
  • What kinds of resources might fulfill these
    needs?
  • Which of these kinds of resources are available
    in the familys community?

87
  • What barriers might be preventing the family from
    accessing resources?
  • What other available resources might provide a
    reasonable alternative solution to the familys
    needs?
  • What might be the benefits and/or disadvantages
    of linking the family to specific community
    resources?

88
  • A significant aspect of the mission of FPS is to
    help families increase their level of
    self-sufficiency.
  • Teaching them where to look and how to access
    resources within their community is an important
    first step.
  • Familiarizing FPS families with community
    resources provides them with valuable tools with
    which to tackle present and future challenges.

89
  • Dont just hand families a list of resourceshelp
    them explore whats out there, show them how to
    discern what might be helpful, and take those
    first steps towards making the connection with
    them.
  • Rememberour clients learn best when we do things
    with them, not for them!

90
  • The key to remember here is that we are NOT
    just connecting families to community resources
    to solve an immediate, one-time need
  • we are showing families how they can respond
    to challenges in a healthy, positive way that may
    prevent the need for future CA intervention.

91
Concrete Goods and Support Services
  • A specific dollar amount (currently 500) is
    allotted to each FPS case.
  • These funds may be utilized by the therapist with
    appropriate written departmental approval.

92
  • Concrete funds may be used for food, clothing,
    shelter, or necessary services for the family
  • But there are conditions and exceptions to the
    availability of this 500.

93
  • For specific information as to what
    constitutes an appropriate usage of Concrete
    Goods and Support Services funds, please refer to
    the contract and to the Billing and Payment
    training module.
  • The Billing and Payment training module also
    provides step-by-step instructions on how to
    access these funds and obtain reimbursement for
    your expenditures.

94
Use of Paraprofessionals
  • From the FPS Client Service Contract
  • Paraprofessional Worker means any
    individual who is trained and qualified to
    provide assistance and community support systems
    development to families and who acts under the
    supervision of a preservation services therapist.
    The paraprofessional worker is not intended to
    replace the role and responsibilities of the
    preservation services therapist.

95
  • The FPS therapist supervises any paraprofessional
    (parapro) involved in a caseprovides clinical
    support, continues to be responsible for the
    case, must complete necessary reporting, etc.
  • Parapros may be used for tasks or activities in
    which the level of skills and/or credentials of
    the therapist are not necessarily required.

96
For example
  • Teaching skills, such as budgeting, meal
    planning/nutrition, basic parenting skills,
    housekeeping, doing laundry, etc.
  • Providing emergency transportation when other
    options are not available.
  • Developing community connectionsteaching
    families how to access and use available
    resources.

97
  • Because the hourly rate for a parapro is
    one-third the hourly therapist fee, the use of
    parapros is an excellent way to maximize the
    number of direct service hours to families.
  • Parapros may also provide back-up crisis coverage
    to the families with whom they are working.

98
Important!
  • The referring social worker must authorize the
    use of paraprofessional staff/subcontractors. If
    authorization was not provided at the time of
    referral (indicated on the referral form), obtain
    this in writing before introducing the parapro to
    the client.

99
Communication Between FPS Therapist and
Referring Social Worker
100
Case Updates
  • FPS therapists must provide case updates to
    the referring social worker at least weeklythis
    means providing feedback regarding each case, at
    least once every calendar week.

101
  • In a high-needs case (as determined by either the
    therapist or the referring social worker),
    updates should occur more frequently, depending
    on the intensity of the case.
  • If the social worker requests a protocol
    regarding updates (e.g., every other day, twice a
    week, etc.), it is the therapists responsibility
    to comply.

102
  • Case updates may include
  • Phone calls, voice messages
  • Faxed or emailed written updates
  • Face-to-face contact with social worker
  • Any formal or informal staffing regarding the
    case.
  • Case updates must be documented in the client
    file and on the Monthly Status Report.

103
  • In addition to regular weekly case updates,
    the FPS Client Service Contract establishes a
    number of special conditions under which the FPS
    therapist is required to contact the referring
    social worker. These are known as
    notifications.

104
Notifications
  • There are six specific conditions for which the
    FPS provider must notify the referring social
    worker. They are
  • Family unwilling to meet
  • Safety plan (new safety concerns found)
  • Change in residence
  • Missed appointments
  • Unusual incidents
  • Death of a client

105
Family Unwilling to Meet
  • When an FPS referral is received, the therapist
    must meet face-to-face with the family within 48
    hours.
  • If the family is unwilling or unable to meet with
    the FPS therapist within that time frame, the
    therapist must document this and notify the
    referring social worker as soon as possible
    (within the 48-hour period).

106
Safety Plan
  • If during an FPS intervention the therapist
    discovers safety concerns not addressed in the
    social workers Safety Plan (or if no Safety Plan
    was developed)
  • the therapist must notify the social worker of
    the safety concern immediately, and follow up
    with written notification within 24 hours.
  • If this safety concern is a CPS issue, CPS intake
    should also be notified immediately.

107
Change in Residence
  • If any member of a DCFS-referred family changes
    residence during an FPS intervention, the
    therapist must contact the referring social
    worker, verbally or in writing, within one
    working day, to notify them of the change.

108
Missed Appointments
  • When the FPS therapist learns that a client has
    missed an appointment (FPS or other significant
    appointment, generally related to the reason for
    referral), he or she must verbally notify the
    referring social worker within one hour of
    learning of the missed appointment.
  • The therapist must then complete a Missed
    Appointment form (IFPS/FPS No-Show and Missed
    Appointment Report).

109
Missed Appointment Form
110
  • The completed form must contain the following
    information
  • Date of appointment missed
  • Type of appointment missed (FPS, doctor,
    probation officer, etc.)
  • Reason appointment missed (illness, no show,
    etc.)
  • Follow-up actions taken (by FPS therapist or by
    client) and
  • Any concerns (e.g., pattern of missed
    appointments, etc.)

111
  • The Missed Appointment form must be faxed or
    delivered to the referring social worker within
    24 hours of learning of the missed appointment.
  • A copy of the Missed Appointment form must be
    retained in the client file.

112
Unusual Incidents
  • In the event an unusual incident occurs which
    impacts a childs health, safety or wellbeing,
    the childs living situation, or permanent plan,
    the FPS therapist must contact the referring
    social worker immediately.
  • The therapist must also follow up verbal
    notification in writing within 24 hours.

113
  • Unusual incidents may include such things as
  • an unexpected change in medical or psychological
    condition
  • adverse reaction to medication
  • severe behavioral incident unlike the child's
    ordinary behavior
  • severe injury
  • running away
  • physical self-abuse or abuse of others
  • sexual assaults, or sexual behaviors that are age
    inappropriate.

114
Death of a client
  • If the therapist learns of the death of a member
    of the immediate family with whom he or she is
    working, the referring social worker must be
    notified immediately.
  • Immediate verbal notification must be followed up
    in writing within 24 hours of learning of the
    death.

115
  • The information in the contract regarding
    Notifications is specific and accuratehowever,
    to ensure easy accessibility to therapists, we
    have provided another cheat sheet listing the
    various notifications.
  • Because the requirements for each of these
    notifications differ in various ways, its a good
    idea to keep this sheet handy for quick reference.

116
Communication Between FPS Therapist and
Referring Social Worker
117
Termination of Services
  • The FPS therapist and referring social worker
    mutually make the decision as to when a case
    should be closed.
  • The FPS Client Service Contract contains a list
    of guidelines for determining the appropriate
    time to terminate services.

118
Termination
119
Documentation
  • From beginning to end, paperwork is one of the
    most important parts of any FPS intervention.
  • Lets look at the range of documentation in
    FPS.

120
Client Service Log
  • This document is known by different names in
    different agencies, and its format varies
    according to each agencys needs.
  • Regardless of name or appearance, this document
    must contain a listing of all dates and hours of
    every case-related activity.

121
Case or Charting Notes
  • Documentation of each case activity must be
    included in the client file.
  • Each case/charting note must include
  • Name of staff providing the service
  • Date of service/activity
  • Location of service/activity
  • Concise notes regarding activity and
  • Signature of staff providing the service.

122
Family Assessment
  • Must address all pertinent domains in the
    NCFAS/NCFAS-R and include NCFAS/NCFAS-R scores.
  • Must be received by the social worker within 20
    calendar days of the first face-to-face meeting.

123
Service Plan
  • Must list goals of service and objectives (action
    steps) leading to goal achievement.
  • Must be consistent with/supportive of case plan
    developed by social worker.
  • Must be signed by therapist and family members
    approved by social worker.
  • Must be received by social worker within 20
    calendar days of 1st meeting.

124
Monthly Status Report
  • Must be completed and submitted to fiduciary
    specialist within 10 working days of the
    completed month of service (i.e., within 10
    working days of the first day of each month).
  • Must be submitted on the CA-designated form,
    which may not be altered or replaced with a
    substitution.

125
Completed Monthly Status Report includes both the
narrative section and the Financial
Reconciliation Page.
  • Narrative portion must include a summary of
    progress made (or lack thereof) on each Service
    Plan goal.

126
If reimbursement for Concrete Goods/Support
Services funds are being requested
  • Attach ORIGINAL receipts for each expenditure,
    and
  • Document how expenditure related to goals of
    service in narrative section.

127
Exit Summary
  • Must be completed and received by social worker
    within 10 working days of termination.
  • Must be submitted on the designated form, which
    may not be altered or replaced with a
    substitution.

128
Consumer Satisfaction Survey
  • A CA-designated form that is provided to the
    client, along with a pre-addressed postage-paid
    envelope, at termination of services.
  • Therapist must document in case notes that survey
    was given to the client.

129
Quarterly Report
  • Must be submitted by the contracted agency for
    all therapists providing services.
  • Must be submitted to the FPS Program Manager in
    Olympia within 30 days of each quarterly
    reporting period, using the database provided by
    CA.

130
Must contain numbers of
  • Referrals
  • Families served
  • Cases with improved NCFAS scores
  • Range of changes in NCFAS scores
  • Average of changes in NCFAS scores
  • Identified reunification cases
  • Children reunified
  • Completed interventions
  • Family eval cases
  • Placemt prevention cases
  • Placements prevented
  • Children at risk of placement
  • Ineligible families
  • Families refusing service

131
Documentation/Deadline Summary
132
Client File
  • Contracting agencies must maintain files on each
    client.
  • Typically, the designated therapist maintains
    their own client files.
  • Files must be presented to CA on demand at any
    time requested.

133
The FPS Client Service Contract contains a
lengthy list of what must be included in each
client file.
  • Please note that while additional documents may
    be kept in the client file, these are the items
    that must be included.

134
Client File
135
Excerpts from Exhibit BProgram Requirements

136
Therapist Credentials and Experience
  • All professional FPS staff must have AT LEAST
    a Bachelors degree in social or behavioral
    science or closely allied field, and at least two
    years of direct casework experience working with
    families and children.

137
Therapist credentials, contd
  • In addition, 50 or more of a contractors
    professional FPS staff must have at least a
    Masters Degree plus one year of direct casework
    experience working with families and children
    (OR Bachelors degree plus four years of direct
    casework experience with families and children).

138
Therapist credentials, contd
  • All professional staff must be registered as a
    counselor or licensed in at least one of the
    following fields Social Worker, Mental Health
    Professional, or Marriage and Family Therapist.

139
Therapist credentials, contd
  • On rare occasions, exceptions to this policy
    may be obtained by contacting the FPS Program
    Manager in Olympia.

140
Degree Requirements
  • Please refer to the current FPS Client
    Service Contract for specific degree requirements.

141
License Standing
  • All required licenses must be in good standing.
  • If any required license is suspended, or any
    limitations/restrictions placed upon a license,
    the contractor must notify the CA regional
    contract manager.

142
Professional Staff/Subcontractor Training
  • Each contractor is required to ensure that all
    FPS therapists obtain the following training
    within 60 days of being hired to provide these
    services

143
Specialized FPS Training
  • A designated number of hours of specialized FPS
    training must be provided by CA-designated
    expert(s) in Family Preservation Services.
  • Must be completed before staff/ subcontractor
    begins work with CA-referred families.

144
NCFAS
  • A designated number of hours of approved training
    on the NCFAS must be completed by each FPS
    therapist.
  • This may be either in-person or utilizing
    approved training materials under supervision of
    an FPS therapist who has completed the in-person
    training.

145
Motivational Interviewing (MI)
  • A designated number of hours of MI
    training provided by CA-approved experts in
    Motivational Interviewing must be completed by
    each FPS provider.

146
Other Training
  • Orientation on Quality Assurance standards.
  • Specialized training in the provision of family
    support services and development of community
    support services.

147
Please note
  • Any professional staff/subcontractor who is
    assigned to work with a family prior to receiving
    the above training must be supervised by an FPS
    therapist who has completed the training!

148
Paraprofessional Staff/ Subcontractors
  • There are no contractually-required credentials,
    years of experience, or training standards for
    parapros.
  • Each contractor is required to develop a list of
    training standards and other requirements for
    parapros these are submitted to CA as part of
    that contractors Operating Procedures.

149
one more thing
  • All staff/subcontractors involved in providing
    FPS must also complete Mandated Reporter training
    and receive certification in CPR and First Aid.
  • Other requirements concerning personnel files,
    etc., are contained in Exhibit Bbe sure to
    familiarize yourself with them!

150
In conclusion...
  • As an FPS provider, you must have a clear and
    thorough understanding of what you have agreed to
    deliverto your clients, and to CA.
  • Complying with these expectations will increase
    your effectiveness as a clinician and better
    serve the families with whom you work.

151
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