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The first two weeks of placement are critical in the child’s transition to foster care placement and to the family's engagement in the change process. The social worker should obtain as much information about the child and family as possible so that appropriate resources may be chosen and so that the social worker can help the substitute family to meet the child's needs. Assessment and planning are the activities that lay the foundation for the future work with the family and are important tasks in the initial placement process. Assessment and planning should involve collaborative efforts by all of the parties involved with the family.
To achieve the goals of foster care placement, MRS and family centered principles of partnership show us that it is critically important to consider a strategy of collaborating with all agencies involved with the family in order to develop one coordinated assessment process that involves the family in a comprehensive evaluation of their strengths and needs. A coordinated assessment process alleviates the need for the family to "tell their story" repeatedly to each different service provider. At the same time, this process ensures that services are coordinated and delivered in a manner that best meets the needs of the child and family over time.
Community Assessment Teams (or other family decision-making models) are valuable tools for assessing the strengths and needs of families and children in the early phase of placements. By involving the child's family, relatives and other kin, foster parents, community supports and all of the agencies involved with the child and family in an early assessment process, everyone involved has the opportunity to understand clearly the reasons for placement and the issues that need to be resolved in order for reunification to occur or, if reunification is not the plan, the child’s need for permanency. Everyone involved contributes to the plan for permanency for the child and can clarify what each person is expected to do to contribute to that plan. Although the assessment process is ongoing throughout the placement, a Community Assessment Team meeting within the first two weeks of the placement provides an opportunity to focus on the permanency plan quickly, thereby facilitating timely achievement of that plan. A Community Assessment Team meeting within the first two weeks can motivate parents to make changes early and often leads to shorter lengths of stay. (Refer to Section 1201, the Yellow Pages for more information on Community Assessment Teams and one coordinated assessment)
Risk assessment is an ongoing process that continues during placement of the child out of the home. As the work with the family proceeds, the factors that have been identified in the initial Safety Assessment, Family Risk Assessment, Family Assessment of Strengths and Needs and Case Decision Summary, and updated with new information from the Family Reunification Assessments, will help to shape the scope of work with the child's parents. In preparing the parents for the removal of the child, explicit discussion of these reasons will already have been done. However, in preparation for the completion of the Out of Home Family Services Agreement, the social worker and the parents can begin the mutual process of reviewing the risk factors and identifying strengths and the needs that must be addressed in order for the child to be returned, if reunification is the plan. This, in turn, will facilitate and solidify the Out of Home Family Services Agreement planning process with the parents.
MRS and System of Care shows us that the work of reunification must be a mutual partnership between the agency, the parents, and any other significant person or agency.
As the risk assessment process continues, the social worker and parents should discuss family strengths with the same degree of intensity as they do the identification of the needs within the family. No matter what problems a family demonstrates, there are strengths within the family. These strengths are the social worker's ally in helping the family make the needed changes so that the child can be returned.
As a part of the risk assessment, social workers should remember the other children that may remain in the parents' home. Frequently, these children have service needs of their own. In many cases, once the "identified child" has been removed, the other children in the home are at greater risk. Thus, the social worker shall continually assess the risk of harm to the remaining children and to incorporate their needs into the Out of Home Family Services Agreement as necessary. Documentation of these ongoing services and risk assessment shall be incorporated into the court report.
According to State law, at each hearing to determine the need for continued non-secure custody, the Court shall:
When a child is placed out of his/her home, information about the child's medical needs, medication, any special conditions, and instructions for care should be given to the foster parent prior to or at the time of placement. The social worker is responsible for bringing any medications, glasses, hearing aids, etc. to the foster care placement with the child. Social workers should document in the record when these items are given to the foster care placement providers. The Child Health Status Component (DSS-5243 shall be completed within seven days of initial placement and a copy shall be provided to the foster parents.
Frequently, it is the foster parent who takes the child to medical appointments. Therefore, it is important that the foster parent have the Child Health Status Component to take with them to those appointments, as well as any other medical or social history information that impacts the delivery of health care services. Any printed summary report that is provided to the physician should have non-essential, confidential information (such as the identity of the perpetrator) removed or obliterated. The Child Physical Evaluation form (dss-5244) is recommended for use by physicians to record findings and to assure continuity of care among providers.
A child must have a physical examination scheduled within seven days of the date of placement. Social workers shall also schedule dental, developmental, psychological, and educational assessments, when needed, within one week from the identification of the need.
It is recognized that foster parents and residential care providers have a need to know the HIV status of children in their care. Infections or viruses that are less serious in a non-infected child can be fatal to an HIV-infected child, and foster parents must be aware of symptoms that require immediate medical attention. However, prior to disclosure of a child’s HIV status, DSS must consider and protect the child’s right to confidentiality. While concern for confidentiality exists throughout the service delivery system, information regarding persons infected with HIV requires special consideration. This is due to the potential social and psychological damage that can be caused by inappropriate sharing of such information.
G.S. 130A-143 provides that HIV status and information is strictly confidential and shall not be released or made public except under certain circumstances. One such circumstance provides that release of all or part of the medical record can be made with the written consent of the person or persons identified or their guardian. In this context, guardian applies to a local DSS having authority to release HIV status and information on a child in its custody on a need to know basis to foster parents and residential care providers.
Information on the child’s HIV status should be shared only with persons who have a need to know, and persons informed should be told that re-disclosure of the information is prohibited without consent of the child, the parent or guardian. Best practice would suggest involving the parents in these decisions to the extent possible and appropriate.
The Fostering Connections to Success and Increasing Adoptions Act (P.L, 110-351) addresses a number of concerns about outcomes for children who have entered foster care placement. Educational instability can cause great harm to children in foster care:
Because of these issues, states are required to specifically address the educational stability of the child in the family services agreement. In order to meet the purposes of this requirement, the Child Education Status Component of the Family Services Agreement (DSS-5245 rev.3/10) has been amended to address the following requirement in Section 204:
“The child’s case plan must include (1) assurances that the child’s placement takes into account the appropriateness of the current education setting and the proximity to the school in which the child was enrolled at the time of the placement;
(2) an assurance that the state agency has coordinated with appropriate local educational agencies to ensure that the child remains in the school in which the child is enrolled at the time of placement; and (3) if remaining in the school is not in the child’s best interests, assurances by the state agency and the local educational agencies to provide immediate and appropriate enrollment in a new school, with all of the educational records of the child provided to the school.”
Completion of the Child Education Status Component (DSS-5245) is required within seven days of placement and a copy shall be provided to the foster parents. However, it is more helpful if that information can be given to the foster parent at the time of the placement in order to facilitate enrolling the child in school. The foster parent(s) as well as the parent(s) should be included in educational decisions about the child.
The social worker shall have face-to-face contact with the child at least once within the first week of initial and subsequent placements. However, a telephone call or visit to the foster parent the day after placement provides reassurance to the child and the foster care provider. Prompt contact after placement also allows the social worker to answer any early questions about the care of the child. The foster care provider and the child should know as early as possible when the next face-to-face contact with the social worker will be and when the first visit for the child with the birth parents and/or siblings will be.
The social worker shall have face-to-face contact with the child at least monthly, unless otherwise indicated in the Out of Home Family Services Agreement. The majority of these visits should be in the child’s residence. The social worker shall also have face-to-face contact with the foster parents at least monthly.
Because these first weeks of placement are so crucial in the child and family's life, it is most important that accurate and timely documentation be kept. Documentation provides a record of the events and processes in the agency’s work with the family as well as a record of the interaction with the agency.
From this documentation, plans can be drawn and the risk that the child will stay too long in care will be minimized. In addition, pictures of the child and the family during this period help the child's adjustment to foster care placement. With the proper foundation laid in the first weeks of placement, the next phase of work with the family can begin.
The dss-5094 and IV-E eligibility determination forms should be completed and data entered within 24 hours of placement.
During the first two weeks, documentation regarding missing parents and relatives should be reviewed and supplemented. The Court will ask about the whereabouts of missing parents, including legal and biological fathers, at the seven day non-secure custody hearing, as well as at subsequent hearings. Available information should have been recorded during the investigative assessment phase, but unknown or unresearched information should be updated. The Child Support Enforcement Unit, the Federal Parent Locator Service, and the Internet White Pages are three useful sources to locate the addresses of missing persons.
(Refer to Section 1201, Record Keeping and Documentation, for further information on record keeping requirements).
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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