Operations Manual Regions 2 and 9

Foster Care Redesign

Texas Department of Family and Protective Services Foster Care Redesign A Guide to Foster Care Redesign in Regions 2 and 9

Welcome to Foster Care Redesign in CPS regions 2 and 9! This is an exciting time to work in CPS and embark on a new way of doing business with our new partner, Providence Service Corporation (PSC) of Texas.

First, it is important to understand that you will continue to maintain your role as a CPS staff member (i.e. investigator, FBSS worker, conservatorship worker) who serves children, youth, and families within regions 2 and 9. Your primary responsibility as CPS case management staff is, first and foremost, to ensure that all children are safe and protected from future harm.

Foster Care Redesign is based on the premise of shared decision making, which is an interactive process in which PSC, CPS, children, youth, and families collaborate to make decisions about the child’s care and protection. “It assumes that [all members] have important information to contribute to the process: [CPS and PSC have relevant clinical expertise and mitigating resources]; [children, youth and families] are the experts on their own values, [beliefs, needs]…and goals.”1

Simply put, Foster Care Redesign is a new way of doing business as it builds on existing good practices already in place. By partnering with PSC in regions 2 and 9, Foster Care Redesign will:  Improve outcomes for children, youth, and families through stability in placements and maintaining community connections;  Enhance collaboration, partnerships and community involvement in support of children and families;  Strengthen CPS accountability efforts;  Strengthen efficiencies in practice (i.e. service delivery);  Provide evaluation and continuous quality improvement with processes in place.

As you embark on this new journey of doing business differently, we invite you to remain open-minded, communicate openly and honestly, and maintain a strength-based focus that is critical to the success of Foster Care Redesign in regions 2 and 9. As Foster Care Redesign is new to CPS and the community, it’s important to recognize and allow for “bumps in the road” to occur and use them as opportunities to improve processes further.

This operations manual is designed to give regions 2 and 9 staff step-by-step instruction and guidance to the implementation of Foster Care Redesign with PSC as the Single Source Continuum Contract (SSCC). This manual will focus primarily on processes and protocols related to:  Child placement,  Child and youth service planning,  Discharge planning,  Transitional living services,  Court requirements,  Adoption, and  Case dispute resolution. While this manual focuses on Stage I of Foster Care Redesign, updates to the manual will be made over time to include instruction and guidance with Stages II and III of Foster Care Redesign in regions 2 and 9.

The protocols detailed in this operations manual are for children from regions 2 and 9 (legal county is within regions 2 or 9) placed with and/or receiving services through PSC as the Single Source Continuum Contractor. The CPS Handbook policies and rules remain in effect, unless specifically waived. However, if differences or conflicts in CPS Handbook policy are present, this manual will govern the operations in 1 Community Mental Health Journal, vol. 42, No. 1, February 2006; Shared Decision Making and Evidence Based Practice. Foster Care Redesign Operations Manual Page 2 of 94 regions 2 and 9. CPS staff should refer to the Foster Care Redesign Texas Administrative Code (TAC) Rules and Policies Waiver for more information.

If you have any questions about any information in this manual, please contact your supervisor or Cyndi Reed, Regions 2/9 CPS Foster Care Redesign Administrator at [email protected], (325) 691- 8241. Thanks for all that you do!

Foster Care Redesign Operations Manual Page 3 of 94 Table of Contents

The CPS Mission The mission of Child Protective Services is to protect children and to act in the children’s best interest. To seek active involvement of the children’s parents and other family members to solve problems that lead to abuse and neglect.

The CPS Vision Children First: Protected and Connected.

CPS Values Respect for Culture, Inclusiveness of Families, Youth and Community, Integrity in Decision Making, Compassion for All, and Commitment to Reducing Disproportionality.

Foster Care Redesign Operations Manual Page 4 of 94 What is Foster Care Redesign? This operations manual gives CPS staff a more in-depth look at the protocols for case actions in CPS cases involving paid foster care placements that are affected by Foster Care Redesign in regions 2 and 9. To begin, staff must understand Foster Care Redesign.

Background CPS recognizes that children and youth are too often placed outside of their home communities, leaving behind family, friends, schools, church and other community support systems. Foster Care Redesign seeks to address this concern by promoting positive outcomes for children, youth and families and thus improve the overall process and quality of care.

Beginning in January 2010, CPS initiated the "Improving Child/Youth Placement Outcomes: A System Redesign" project, commonly referred to as "Foster Care Redesign." The goal of Foster Care Redesign is to improve outcomes for children and families by creating sustainable placement resources in communities that will meet the service needs of children in foster care using the least restrictive placement settings.

A Public Private Partnership (PPP) comprised of 26 individuals who represent Texas foster youth alumni, members of the judiciary, providers, trade associations, advocates and CPS staff serve as the guiding body for development and implementation of the new foster care model.

The PPP considered input from over 3,000 stakeholders, research findings from foster care models used in other states and analyses of Texas specific data to reach consensus on its recommendations for the Texas Foster Care Redesign model. These recommendations were submitted to CPS and subsequently the agency was granted permission to move forward with Foster Care Redesign by the 82nd Texas Legislature through the passage of Senate Bill 218.

What does the Texas Foster Care Redesign Do? The Foster Care Redesign model changes the manner in which CPS procures, contracts and pays for paid foster care and other purchased services and promotes a community-based approach to service coordination and delivery.

In the new foster care model, a Single Source Continuum Contractor (SSCC) is responsible for ensuring the full continuum of services in a designated geographic catchment area and therefore must have a good understanding of the strengths and needs of the community. Additionally, the redesign provides opportunities for better coordination of services to children and families, and enhances opportunities for collaboration both between CPS and other stakeholders.

Procurement for Initial SSCC In a Request for Proposals (RFP) released on August 1, 2011, CPS solicited proposals for SSCC contractors in metropolitan catchment areas and non-metropolitan catchment areas.

The following Best Value Factors were considered to decide which proposals advanced through the procurement phase and were the basis for tentative contract award selections:

 The extent to which the respondent's proposed services meet CPS' needs and those of the children and families to be served.  The respondent's fiscal/financial position and stability.  The respondent's probable performance, per indicators such as past performance, ability to perform, and experience and responsibility, including previous relevant experience.  The respondent's accreditation in the field of residential child-care services.

Foster Care Redesign Operations Manual Page 5 of 94  The respondent's historical experience providing residential child-care services and family services in the State of Texas.

Single Source Continuum Contract: Providence Service Corporation On February 1, 2013, the first single source continuum contract (SSCC) of the Foster Care Redesign initiative went into effect with Providence Service Corporation (PSC) of Texas. The contract is for CPS regions 2 and 9.

Providence has been providing services in Texas since 1998 and through the SSCC contract will operate a model that includes:

 Developing a strong network of providers.  Strong community involvement, including forming a provider council and community advisory committee, coordination with school systems, coordination with STAR Health providers, collaboration with the courts, CASA, and other stakeholders.  Providing wraparound services designed to serve children in family-like settings in their own communities.  A strong intake and assessment component seeking to make the first placement the best placement.  Strategic family foster home development and training.  A strong quality assurance component.  The use of solution-based casework and trauma-informed care.  More family-centered, in-home and community-based services so that fewer children with complex needs will need to be in out-of-home group or residential clinical care.  Expansion of community based services (traditional and non-traditional)

Foster Care Redesign Operations Manual Page 6 of 94 For more information about Foster Care Redesign, go to: http://www.DFPS.state.tx.us/Adoption_and_Foster_Care/About_Foster_Care/Foster_Care_Redesign CPS Initiated Placements Regions 2 and 9 staff will work directly with Providence Service Corporation (PSC) upon determining that a child in CPS conservatorship requires placement in a paid foster care setting. This section outlines protocols for new placements and placement changes initiated by CPS only.

CPS staff must follow CPS Handbook policy related to the assessment, consideration, and selection of the least restrictive placement for every child’s initial or subsequent placement (new placement or placement change) in substitute care. For more information, see CPS Handbook policy:  4120 Consider Key Issues in Selecting a Caregiver ; and  4121 Required Issues to Consider.

Since PSC will be paid one blended foster care rate for all children placed within PSC’s provider network, CPS will no longer submit service level requests to Youth for Tomorrow (YFT). Regardless of the child’s needs or services to meet those needs, PSC is responsible for providing a continuum of care to each child placed within their provider network. CPS handbook policy items related to requesting a service level for a child, therefore, is waived. See Foster Care Redesign Texas Administrative Code (TAC) Rules and Policies Waiver for more information.

There will be a small number of children and youth placed in PSC’s provider network with exceptional needs that cannot be met appropriately through the use of a blended foster care rate. PSC will request exceptional care for children and youth through the IMPACT Placement page (SSCC Placement Option & Circumstance page) as necessary to meet the child’s or youth’s exceptional needs. All exceptional care requests from PSC require supervisor approval.

Regardless of the type of placement (new or change), workers must staff the child’s case with their supervisor and obtain approval prior to requesting a paid foster care placement from Providence Service Corporation (PSC).

New Placements After CPS determines, with supervisor approval, that the child requires placement in a paid foster care setting, the worker must decide if the child needs emergency or non-emergency placement.

Emergency Placement Process: The emergency placement process is used when CPS makes a referral to PSC for a child or youth who is in immediate need for paid foster care placement and services and is not currently served by PSC. This process, therefore, will be used for all emergency and non-emergency removals, as well as any child requiring immediate paid foster care placement and services.

The chart below reflects the specific steps a CPS worker (removal or conservatorship) must take in order to request and complete an emergency foster care placement from Providence Service Corporation (PSC): Contact PSC Placement Unit via phone at #855-488-1046 and provide: Notification  CPS worker contact information  CPS worker back-up contact information (i.e. supervisor)  Establish PSC worker to be assigned as secondary  Child’s placement information (can be verbal):* o Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information) o Therapeutic needs o Social needs o Court orders/affidavit

Foster Care Redesign Operations Manual Page 7 of 94 o Medical, dental, and mental health records (only needed if specific care instructions are required for the child’s care) o Visitation plans with siblings, parents, or other family member and fictive kin (if established) o General Release of Information (any & all information and records about the child).

*All child’s placement information may be given verbally to PSC with the exception of form 2087ex & General Release of Information, which must be sent via email ([email protected]) to PSC within 2 hours of referral; email subject title, “DFPS Emergency Placement-Child Placement Information.” Evaluate and approve PSC’s recommended placement option and medical consenter Placement of Child/Youth within 1 hour of receipt of notification from PSC by telephone or via IMPACT*

*If there are concerns about the placement recommendation, CPS worker must get supervisor and PD approval to deny recommendation. FCR Administrator must also be notified.

*If approval is granted by telephone, IMPACT approval must follow by 7:00pm the next calendar day.

*Approval will be assumed if denial is not received within 1 hour. Within 4 hours of emergency placement referral, CPS will physically transfer the child to PSC. Worker and PSC decide on meeting location and transportation of the child to the foster placement in consideration of child's best interest and to minimize transitions with the child. At the time of placement, CPS worker will provide PSC with:  Signed education decision-maker (form 2085e);  Signed medical consenter (form 2085b);  Signed Placement Authorization (form 2085fc).*

*Providence will always be the placement. *For a child's initial placement (brand new removal or other emergency placement), when a placement has not been identified, CPS worker will remain medical consenter until a placement is identified. Within 4 hours of initial contact with PSC (referral): Documentation  Update Person Information and open FSU and SUB stages in IMPACT;  Enter referral information in each child’s SUB stage in IMPACT;  Make PSC staff secondary on each child’s SUB stage in IMPACT. By 5:00pm the next business day, complete any remaining placement documentation including:  Birth verification/certificate;  Social Security card (if available);  Education portfolio;  Medicaid/Star Health card (if available);  Any external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child;  Update person characteristics in IMPACT;  Update education log in IMPACT;  Update medical/dental page in IMPACT; and  Notification of all legal parties (parents, parents’ attorneys, AAL, GAL,

Foster Care Redesign Operations Manual Page 8 of 94 CASA) of the emergency placement change, if applicable.

Any external forms and written placement information not available in IMPACT should be emailed to PSC with subject line, “CPS Emergency Placement.” Within 30 days of placement referral:  complete the Common Application (form 2087); excluding level of care information) in IMPACT; and  notify PSC that Common Application (form 2087) is complete and accessible in IMPACT. If placement is not identified by PSC within the 4 hour timeframe and the child has been physically transferred to PSC, then the CPS worker will provide verbal approval of the placement, medical consenter, and education decision-maker. CPS worker must follow-up with written approval by:  Approving the placement option and medical consenter in IMPACT; and  Providing the signed medical consenter & education decision-maker forms to PSC via email with subject line, "CPS Emergency Placement-Medical Consenter/Education Decision-Maker."

Expectations of Providence Service Corporation (PSC): 1) No later than 7 hours of receipt of notification of need of emergency placement, PSC will provide CPS: a. Notification of a recommended placement by phone or electronically (IMPACT) b. The name of the sub-contractor c. Name and location of recommended placement If PSC has not established a placement for a child within 7 hours of initial notification, PSC will notify CPS with status and strategy for finding a placement. Worker will notify supervisor that no placement has been found. Supervisor will notify the FCR Administrator.

2) Documentation of placement in IMPACT within 12 hours of referral. If CPS worker does not receive the placement information in IMPACT from PSC within 12 hours, CPS worker will call PSC Intake Worker/Supervisor. CPS Worker will notify supervisor and FCR Administrator.

*CPS worker is responsible for ensuring all placement documentation is entered in IMPACT within current policy timeframes. See CPS Handbook policy 4133 Making the Placement/Recording the Placement in IMPACT.

3) Within 3 days of placement, PSC will ensure any child under age 3 years is referred to ECI if the child is suspected of having a disability or developmental delay as a result of exposure to illegal substances, or the disability or developmental delay requires evaluation prior to their scheduled TX Health Steps check-up.

Non-Emergency Placement Process: The non-emergency placement process is used when CPS makes a referral to PSC for a child or youth in CPS conservatorship who is moving to a paid foster care placement in PSC’s provider network.

The chart below reflects the specific steps a CPS worker (removal or conservatorship) must take in order to request and complete a non-emergency foster care placement from Providence Service Corporation (PSC): Within 72 hours of identifying placement need: Notification  Complete referral in IMPACT;  Email PSC with the subject, "CPS Non-Emergency Placement":

Foster Care Redesign Operations Manual Page 9 of 94 o Indicate possible times available for pre-placement staffing; o Establish the PSC worker for secondary assignment; o Provide child’s placement information: . Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information) . Therapeutic needs; . Social needs; . Court orders/affidavit; . Medical, dental, and mental health records (only needed if specific care instructions are required for the child’s care) . Visitation plans with siblings, parents, or other family member and fictive kin (if established) . General Release of Information (any & all information and records about the child).

CPS will coordinate and facilitate the pre-placement staffing as outlined in Pre- Pre-Placement Staffing Placement Staffing. CPS will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure PSC staff receive a copy. Evaluate and approve recommended placement option and medical consenter in Placement of Child/Youth IMPACT within 24 hours of receipt from PSC.

*If CPS has concerns about recommended placement, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified.

*Approval will be assumed if denial is not received within 24 hours. CPS and PSC will decide on a designated location to:  exchange the completed placement documentation, including: o Signed education decision-maker (form 2085e); o Signed medical consenter (form 2085b) o Signed Placement Authorization (form 2085fc). o Birth verification/certificate; o Social Security card (if available); o Education portfolio; o Medicaid/Star Health ID card (if available); o Most recent child service plan (if applicable); and o Any relevant external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child.  physically transfer the child based on the child's best interest and to minimize transitions with the child.

*CPS will arrange for transportation for the child if current provider is unable to transport. PSC will not be expected to transport child from current placement. Upon approval to request placement & before pre-placement staffing: Documentation  Update person characteristics;  Update education log;  Update medical/dental page. Document pre-placement staffing in IMPACT contact detail page. By 7:00 pm the next calendar day after the child has been placed, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT.

Foster Care Redesign Operations Manual Page 10 of 94 Within 30 days of placement referral:  complete the Common Application (form 2087; excluding level of care information) in IMPACT; and  notify PSC that Common Application (form 2087) is complete and accessible in IMPACT.

Expectations of Providence Service Corporation (PSC): 1) No later than 3 days prior to placement needing to occur, PSC will notify CPS, through IMPACT and follow-up email, of recommended placement and medical consenter.

2) Within 12 hours of placement occurring, documentation of placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement). If CPS worker has not received the placement information in IMPACT within 12 hours of placement, CPS will call PSC Intake Worker/Supervisor. CPS Worker will notify supervisor and FCR Administrator.

Placement Changes Placement changes or disruptions in regions 2 and 9 will likely take place when a child or youth, who is placed in a paid foster care setting within the PSC network, requires a new foster care placement within the PSC network. PSC must make all reasonable attempts to prevent placement changes or disruptions.

Placement changes, initiated by CPS, are typically non-emergency in nature. CPS workers must obtain supervisor and PD approval to request a placement change from Providence Service Corporation (PSC).

The chart below reflects the specific steps a CPS worker must take in order to request and complete a non-emergency foster care placement change from Providence Service Corporation (PSC).

Non-Emergency Placement Changes: Within 72 hours of identifying need for placement change: Notification  Obtain supervisor and PD approval for the placement change;  Email PSC with the subject, "CPS Non-Emergency Placement-Placement Change": o Reason for desired change, o Timeframe for change, o Establish and assign PSC worker for secondary assignment in IMPACT, o Establish need for pre-placement change staffing, and o Cc supervisor, PD, and FCR Administrator on email. Pre-Placement Change CPS will coordinate and facilitate the pre-placement change staffing as outlined in Staffing (optional) Pre-Placement Staffing.

*Pre-placement change staffing is optional & determined jointly by PSC and CPS worker.

*CPS will ensure all legal parties (parents, parents’ attorneys, AAL, GAL, CASA) are consulted about the placement change prior to the placement change occuring

Foster Care Redesign Operations Manual Page 11 of 94 whether a pre-placement staffing is held or not. CPS will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure PSC staff receive a copy. Evaluate and approve recommended placement option and medical consenter in Placement of Child/Youth IMPACT within 24 hours of receipt from PSC.

*If CPS staff has concerns about recommended placement, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified.

*Approval will be assumed if denial is not received within 24 hours. PSC will complete the physical placement of the child with the new placement and complete all placement forms.

Decision for CPS to participate in the physical placement of the child is based on the best interest of the child. CPS worker will provide PSC with signed medical consenter (form 2085b) and signed education decision-maker (form 2085e). Document pre-placement change staffing (if occurred) in IMPACT contact detail Documentation page. By 7:00 pm the next calendar day after the child has been placed, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT.

2) Within 12 hours of placement occurring, documentation of placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement). If CPS worker has not received the placement information in IMPACT within 12 hours, CPS will call SSCC Intake Worker/Supervisor. CPS Worker will also notify supervisor and FCR Administrator.

3) Prior to the placement change, ensure that the child’s substitute care provider completes the Residential Child Care Discharge Form (2109) and provides copies to the child’s new provider and to PSC. PSC must keep copies of form 2109 and provide such copies to DFPS upon request. Note: Form 2109 is not required when a child discharges from PSC’s provider network to a kinship placement or returns home.

Placing Children Who Have Habilitative or Primary Medical Needs Placing children who have habilitative or primary medical needs requires careful consideration in order to make the best placement matches to serve the special needs of these children. CPS Handbook policy 4212.3 describes the needs of children who have Primary Medical Needs and policy 4212.4 describes the needs of children who have Habilitative needs.

Foster Care Redesign Operations Manual Page 12 of 94 Emergency Placement CPS workers should follow the process outlined in New Placements/Emergency Placements when requesting an emergency paid foster care placement from Providence Service Corporation (PSC) for a child with habilitative or primary medical needs.

In addition to the emergency placement process, the CPS worker will:  Upon placement referral, coordinate a telephone staffing with the CPS on-call supervisor and Program Director, regional CPS Nurse, Well-Being Specialist, and Developmental Disability Specialist (as needed), and PSC intake worker to discuss: o The specific needs of the child; and o The ability of available placement options to meet the child’s specific needs.  After a placement has been recommended by PSC and approved by CPS, work with the CPS Well-Being Specialist to coordinate a telephone staffing with the chosen caregivers, medical staff (if applicable), PSC staff, CPS on-call supervisor and Program Director, regional CPS Nurse, Star Health staff to: o discuss the specific needs of the child, o discuss the expectations of placement, and o develop a plan to move the child and establish services in the new placement. The CPS Education and Developmental Disability Specialists should be included in the staffing as appropriate. If possible, the staffing should occur prior to the child arriving in his or her new placement, but no later than two business days after the child’s placement.

Non-Emergency Placement and Placement Changes CPS workers should follow the process outlined in New Placements/Non-Emergency Placements or Placement Changes (depending on the type of placement needed) when requesting a non-emergency paid foster care placement or placement change from Providence Service Corporation (PSC) for a child with habilitative or primary medical needs.

In addition to the non-emergency placement or placement change processes, the CPS worker will:  Within 24 hours of the placement referral, coordinate a telephone staffing with the CPS supervisor and Program Director, regional CPS Nurse, CPS Developmental Disability Specialist (as appropriate), regional Well-Being Specialist, CVS Program Director, and PSC intake worker and Director to discuss: o The specific needs of the child; and o Available times for a pre-placement staffing.  Work with the regional Well-Being Specialist to coordinate the pre-placement staffing, including relevant CPS staff CASA, GAL, ad litems, PSC staff, and current caregivers.  After a placement has been recommended by PSC and approved by CPS, work with the regional Well-Being Specialist to coordinate a telephone staffing with the chosen caregivers, medical staff (if applicable), PSC staff, CPS supervisor and Program Director, regional CPS Nurse, Star Health staff, and PSC intake worker to: o discuss the specific needs of the child, o discuss the expectations of placement, and o develop a plan to move the child and establish services in the new placement. The CPS Education and Developmental Disability Specialists should be included in the staffing as appropriate.

Foster Care Redesign Operations Manual Page 13 of 94 SSCC Initiated Placements Occasionally, Providence Service Corporation (PSC) may need to initiate emergency and non-emergency placement changes within their provider network. PSC must make all reasonable attempts to prevent placement changes or disruptions.

Emergency placement changes may only be initiated when there is a perceived or actual threat to the safety or well-being of the child. Non-emergency placements may need to be initiated based on a variety of reasons, all of which must be justified by Providence Service Corporation (PSC).

It should be noted that if PSC receives a request from an external party for a placement change (i.e. ad litem or CASA) then PSC will notify the CPS worker. If a placement change is needed, then the CPS Placement Changes process described previously must be followed.

The charts below reflect the specific tasks CPS and PSC must take in order to facilitate a SSCC initiated emergency or non-emergency placement change.

Emergency Placement Changes: Upon notification from PSC (via phone or email) of the need for placement change, Notification PSC will provide CPS with:  the reason for emergency placement change,  when PSC contacted Statewide Intake (SWI),*  PSC worker for secondary assignment, and  need for emergency placement change staffing.

*The CPS investigator who receives the call from SWI will follow existing protocols for notifying the on-call CVS supervisor and/or worker as needed.

*CPS worker must follow CPS protocol if there is a RCCL investigation initiated due to the safety threat or well-being concern that led to the placement change. Emergency Placement PSC will coordinate and facilitate the placement change staffing as outlined in Pre- Change Staffing (optional) Placement Staffing.

*Emergency placement change staffing is optional & typically takes place after the emergency placement change is completed. Decision to hold a staffing is determined jointly by CPS worker and PSC.

*PSC will ensure all legal parties (parents, parents’ attorneys, AAL, GAL, CASA) are notified of the placement change. PSC will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure CPS staff receive a copy. Within 1 hour of receiving placement options from PSC, the CPS worker (or on-call Placement of Child/Youth worker, if applicable) will evaluate and approve placement option and medical consenter.

*Approval may be given verbally, but must be followed up with approval in IMPACT by 7:00 pm the next calendar day.

*If CPS staff has concerns about recommended placement, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified. PSC will complete the physical placement of the child with the new placement and complete all placement forms.

Foster Care Redesign Operations Manual Page 14 of 94 *Decision for CPS to participate in the physical placement of the child is based on the best interest of the child. CPS and PSC will coordinate the exchange of relevant child’s placement information, including the signed education decision-maker (form 2085e) and signed medical consenter (form 2085b). CPS worker will document placement change staffing (if occurred) in IMPACT Documentation contact detail page. Within 12 hours of placement occurring, PSC will document the placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement).

*If CPS worker has not received the placement information in IMPACT within 12 hours, CPS will call PSC Intake worker/supervisor. CPS Worker will also notify CPS supervisor and FCR Administrator. By 7:00 pm the next calendar day, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT.

*Placement information will need to be added if it is not in IMPACT so that eligibility is not disrupted. Prior to the placement change, PSC will ensure that the child’s substitute care provider completes the Residential Child Care Discharge Form (2109) and provides copies to the child’s new provider and to PSC. PSC must keep copies of form 2109 and provide such copies to DFPS upon request.

*Form 2109 is not required when a child discharges from PSC’s provider network to a kinship placement or returns home.

Non-Emergency Placement Changes: Upon notification from PSC (via email) of need for placement change, PSC will Notification provide CPS with:  the reason for placement change;  PSC worker needed for secondary assignment;  scheduling options for non-emergency placement change staffing;

*CPS must receive notification of non-emergency placement change from PSC within 30 days of needed placement. Non-Emergency Placement PSC will coordinate and facilitate the placement change staffing as outlined in Pre- Change Staffing Placement Staffing. PSC will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure CPS staff receive a copy. No later than 3 days prior to placement needing to occur, PSC will notify CPS, Placement of Child/Youth through IMPACT and follow-up email, of recommended placement and medical consenter. Within 24 hours of receiving placement options from PSC, the CPS worker will evaluate and approve placement option and medical consenter in IMPACT.

*If CPS has concerns about recommended placement, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified. PSC will complete the physical placement of the child with the new placement and Foster Care Redesign Operations Manual Page 15 of 94 complete all placement forms.

*Decision for CPS to participate in the physical placement of the child is based on the best interest of the child. CPS worker will provide PSC with signed education decision-maker (form 2085e) and signed medical consenter (form 2085b). Upon receipt of non-emergency placement change notification from PSC, the CPS Documentation worker will:  Update person characteristics;  Update education log;  Update medical/dental page, CPS worker will document placement change staffing in IMPACT contact detail page. Within 12 hours of placement occurring, PSC will document the placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement).

*If CPS worker has not received the placement information in IMPACT within 12 hours, CPS will call PSC Intake Worker/Supervisor. CPS Worker will also notify CPS supervisor and FCR Administrator. By 7:00 pm the next calendar day after the child has been placed, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT. Prior to the placement change, PSC will ensure that the child’s substitute care provider completes the Residential Child Care Discharge Form (2109) and provides copies to the child’s new provider and to PSC. PSC must keep copies of form 2109 and provide such copies to DFPS upon request.

*Form 2109 is not required when a child discharges from PSC’s provider network to a kinship placement or returns home.

Foster Care Redesign Operations Manual Page 16 of 94 Placing Children in Certain Institutions CPS and Providence Service Corporation (PSC) will work together when considering and requesting placement of a child in one of the following settings:  DFPS-Licensed Institutions for children with intellectual and developmental disabilities;  State Supported Living Centers;  State Hospitals;  Home and Community-Based Services (HCS) Residential Placements;  Nursing Facilities; or  Intermediate Care Facilities for the Intellectual Disabilities/Related Conditions (ICF/IID-RC). Placing a child in a certain institution should only take place when no other less restrictive placement is available that can meet the child’s needs.

Placement in a certain institution requires careful consideration, assessment, and justification. CPS and PSC will coordinate with the regional Developmental Disability Specialist to carefully assess the child’s specific needs and exhaust all least restrictive placement options before recommending a child’s placement in a certain institution.

Depending on the type of institutional placement requested for the child, the CPS worker must follow current CPS Handbook policy in: 4214 DFPS-Licensed Institutions Serving Children with Intellectual or Developmental Disabilities 4221 Home and Community-Based Services Program 4222 ICF/IID-RC. 4229 Nursing Facilities.

If a child is placed in a certain institution, the CPS worker must discharge the child from placement with PSC in IMPACT. See Discharge Planning for more information.

Foster Care Redesign Operations Manual Page 17 of 94 Initial Coordination Meeting The Initial Coordination Meeting (ICM) is a collaborative process between CPS and Providence Service Corporation (PSC) that focuses on the unique, individualized needs of the child or youth in CPS conservatorship and outlines services to address those needs. The ICM process seeks to share all relevant information about a child who required a new emergency placement within PSC’s provider network. Relevant information includes assessments, evaluations, medical reports, recommended services, and all other information that pertains to the child’s individual needs. During the ICM, CPS and PSC jointly identify the child’s initial and concurrent permanency goals.

The ICM takes the place of the traditional removal staffing.

Timeframes Within 7 days of a new emergency placement referral to Providence Service Corporation (PSC), CPS will host and participate in the Initial Coordination Meeting (ICM).

The ICM may be extended up to 3 days if an emergency placement occurs on a holiday or weekend day (Friday, Saturday, Sunday) or inclement weather prevents the ICM from occurring as scheduled. All other extensions to an ICM must be approved by the Program Director.

Coordination Each investigative PD in regions 2 and 9 has identified a day of the week to serve as the standard schedule for ICM’s in their area. See Regions 2 and 9 ICM/Pre-Placement Staffing Schedule.

The Investigative PD or designee will coordinate all meeting logistics, including:  schedules with participants a meeting date and time;*  reserves a conference room and scan call line;  ensures all relevant participants are invited to the meeting; and  provides notice (2 business days) of the ICM to all participants.

To begin the coordination process, CPS staff will send an email to the Investigative PD or designee containing all placement referrals. The Investigative PD will compile the list of placement referrals and send an email to all appropriate CPS and PSC staff as notification of the up-coming ICM.

Participants At a minimum, the following participants will be notified of the up-coming ICM:  PSC staff  Removal worker and supervisor;  Conservatorship worker and supervisor;  Family Group Decision Making Specialist or coordinator (if assigned); and  Other CPS staff or subject matter experts as needed. . Additional CPS staff may be included in the notification email, but may not need to participate in the ICM.

All CPS staff invited to the ICM should attend the meeting in person if possible.

Documentation

Before the ICM Prior to the ICM, the removal worker will complete:

Foster Care Redesign Operations Manual Page 18 of 94  as much of the Removal Checklist as possible, which has been updated per Foster Care Redesign protocols; and  page 1 of the ICM form. The removal worker will bring a copy of the removal checklist and ICM form to the meeting.

During the ICM During the ICM, the conservatorship worker or their designee will:  record notes from the meeting discussion on the ICM form, including but not limited to the primary and concurrent permanency goals for the child;  record the ICM as a contact in the FSU stage, Contact Detail page in IMPACT. The ICM will typically be the first contact in the FSU stage for new removals;  ensure the notes from the meeting are recorded in the Contact Detail Narrative; and  establish the provider worker to be assigned secondary to the case in IMPACT.

PSC and CPS staff will share and exchange copies of all external documentation gathered thus far related to the child’s needs, including but not limited to birth certificates, social security cards, medical/dental reports or records, school records, progress notes, assessments, evaluations, and so on.

The first or subsequent service planning meeting date will be identified by PSC prior to ending the ICM.

After the ICM Within 24 hours after the ICM, the conservatorship worker or supervisor will initiate the Child Service Plan in IMPACT. The type of plan, and primary and concurrent permanency goals for the child must be indicated on the service plan. This will enable PSC staff to complete the PSC required sections of the child service plan in IMPACT after the ICM.

Foster Care Redesign Operations Manual Page 19 of 94 Pre-Placement Staffing A Pre-Placement Staffing is a collaborative process between CPS and Providence Service Corporation (PSC) that focuses on the unique, individualized needs of the child or youth in CPS conservatorship in order to determine the best possible placement for the child or youth. The pre-placement staffing seeks to share all relevant information about a child or youth who requires a non-emergency placement or placement change. Relevant information includes:  Additional information about the child or youth’s present behaviors, circumstances, and history beyond what has been provided to PSC at intake,  Possible placement options,  Current visitation plans, and  Pre-placement visitation plans. In most cases, there is some time between the placement referral and the time the child needs to be placed. Prior to the pre-placement staffing, PSC staff will gather information about the child or youth (through IMPACT, previous caregivers, placement information from CPS, etc.) in order to propose the best placement options for the child.

Timeframes A pre-placement staffing must occur at least 7 to 10 days prior to the time that the child needs to be placed. A pre-placement staffing can also occur as soon as PSC has informed CPS that they are ready for the staffing to occur.

Coordination The CPS worker will ensure the pre-placement staffing is arranged in accordance with the Regions 2/9 ICM/Pre-Placement Staffing Schedule.

Pre-placement staffings will usually be conducted by telephone. However, pre-placement staffings may occur in-person as needed and determined by PSC and CPS.

CPS initiated placement The CPS worker will coordinate with appropriate parties to:  identify scheduling options for the pre-placement staffing, and  assess the appropriateness and level of the child and parent’s participation in the staffing.

The CPS worker will complete all logistical arrangements (date, time, location, conference call information, notices) for the pre-placement staffing. The CPS worker will give all participants as much prior notice of the pre-placement staffing as possible.

The CPS supervisor or their designee will facilitate the meeting.

SSCC initiated placement The PSC utilization management staff will coordinate with appropriate parties to:  identify scheduling options for pre-placement staffing, and  assess the appropriateness and level of the child and parent’s participation in the staffing.

The PSC utilization management staff will complete all logistical arrangements (date, time, location, conference call information, notices) for the pre-placement staffing. The PSC utilization management staff will give all participants as much prior notice of the pre-placement staffing as possible.

The PSC utilization management staff or their designee will facilitate the meeting.

Foster Care Redesign Operations Manual Page 20 of 94 Participants The following participants will be notified of the pre-placement staffing:  CPS worker,  CPS supervisor,  Court Appointed Special Advocate (CASA),  Guardian ad litem,  Attorney ad litem,  PSC utilization management staff,  PSC intake staff,  Current CPA case manager,  Current caregiver,  Child or youth,  Parent(s), and  Other relevant subject matter experts.

Efforts should be made to invite all participants to the pre-placement staffing. If the pre-placement staffing conflicts with a participant’s schedule, the staffing coordinator (PSC or CPS) must make every effort to:  obtain the participant’s input about the child or youth’s placement prior to staffing, and  include the participant’s input in the discussion and decisions made at the staffing.

Inclusion and Participation of Children and Youth in Pre-Placement Staffings The inclusion of the child's or youth's voice in the decision making and planning about his or her placement is critical to achieving positive results for children, youth, and families. Children and youth, therefore, must be given an opportunity to participate in pre-placement staffings.

Although a child's or youth's participation in a staffing is never forced, the staffing coordinator (PSC or CPS) must make every effort to include the child or youth in the staffing. If a child or youth cannot or chooses not to participate, the staffing coordinator (PSC or CPS) provides the child or youth with alternate methods of participation.

Alternate Methods of Participation for Children If a child or youth is unable to participate in a staffing, the staffing coordinator (PSC or CPS) may ask the child or youth to express his or her thoughts about the placement by either:  writing them down in a letter to be read during the staffing;  drawing them in a picture to be shared during the staffing;  verbalizing them in a video or audiotape to be played during the staffing; or  verbalizing them to a designated person, such as the CPS caseworker, current caregiver, or CASA volunteer, to be addressed at the staffing.

Alternate Methods of Participation for Older Youth Older youth are strongly encouraged to participate in pre-placement staffings, unless they decline.

If the youth declines to participate, the staffing coordinator (PSC or CPS):  ascertains the reason for the decline;  ensures that the youth fully understands the purpose of the staffing; and  ensures that the youth understands the importance of having a voice in planning for their future.

The staffing coordinator (PSC or CPS) must hold a follow-up discussion with the youth, regardless of how the youth plans to participate in the staffing, to ensure that the youth is aware of and understands the planning and decision-making that will be made on his or her behalf.

Foster Care Redesign Operations Manual Page 21 of 94 Documentation

Before the Pre-Placement Staffing Before the pre-placement staffing, the CPS worker must update the following information in IMPACT:  Person characteristics;  Education log; and  Medical/dental page.

During the Pre-Placement Staffing

CPS initiated placement CPS will record notes from the staffing discussion on the Pre-Placement Staffing form and ensure PSC staff receive a copy. Additional copies of the notes can be distributed to participants upon request.

SSCC initiated placement PSC will record notes from the staffing discussion on the Pre-Placement Staffing form and ensure CPS staff receive a copy. Additional copies of the notes can be distributed to participants upon request.

After the Pre-Placement Staffing After the pre-placement staffing, the CPS worker will:  Document the pre-placement staffing in the IMPACT contact detail page.  File a copy of the completed pre-placement staffing form in the CPS case file.  Initiate a new child service plan in IMPACT, in order for PSC to begin completing the plan after the staffing.

Foster Care Redesign Operations Manual Page 22 of 94 Child and Youth Service Planning Child and youth service planning is a collaborative and inclusive process between CPS, Providence Service Corporation (PSC), the child, and family that focuses on developing and reviewing plans to meet the individualized and unique needs of the child. Under Foster Care Redesign, service planning with children and youth will occur with all:  new placements (children placed within Providence Service Corporation (PSC) network upon removal), and  current placements (children currently placed in paid foster care who require a placement change into the PSC network).

Service Planning Meetings Child/youth service plans will be developed and reviewed through service planning meetings. Primary and concurrent permanency goals for the child will be reviewed at each service planning meeting. PSC placement staff will be primarily responsible for coordinating and facilitating all initial and subsequent (aka 90-day review) service planning meetings.

Timeframes PSC will schedule and conduct initial service planning meetings at the following intervals:  New placements (new removals): within 30 days of removal.  Current placements (new to PSC provider network): within 30 days of placement.

PSC will schedule and conduct all subsequent service planning meetings within 90 days of the initial service planning meeting.

Coordination PSC placement staff will coordinate all service planning meeting logistics, including:  schedules with participants a meeting date and time;  reserves a conference room and scan call line;  ensures all relevant participants are invited to the meeting;  coordinates with CPS staff to ensure barriers to parent and/or family member participation are mitigated (i.e. transportation needs); and  provides notice of the service planning meeting to all participants: o PSC will send an email invitation for scheduled service planning meetings to CPS and other relevant professionals; o PSC will provide 14 days notice of service planning meetings to CPS; o PSC will ensure parents, family members, and other participants (who may not have access to email) receive timely notice of service planning meetings.

CPS staff will ensure PSC knows how to contact the parents and other family members.

All service planning meetings will be hosted in a venue that allows for maximum participation either in-person or through conference call. In-person participation by the child’s parents at all service planning meetings is best practice.

Participants Service planning meeting participants will generally include,at a minimum:  the child’s parents and the parents’ attorney, who must be invited when the parents have been invited,  child(ren),  family members,  current caregiver, Foster Care Redesign Operations Manual Page 23 of 94  CPS conservatorship worker and supervisor,  legal representatives (i.e. CASA, ad litem, etc),  other relevant professionals,  other persons identified in the case who can contribute to service planning with the child.

Documentation

Before the Meeting Prior to the service planning meeting, the CPS worker will ensure the Child Service Plan or Child Service Plan Review has been initiated in IMPACT. The type of plan, and primary and concurrent permanency goals for the child will be indicated on the service plan or review. This will enable PSC staff to complete PSC required sections of the initial child service plan or review in IMPACT after the service planning meeting.

During the Meeting During the child’s service planning meetings, PSC will:  record notes from the meeting discussion; and  distribute a copy of the notes to all participants.

PSC and CPS staff will share and exchange copies of all external documentation related to the child’s needs, including but not limited to birth certificates, social security cards, medical/dental reports or records, school records, progress notes, assessments, evaluations, and so on.

After the Meeting CPS will document the service planning meeting and participants in IMPACT on the contact detail page.

If a service planning meeting is held in place of a CPS Permanency Planning Meeting (PPM), the CPS worker is responsible for documenting the service planning meeting in each child’s PPM detail page in IMPACT.

See CPS Handbook Appendix item 1121: Documentation Requirements for Models of Family Group Decision Making (FGDM).

Child Service Plan Development Child service plans must be developed with children/youth in accordance with Texas Family Code timeframes and applicable licensing standards.

Regions 2 and 9 staff will use the following types of Child Service Plans:  Initial Plan with PAL and Therapeutic Assessment;  Review with PAL and Therapeutic Assessment;  Adoption Plan.

Unless specifically waived, CPS staff must adhere to the following CPS Handbook policy:  6251. Child Service Plan  6260 Case Plan Review  6262 Reviewing the Child’s Service Plan

Foster Care Redesign Operations Manual Page 24 of 94 New Placements

Initial Child Service Plan Initial child service plans must be developed and approved with children/youth in CPS conservatorship within 40 days of removal.

The CPS worker and PSC utilization management staff will share the child service plan documentation requirements in IMPACT as follows:

Within 24 hours after the ICM, initiate the child service plan in IMPACT and enter: CPS worker  Type of plan;  Primary permanency goal; and  Concurrent permanency goal. Within 25 days of removal, complete the required sections of the service plan (see Child Service Plan Matrix). Within 3 business days of receipt of service plan from PSC, review the service plan:  Send written notification to PSC if proposed service plan is denied;  Work with PSC to make any edits needed to the service plan. Send service plan to supervisor for approval.

*CPS supervisor will approve the service plan in IMPACT within 40 days of removal. Ensure PSC receives a signed copy of the child’s service plan.

*Electronic signatures are acceptable. Within 30 days of removal, complete required sections of the service plan (see Child PSC utilization management Service Plan Matrix). Once plan is complete, send notification to CPS worker. If service plan is denied in IMPACT, contact CPS worker to discuss needed edits.

*CPS worker is responsible for ensuring the child service plan completion in IMPACT within current policy timeframes. See CPS Handbook policy 6251 Child Service Plan.

Child Service Plan Reviews Child service plans will be reviewed every 90 days from the date of the initial service planning meeting. Service plans will be reviewed through subsequent service planning meetings (90 day reviews).

Child service plans will be updated or reviewed more frequently when a child’s circumstances change or significant events occur that dramatically alter the child’s needs.

The CPS worker and PSC utilization management staff will share the child service plan review documentation requirements in IMPACT as follows:

Send CPS invitation to subsequent service planning meeting (90 day review). PSC utilization management 10 days prior to child service plan review due date, complete the required sections of the service plan (see Child Service Plan Matrix). Once child plan review is complete, send notification to CPS worker. If child service plan review is denied in IMPACT, contact CPS worker to discuss needed edits. Upon receipt of the invitation to the subsequent service planning meeting (90 day CPS worker review), initiate the child plan review in IMPACT by using the “new using” Foster Care Redesign Operations Manual Page 25 of 94 functionality and entering:  Type of plan;  Primary permanency goal; and  Concurrent permanency goal. Within 3 business days of receipt of child service plan review from PSC, review the child plan review:  Send written notification to PSC if proposed review is denied;  Work with PSC to make any edits needed to the review. Within 5 days of receipt of child service plan review from PSC, complete the required sections of the service plan review (see Child Service Plan Matrix). Send to supervisor for approval.

*CPS supervisor must approve child plan review in IMPACT within 5 days of receipt of completed review. Ensure PSC receives a signed copy of the child’s service plan.

*Electronic signatures are acceptable.

*CPS worker is responsible for ensuring the child service plan completion in IMPACT within current policy timeframes. See CPS Handbook policy 6251 Child Service Plan.

Current Placements A child service plan will be developed and reviewed for every child in CPS conservatorship who is currently placed in a paid foster care setting, but requires a new paid foster care placement within PSC’s provider network.

Child service plan reviews for these children will follow the same protocol referenced in Child Service Plan Reviews .

Initial Child Service Plan (new to PSC) Initial child service plans must be developed with children/youth in CPS conservatorship within 30 days of placement within PSC’s network provider.

The CPS worker and PSC utilization management will share the child service plan documentation requirements in IMPACT as follows:

Send CPS invitation to initial service planning meeting. PSC utilization management Within 20 days of placement, complete required sections of the service plan (see Child Service Plan Matrix). Once plan is complete, send notification to CPS worker. If service plan is denied in IMPACT, will contact CPS worker to discuss needed edits. Upon receipt of invitation to initial service planning meeting, initiate the child service CPS worker plan in IMPACT by using the “new using” functionality and entering  Type of plan;  Primary permanency goal; and  Concurrent permanency goal. Within 3 business days of receipt of service plan from PSC, review the service plan:  Send written notification to PSC if proposed service plan is denied;  Work with PSC to make any edits needed to the service plan. Within 25 days of placement, complete the required sections of the service plan (see Child Service Plan Matrix).

Foster Care Redesign Operations Manual Page 26 of 94 Send service plan to supervisor for approval.

*CPS supervisor must approve the service plan in IMPACT within 30 days of placement. Ensure PSC receives a signed copy of the child’s service plan.

*Electronic signatures are acceptable.

*CPS worker is responsible for ensuring the child service plan completion in IMPACT within current policy timeframes. See CPS Handbook policy 6251 Child Service Plan.

Medical/Dental/Vision Examinations A person consenting to medical care for a child must participate in each appointment set for the child with the healthcare provider. Texas Family Code §266.004(i) Participation must be in person or, if it is appropriate and acceptable to the provider, by telephone. The level of participation depends on the nature of the medical care the child is receiving, except that medical consenters must attend in person any appointments when a child may be prescribed psychotropic medications. Healthcare providers may have varying requirements for participation. Medical consenters and residential providers must discuss with healthcare providers their expectations for participation. See 11122 Participating in Each Medical Appointment.

When a child is placed with Providence Service Corporation (PSC), PSC will ensure substitute care providers receive the DFPS Medical/Dental/Vision Examination Form (2403) with instructions in order for the caregiver (usually the medical consenter) and doctor to complete the form at a child's medical, dental, or vision appointments. The form is filled out jointly by the person taking the child to the appointment (usually the caregiver) and doctor/dentist.

As soon as possible, after the child's appointment, the caregiver will provide the completed Examination Form (2403) to PSC. Within 7 days from the date of the child's appointment, PSC will provide a copy of the completed Examination Form (2403) to the CPS caseworker.

Within 7 days of receipt of the completed Examination Form (2403), the CPS caseworker will enter the information into IMPACT as outlined in CPS Handbook item 11261 Documenting Checkups (Medical and Dental) in IMPACT and the Case File.

PSC must advise youth ages 16 to 22 of their right to request to become their own Medical Consenter.

Psychotropic Medication Appointments Providence Service Corporation (PSC) will ensure that all substitute care providers and employees who serve as medical consenters for a child who is prescribed psychotropic medications facilitate an office visit with the prescribing physician, physician assistant, or advanced practice nurse in the STAR Health Network at least once every 90 days to allow the practitioner to:  appropriately monitor the side effects of the drug;  determine whether the drug is helping the child achieve the treatment goals; and  determine whether continued use of the drug is appropriate.

For all children receiving psychotropic medication, PSC must assess the extent to which the child:  has been provided appropriate psychosocial therapies, behavior strategies, and other non- pharmacological interventions; and  has been seen by the prescribing physician, physician assistant, or advanced practice nurse in the STAR Health Network at least once every 90 days.

Foster Care Redesign Operations Manual Page 27 of 94 In the event that a CPS staff member is designated as the medical consenter for a child, the CPS staff member must attend in person any appointments where psychotropic medication may be prescribed and all medication review appointments as described in 11122 Participating in Each Medical Appointment.

Consenting to Psychotropic Medication When a healthcare provider initially prescribes a psychotropic medication, Providence Service Corporation (PSC) will ensure that all substitute care providers and employees who serve as medical consenters for a child:  notify the CPS worker in writing of any initial psychotropic medications and subsequent dosage changes by the next business day;  complete and sign the Psychotropic Medication Treatment Consent (form 4526) with the healthcare provider; and  provide a copy of the form to the CPS worker within 5 business days. Form 4526 is not required for changes in dosage or for refills of the same medication.

The CPS worker will file a copy of the form 4526 in the child's section of the case file.

The CPS worker will notify a child's parents of the initial prescription of a psychotropic medication and any change in dosage of the psychotropic medication at the first scheduled meeting between the parents and the child's worker after the date the psychotropic medication is prescribed or the dosage is changed.

See 11000 Health Care – Medical and Behavioral for more information.

Foster Daycare Services When foster daycare services are needed for a child placed within Providence Service Corporation’s (PSC) provider network, PSC will:  provide the Daycare Verification Form (1809) to each foster parent household each time application or renewal for daycare is requested. This form acknowledges in writing that the caregiver has checked the availability of community services and identifies the caregiver’s household size and income.  scan and send the completed Daycare Verification Form to the child’s CPS worker unless an exception is met as described below: Exception: For the initial daycare authorization, the requirement for the foster parent to complete the form may be waived if it is determined the verification would prevent an emergency placement in the child’s best interest. Such an emergency placement would be one where the placement cannot be sustained or is unlikely to be sustained if the person requesting daycare were required to verify the unavailability of community resources. The waiver of the requirement must be approved by the program director and should only be utilized where the foster parent has exercised reasonable diligence but has been unable to verify community resource unavailability. If such a waiver is approved, the foster parent will be required to verify the unavailability of community resources at the time of the first daycare renewal.  complete a daycare request in IMPACT; and  save and submit the request to the CPS caseworker.

The CPS caseworker will:  review the daycare request in IMPACT and Daycare Verification Form for accuracy;  send to the CPS supervisor for approval; and  place a copy of the Daycare Verification Form in the external documentation in the child’s record..

Foster Care Redesign Operations Manual Page 28 of 94 Once the daycare request in IMPACT is approved by the CPS supervisor, the request is sent to the regional Daycare Coordinator for authorization.

Discharge Planning CPS and PSC will work jointly together to determine when a child is ready for discharge from placement in paid foster care with Providence Service Corporation (PSC). This section does not include discharge planning for a child from CPS conservatorship. A family meeting (Family Group Conference (FGC), Permanency Conference (PC), Circle of Support (COS), or service planning meeting) will be held to discuss and develop the child’s discharge plan from PSC.

The chart below reflects the specific tasks CPS and PSC must take in order to facilitate the discharge of a child from PSC placement: Update Discharge Notification Request in IMPACT. PSC utilization management Send an email to the CPS caseworker and supervisor requesting discharge and provide a summary of the discharge recommendation. Work with CPS to coordinate the family meeting logistics. Participate in family meeting, including presentation of current services and needed services. Update child service plan to reflect discharge plans, including services to prepare a child/youth for permanency. Prior to the child’s discharge, ensure that the child’s substitute care provider completes the Residential Child Care Discharge Notice Form (2109) and provide copies to PSC.

Upon receipt of completed form 2109, PSC will retain a copy and provide copies to the CPS worker, the worker’s chain of command, and the State Office Discharge Mailbox at [email protected].

*Form 2109 is not required when a child discharges from PSC’s provider network to a kinship placement or returns home. Upon supervisor review, approve or deny PSC’s recommendation for discharge CPS worker within 5 business days of receipt of email from PSC.

*Denial of discharge recommendation requires PD approval and FCR Administrator notification. Update Discharge Notification Request page in IMPACT. In conjunction with CPS supervisor, determine the type of family meeting that will be most beneficial to the family for discussion and planning the discharge from PSC. Within 7 days of discharge approval,  Scan and email all relevant case information to PSC, including court documents and significant events impacting the child’s permanency plan;  initiate coordination of family meeting: o Submit FGC, PC, or COS referral to relevant CPS staff; o If service planning meeting will be held, work together with PSC to complete all meeting logistics. Participate in family meeting. If an unplanned discharge occurs (i.e. through a court order), update child service plan to reflect discharge plans, including services to prepare a child/youth for permanency. Remove PSC staff as secondary on the child’s SUB and corresponding FSU stages in IMPACT.

Foster Care Redesign Operations Manual Page 29 of 94 See CPS Handbook policy:  1121 Family Group Decision Making  6273 Permanency Planning Meetings  6274 Permanency Planning Meetings for Youth 16 and Older

Foster Care Redesign Operations Manual Page 30 of 94 Transitional Living Services CPS and Providence Service Corporation (PSC) will work together to prepare older youth in DFPS conservatorship who are transitioning from substitute care to adulthood. PSC, in general, will take the lead in the provision of transitional living services for older youth. During PSC’s provision of transitional living services with youth, CPS will:  confirm a youth’s eligibility for all transitional living services and financial supports;  track all transitional living services for youth; and  utilize transitional living services information from PSC for the completion of court reports.

The following sections outline the specific responsibilities of CPS and PSC as it relates to transitional living services for older youth in DFPS conservatorship.

Transition Plan Development The transition plan is enhanced over time until the youth leaves substitute care or ages out of care. The plan must address the issues that are important for the youth as he or she leaves care and enters the adult world.

CPS and PSC will work together to initiate the discussion and development of the youth’s transition plan:

During a subsequent service planning meeting (90 day review) just prior to the youth CPS worker turning age 15.5:  Introduce the transition plan (form 2500) and planning processes (Circle of Support-COS and Transition Plan Meeting-TPM) to the youth.  Inform the youth that a Family Group Decision Making staff member will discuss COS or TPM with them further.  Discuss possible dates for the scheduling of the COS or TPM. Submit referral for COS to the appropriate Family Group Decision Making (FGDM) area contact. *If the youth declines a COS, a TPM will be scheduled instead. Approves and signs the youth’s transition plan each time the plan is reviewed and updated at subsequent service planning meetings or follow-up COS or TPM. Discuss the elements of the transition plan (form 2500) with the youth. PSC utilization management Record initial transition plan discussion on the plan document (i.e. goals, strengths, fears, etc). Continue the development of and update the transition plan with the youth overtime during face to face visits, subsequent service planning meetings (90 day reviews), and subsequent COS or TPM.

Circles of Support (COS) and Transition Plan Meetings (TPM) Circles of Support and/or Transition Plan Meetings will be generally coordinated and facilitated according to current CPS policy. Some exceptions apply and are noted within the chart below. The COS or TPM may be combined with regularly scheduled service planning meeting (90 day review), as agreed upon by the youth.

See CPS Handbook policy 6274 Permanency Planning Meetings for Youth 16 and Older

Submit referral for COS to the appropriate Family Group Decision Making area CPS worker contact. *If the youth declines a COS, a TPM will be scheduled instead. *If the youth declines a COS and TPM, then transition planning will proceed during regularly scheduled service planning meetings (90 day reviews).

Foster Care Redesign Operations Manual Page 31 of 94 Work with FGDM staff to prepare and schedule the COS or TPM with the youth. Participate in the COS or TPM. Approves and signs the youth’s transition plan each time the plan is reviewed and updated at subsequent service planning meetings or follow-up COS or TPM. Ensures documentation of COS or TPM in IMPACT per CPS policy item Appendix item 1121: Documentation Requirements for Models of Family Group Decision Making (FGDM). Work jointly with FGDM staff and CPS worker to engage youth, family, and other PSC utilization management caring adults in the COS or TPM. Work with the youth and other significant individuals to identify caring adults and other lifelong connections that can be sustained once the youth transition to adulthood. Ensure youth attends the COS or TPM. Participate in the COS or TPM. Document all discussion and plans made during the COS or TPM on the transition plan (form 2500). Provide a copy of the transition plan to all participants within 7 days of the COS/TPM. Continue the development of and update the transition plan with the youth overtime during face to face visits, subsequent service planning meetings (90 day reviews), and subsequent COS or TPM. Update the transitional living services section on the child service plan in IMPACT.

Preparation for Adult Living (PAL) PSC will develop and deliver PAL Life Skills Training utilizing the curriculum topics found in CPS Handbook policy Appendix 10212 Preparation of Adult Living Life Skills Training Curriculum Outline.

As part of the delivery of PAL training, PSC will arrange for annual standardized Ansell-Casey Skills Assessments and its interpretation to be shared and discussed with the youth and caregiver. PSC will ensure that experiential and community-based learning is included in all PAL training and services.

The following chart details the responsibilities of CPS PAL staff and PSC related to delivery and documentation of PAL training and services:

Once the “Life Skills Assessment” email notification is received from PSC, document PAL staff the youth’s Ansell-Casey Skills Assessment results in IMPACT. Within 5 business days of receiving email request for PAL service authorization from PSC:  complete the service authorization (form 2054) for PAL services to PSC in IMPACT; and  send email notification to PSC when the service authorization (2054) for PAL services has been approved in IMPACT. As notification is received by PSC, document the youth’s completion of PAL training in IMPACT. Document all PAL related information in IMPACT according to current policy. Ensure CPS worker is kept updated on the youth’s participation in any PAL related activities. Notify CPS PAL staff and CPS worker by email when the youth has completed the PSC utilization management Ansell-Casey Skills Assessment:  Email notification with subject line of “Life Skills Assessment;” and  Attach assessment results of the email. Notify CPS PAL staff and CPS worker by email when PAL services need to be

Foster Care Redesign Operations Manual Page 32 of 94 authorized in IMPACT for the youth.*

*PSC worker will access the completed service authorization (form 2054) for PAL services from IMPACT. Provide identified services to youth to assist with their transition to adulthood. Assist youth with applying for and securing services to aid in their transition to adulthood. On the 15th of each month, submit a monthly report to the regional CPS PAL mailbox with a subject line of “Life Skills Training”:  youth’s status, progress, and completion of PAL training;  services provided to the youth to assist with their transition to adulthood; and  assistance provided to the youth with applying for and securing services to aid in their transition to adulthood.

*More frequent reporting will be required during specific months to be in compliance with National Youth in Transition Database. Document the youth’s progress and status of PAL Life Skills Training as well as experiential life skills learning in the child service plan in IMPACT.

Extended Care and Return to Extended Care CPS and PSC will work together to identify youth for either Extended Care or Return to Extended Care programs. Participation in the Extended Care or Return to Extended Care programs will be discussed and planned with the youth during regularly scheduled service planning meetings (90 day reviews), during the youth’s Circle of Support or Transition Plan Meeting, or upon the youth’s request.

CPS Worker PSC Utilization Management

Determine eligibility according to If eligible, assist the youth with completing the Extended Care current Extended Care Guidelines. Voluntary Extended Foster Care Agreement (form 2540) within 30 days prior to the youth’s 18th birthday. Review the completed Agreement Provide completed Voluntary Extended Foster (form 2540), including signature, and Care Agreement (form 2540) to CPS worker. distribute according to policy. Follow current policy as it relates to Assist the youth in maintaining necessary Extended Foster Care. documentation for the Extended Care program. Work with PAL staff to determine Notify regional Foster Care Redesign (FCR) Return to Extended eligibility according to current Administrator of youth’s request to Return to Care guidelines for Return to Extended Extended Care. Care. Review the completed Voluntary If eligible, assist youth with completing the Extended Foster Care Agreement (form Voluntary Extended Foster Care Agreement 2540), including signature, and (form 2540). distribute according to policy. If youth is eligible, complete CPS Assist the youth in maintaining necessary referral for placement. documentation for the Return to Extended Care program. The following chart outlines the responsibilities of CPS and PSC if a youth requests participation in either the Extended Care or Return to Care program:

Foster Care Redesign Operations Manual Page 33 of 94 See CPS Handbook policy: 10400 Extending Foster Care for Youth Who Are Age 18 or Older 10530 Processing a Young Adult’s Initial Request to Return to Extended Foster Care

Supervised Independent Living (SIL) Supervised independent living (SIL) placement settings are living arrangements offered through the Extended Foster Care program that allow young adults to reside in a less restrictive, nontraditional foster care setting while continuing to receive casework and support services to become independent and self- sufficient.

This section will be updated soon.

National Youth in Transition Database (NYTD) CPS will take the lead on identifying youth (ages 17, 19, and 21) who will participate in surveys for the National Youth in Transition Database (NYTD). CPS will inform PSC of the youth who will participate in NYTD surveys via email with subject line of “NYTD Survey Participant.”

Once notified, PSC will assist CPS in obtaining NYTD surveys from identified youth. PSC will maintain and current contact information for youth placed within their provider network and inform CPS when updated information becomes available.

Foster Care Redesign Operations Manual Page 34 of 94 Court Requirements CPS will take the lead on all court and legal activities (court hearings and court reports) for children in CPS conservatorship and placed within Providence Service Corporation’s (PSC) provider network.

See Regions 2/9 Court Jurisdictional Differences.

Court Hearings The chart below reflects the specific responsibilities of CPS and PSC related to court hearings:

Notify PSC of scheduled court hearings within 20 days of scheduled hearing by: CPS worker  Scanning and emailing a copy of court orders that show scheduled court dates/times; or  Immediately sending an email titled “Court Hearing Notice” with date and time of hearing, if no court orders are available.

*If a court hearing is scheduled prior to 20 day required notification timeframe, then CPS will share court hearing schedule immediately.

*If date and time of a court hearing is announced during court, this shall serve as notice to both agencies. Attend and testify in court hearings. Within 20 days prior to scheduled court hearings, send CPS (via email) notification of PSC utilization management who will be attending the court hearing.

*If a court hearing is scheduled prior to 20 day required notification timeframe, then PSC will share the attendee list as soon as possible. Immediately notify CPS of any service of legal process (i.e. subpoena, summons, discovery notices) related to performance under contract.

Send CPS worker an email with subject line of “Court Alert” with the attached copy of the court document. Provide notice to the caregiver of all court hearings. Ensure children attend court hearings, unless excused by the presiding judge prior to the court hearing.

*Attendance may occur through video conference and/or teleconference when appropriate and approved by the court.

*Attendance at Adversary Hearings (14-day hearings) is, generally not expected, unless the child’s attorney ad litem requests the child’s attendance. Attend court hearings and/or preparation meetings as requested by CPS, CASA, attorney ad litem, or other members of the judiciary.

*Attendance at Adversary Hearings (14-day hearings) is not expected. Ensure attendance of staff with personal knowledge of the case at all court hearings unless excused by the presiding judge. Maintain documentation of all court orders received from CPS.

Court Reports CPS holds ultimate responsibility and ownership of all information contained in court reports submitted to the court. PSC will complete the sections of court reports that are relevant to the child.

Foster Care Redesign Operations Manual Page 35 of 94 The chart below reflects the specific responsibilities of CPS and PSC related to court reports:

Prepare court reports in accordance with regional policy. CPS worker Ensure PSC staff uses the correct Court Report Template based on the type of scheduled court hearing:  Status Report to the Court (form 2070)  Permanency Plan & Progress Report to the Court (form 2088)  Placement Review Report to the Court (form 2088b) Upon receipt of Court Report Template from PSC, add and edit information to the court report as needed for completion.

*When the Court Report Template is incomplete and/or additional information is needed for the court report, CPS worker will contact PSC placement worker to obtain needed information. Submit completed court report that includes both CPS and PSC information to supervisor for approval 15 calendar days prior to court date.

*CPS supervisor must review and return the court report to CPS worker within 3 days to allow time for filing of court report. Send an email to PSC titled “Court Documents” and include scanned, “filed marked” copies of all available:  CPS court reports,  settings,  notices,  CASA court reports,  guardian ad litem reports,  court orders, and  any other relevant court information. PSC will complete the following sections of the court report: PSC utilization management  Status Report to the Court (form 2070): Section VIII. Summary of Child's Medical  Permanency Plan & Progress Report to the Court (form 2088): Section VII. Summary of Case Since Last Court Review/ A. Well-Being of the Child  Placement Review Report to the Court (form 2088b): Section IV. Summary of Case Since Last Court Review/A. Well-Being of the Child Within 20 days prior to scheduled court hearings, send CPS an email titled “Court Report Information” and attach a completed Court Report Template.

*If additional information for the Court Report Template is requested by CPS, PSC will provide the requested information within 24 hours. Provide supplemental information for inclusion in the court report when significant events occur prior to the scheduled hearing.

Foster Care Redesign Operations Manual Page 36 of 94 Permanency Care Assistance When a child’s permanency plan calls for a change to permanent managing conservatorship by a relative or fictive kin, with intent to pursue permanency care assistance, CPS staff must follow current CPS Handbook policy 4700 Permanency Care Assistance.

The CPS worker must obtain supervisor approval before referring a kinship caregiver to Providence Service Corporation (PSC) for verification as a foster parent. Before referring kinship caregivers to PSC for verification, CPS staff must ensure that:  The kinship caregiver has been approved by CPS to provide care for a child in CPS conservatorship; and  An approved kinship home assessment, with kinship safety evaluation (if applicable), has been completed on the kinship caregiver. Once supervisor approval is obtained, the worker must follow CPS Handbook policy 4600 Verified Kinship Caregivers in order to refer the kinship caregiver to PSC for verification as a foster parent. Upon referral, the CPS worker will provide PSC utilization management director, Melynn Conway @ [email protected], the following:  Name and contact information (address, phone, email) of the family being referred; and  A copy of the family’s approved kinship home assessment.

Placing a Child/Youth with a Verified Kinship Caregiver Once a kinship caregiver is verified as a foster home and approval is given to place the child with the caregiver, CPS and Providence Service Corporation (PSC) will follow the New Placements/Non- Emergency Placements or Placement Changes process (depending on the child’s current placement type) with some minor differences.

Prior to referring a child or youth to PSC for placement, the CPS worker must first verify that the kinship family is an active resource in IMPACT.

Non-Emergency Placement of a Child/Youth with a Verified Kinship Caregiver When a child or youth is placed with an unverified kinship caregiver and the kinship caregiver later becomes verified as a kinship foster home within the PSC network, then the non-emergency placement process will be used to place the child or youth with PSC.

The chart below reflects the specific steps CPS and PSC must take in order to complete a non-emergency placement of a child/youth with a verified kinship caregiver within the PSC network: Within 72 hours of identifying placement need, the CPS worker will: Notification  Complete referral in IMPACT;  Email PSC with the subject, "CPS Non-Emergency Placement": o Indicate the date the caregiver was verified as a foster parent; o Indicate the expected start date of the child’s foster placement with the caregiver; o Indicate possible times available for pre-placement staffing; o Assign PSC utilization management director, Melynn Conway, as secondary on the child’s subcare stage in IMPACT; o Provide child’s placement information: . Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information) . Therapeutic needs; . Social needs; . Court orders/affidavit; Foster Care Redesign Operations Manual Page 37 of 94 . Medical, dental, and mental health records (only needed if specific care instructions are required for the child’s care); . Visitation plans with siblings, parents, or other family member and fictive kin (if established); . General Release of Information (any & all information and records about the child). CPS will coordinate and facilitate the pre-placement staffing as outlined in Pre- Pre-Placement Staffing Placement Staffing. CPS will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure PSC staff receive a copy. No later than 3 days prior to placement needing to occur, PSC will notify CPS, Placement of Child/Youth through IMPACT and follow-up email, of verified kinship placement option and medical consenter. The CPS worker will evaluate and approve the verified kinship placement option and medical consenter in IMPACT within 24 hours of receipt from PSC.

*Approval will be assumed if denial is not received within 24 hours. CPS and PSC will decide on a designated location to exchange the completed placement documentation, including: o Signed education decision-maker (form 2085e); o Signed medical consenter (form 2085b); o Signed Placement Authorization (form 2085fc); o Birth verification/certificate; o Social Security card (if available); o Education portfolio; o Medicaid/Star Health ID card (if available); o Most recent child service plan (if applicable); and o Any relevant external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child. Upon approval to request placement & before pre-placement staffing: Documentation  Update person characteristics;  Update education log;  Update medical/dental page. Document pre-placement staffing in IMPACT contact detail page. During the pre-placement staffing or within 2 hours after the pre-placement staffing, the CPS worker:  Enters an end date for the current unverified kinship placement; and  Selects from the drop down box the Placement Removal Reason “Placed with Relatives.” Within 6 hours after the pre-placement staffing, PSC documents the placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement).

*If CPS worker has not received the placement information in IMPACT within 12 hours of CPS ending the placement in IMPACT, the CPS worker will call PSC utilization management director, Melynn Conway. CPS Worker will notify CPS supervisor and FCR Administrator. By 7:00 pm the next calendar day after the child’s placement is entered into IMPACT, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT. Once the new placement is approved in IMPACT for a verified kinship foster placement, the CPS worker ensures the Kinship stage is closed in IMPACT. Within 30 days of placement referral, the CPS worker: Foster Care Redesign Operations Manual Page 38 of 94  completes the Common Application (form 2087; excluding level of care information) in IMPACT; and  notifies PSC that Common Application (form 2087) is complete and accessible in IMPACT.

*CPS worker is responsible for ensuring all placement documentation is entered in IMPACT within current policy timeframes. See CPS Handbook policy: 4133 Making the Placement/Recording the Placement in IMPACT; 4612 When a Kinship Caregiver is Verified as a Foster Parent.

Placement Change of a Child/Youth with a Verified Kinship Caregiver The placement change process will be used when a child or youth is placed in a paid foster care setting within the PSC network and requires a placement change to a verified kinship caregiver (kinship foster home) within the PSC network.

The chart below reflects the specific steps CPS and PSC must take in order to complete a placement change of a child or youth with a verified kinship caregiver within the PSC network: Within 72 hours of identifying need for placement change: Notification  Obtain supervisor and PD approval for the placement change;  Email PSC with the subject, "CPS Non-Emergency Placement-Placement Change": o Reason for desired change, o Indicate the date the caregiver was verified as a foster parent; o Indicate the expected start date of the child’s foster placement with the caregiver; o Establish need for pre-placement change staffing; o Assign PSC utilization management director, Melynn Conway, as secondary on the child’s subcare stage in IMPACT; o Cc supervisor, PD, and FCR Administrator on email. Pre-Placement Change CPS will coordinate and facilitate the pre-placement change staffing as outlined in Staffing Pre-Placement Staffing. CPS will record notes from the meeting discussion on the Pre-Placement Staffing form and ensure PSC staff receive a copy. No later than 3 days prior to placement needing to occur, PSC will notify CPS, Placement of Child/Youth through IMPACT and follow-up email, of verified kinship placement option and medical consenter. The CPS worker will evaluate and approve the verified kinship placement option and medical consenter in IMPACT within 24 hours of receipt from PSC.

*Approval will be assumed if denial is not received within 24 hours. PSC will complete the physical placement of the child with the new placement and complete all placement forms.

Decision for CPS to participate in the physical placement of the child is based on the best interest of the child. CPS worker will provide PSC with signed education decision-maker (form 2085e) and signed medical consenter (form 2085b). CPS worker will document pre-placement change staffing in IMPACT contact detail Documentation page. Within 12 hours of placement occurring, PSC will document the placement in IMPACT (including placement approval, placement information, and the time the child was taken to the placement).

Foster Care Redesign Operations Manual Page 39 of 94 *If CPS worker has not received the placement information in IMPACT within 12 hours of placement occurring, the CPS worker will call PSC utilization management director, Melynn Conway. CPS Worker will notify CPS supervisor and FCR Administrator. By 7:00 pm the next calendar day after the child has been placed, CPS worker and supervisor review and approve placement information (entered by PSC) and medical consenter in IMPACT.

Foster Care Redesign Operations Manual Page 40 of 94 Adoption Providence Service Corporation (PSC) will take primary lead on adoption activities in regions 2 and 9. Out of state ICPC adoption services requests will follow established regional protocols.

The following sections outline what regions 2 and 9 CPS staff can expect from PSC, as well as the responsibilities that CPS staff will maintain during the adoption process.

Legal and Court Activities CPS conservatorship and adoption staff will continue to be responsible for all legal and court activities related to:  termination of parental rights,  legal risk placement,  adoption (giving or withholding consent to adoption and waiving service to adoption hearings), and  eligibility for and authorization of post-adoption subsidies and services.

Recruitment PSC will conduct general and child-specific recruitment activities for legal risk and adoptive homes for children placed within regions 2 and 9. The PSC Utilization Management Specialist (UM) is fully responsible for all general and child-specific adoption recruitment activities.

The CPS adoption worker will work with PSC on general and child-specific recruitment, including:  using current adoption recruitment tools, such as Heart Gallery, Sunday’s Child, TARE;  distributing child-specific profiles to PSC;  providing notice to PSC of any matching meetings or adoption events hosted by CPS; and  providing PSC with general or child-specific adoption inquiries as they are received.

As general or child-specific adoption inquiries are received, CPS will:  Document the inquiry on the Foster/Adoptive Parent Inquiry form ;  Inform the requestor of next steps, using the following Foster/Adoptive Parent Inquiry Script as needed: “Thank you for contacting us and sharing your interest in becoming a foster (or foster/adopt) home. DFPS in Regions 2 and 9 are not currently licensing any homes at this time, but I would be happy to send your information to our contracted provider, Providence Service Corporation, so that they can provide you information about the process;”  Within 3 business days of receiving the inquiry, email PSC at [email protected] the completed Foster/Adoptive Parent Inquiry form (requestor’s name, phone number, address, and date of initial contact) with a subject line of “Foster/Adoptive Inquiry;”  Attach to the email any previously approved home studies from the requesting family.

Within 30 calendar days of receiving the adoption inquiry, PSC will provide a response to CPS about the adoption inquiry.

Home Studies PSC will conduct and approve home studies on all potential legal risk and adoptive homes within regions 2 and 9.

To request an adoption home study, CPS staff will send an email to PSC with subject line of “Adoption Referral.” CPS will provide (attached to email) the Adoption Referral form and any supporting documentation, such as the kinship home assessment, to PSC.

Foster Care Redesign Operations Manual Page 41 of 94 CPS staff will follow normal regional protocols for requesting adoption home studies for relatives and fictive kin.

Home Selection and Staffing Upon review of a child and available home studies, PSC will provide adoptive home (match) recommendations to CPS. PSC will inform the CPS adoption worker and supervisor of the recommended adoptive home by email, with the home study attached, with subject line of “Adoptive Home Recommendation.”

Approval To approve PSC’s adoptive home recommendation, CPS staff will send an email within 5 business days after the selection staffing, to PSC with the subject line of “Approved Adoptive Home.”

Once an adoptive home is approved, PSC will provide all appropriate information to the prospective family (i.e. psychological evaluation, service plans, HSEGH, etc.).

When the prospective family agrees to proceed with the adoption process, CPS will:  scan the child’s case file and request redaction within 10 business days; and  provide PSC a copy file within 5 business days upon receipt of the redacted case file.

Denial To deny PSC’s adoptive home recommendation, CPS staff will send an email, within 5 business days, to PSC with the subject line of “Denial of Adoptive Home.” The email must contain the rationale for the decision, including specific reasons that would indicate why the family was not an appropriate adoptive home and/or how the decision is not in conformity to the agreed upon placement guidelines. For more information, see Exhibit B: Statement of Work…/Chart 9 Adoptions of the PSC of Texas single source continuum contract.

When an adoptive home recommendation is denied, PSC will continue the recruitment of adoptive homes to find a match for a child.

For any match recommendation that CPS is not ready to approve or deny, CPS staff will contact PSC for clarification within 5 business days.

CPS will host a selection staffing with PSC presenting recommended adoptive homes for a child to all appropriate parties. This can be accomplished at a subsequent service planning meeting (90-day review) or other scheduled meeting for the child.

Presentation Staffing After the prospective family has reviewed the child’s case file, CPS will host a Presentation Staffing with the prospective family, current family, and PSC. A Presentation Staffing is an opportunity for the prospective family to ask questions, for the current family to discuss the child’s daily care, and for the attendees to collectively develop an appropriate transition plan. The transition plan should include adoption preparation activities, pre-placement visits, among other tasks. For more information, see Adoption Best Practice Guide (form 2140).

When placement of the child with the adoptive family is determined, PSC will facilitate the physical placement of the child/youth in the home. At the time of placement, CPS will facilitate the execution of the Adoptive Placement Agreement (form 2226) with the adoptive family.

Foster Care Redesign Operations Manual Page 42 of 94 If the prospective family elects to not accept a child, PSC will send an email to CPS, within 5 business days of the Presentation Meeting, with the subject line of “Adoptive Family Refusal.”

Adoption Services In order to ensure placement stability, PSC is responsible for obtaining and delivering services to children placed with adoptive families prior to consummation of the adoption. The PSC adoption specialist is responsible for managing all services (including but not limited to monthly post-placement supervision) to prepare and support adoptive placements. The PSC adoption specialist will provide documentation of these services to the CPS adoption worker.

CPS adoption staff will continue to provide quarterly supervision of children who are placed with adoptive families until consummation is achieved and CPS is dismissed as the child's conservator. CPS adoption staff should seek supervisor guidance if more frequent supervision of children in adoptive placements is needed.

Authorization of Adoption Services As requested by PSC, the CPS adoption worker will:  complete the service authorization (form 2054) for the identified adoption service to PSC in IMPACT; and  send email notification to PSC when the service authorization (2054) has been approved in IMPACT.

Foster Care Redesign Operations Manual Page 43 of 94 Case Dispute Resolution There may be times when CPS and Providence Service Corporation (and network providers) may not agree on a case decision or what should happen with a child and/or family. The following chart outlines the protocol to resolve any type of case disputes between CPS and PSC:

Case Dispute Resolution Process: Workers and supervisors (who are closest to the issue in dispute) will work together to Step 1 resolve case specific issues informally. This will be done through an objective, solution-driven discussion or meeting.

If a mutually agreeable solution is not achieved, the individual will notify the other individual that they plan to involve their chain of command. Disputes proceeding to Step 2 will be elevated to a knowledgeable, neutral CPS staff Step 2 member (Foster Care Redesign Administrator) who understands the philosophy and goals of foster care redesign and is not a direct supervisor of the individual involved in the appeal. PSC must ensure continuity of services, as defined by CPS, to the child or family affected while seeking to resolve case-specific disputes. The escalating party will send an email with supporting documentation to the Foster Escalation Care Redesign Administrator and PSC Administrator with the subject line of “Dispute Resolution.” Once a dispute is escalated (appeal), the Foster Care Redesign Administrator will Resolution provide a written decision to the appeal within 5 business days.

The written decision will be emailed to the PSC Administrator with the subject line of “Dispute Resolution Appeal Decision.” The Administrators will distribute the decision to the appropriate staff and management.

Foster Care Redesign Operations Manual Page 44 of 94 Appendix

Regions 2 and 9 Foster Care Redesign Case Flow Chart

Description: the chart below describes the case flow for children in DFPS conservatorship, who are legally from regions 2 or 9 and are placed with Providence Service Corporation (PSC).

The first step is Placement Referral which can go in three major directions:

Direction #1 starts with CPS New Placement (step #2) which can go in two different directions: a) the first going to step #3 Emergency going to step #4 Initial Coordination Meeting (ICM) going to step #5 Initial Child Service Plan going to step #6 Service Planning Meetings (every 90 days) going to step #7 Child Service Plan Reviews going to step #8 Court Hearings going to step #9 Transitional Living Services or step #10 Adoption Services and finally to step #11 Discharge Planning (from paid placement). b) the second going to step #3 Non-Emergency (new to PSC) going to step #4 Staffing (Pre- placement) (Pre-placement change) going to step #5 Service Planning Meetings (every 90 days) going to step #6 Child Service Plan Reviews going to step #7 Court Hearings going to step #8 Transitional Living Services or step #9 Adoption Services and finally to step #10 Discharge Planning (from paid placement).

Direction #2 starts with CPS Placement Change with the option of going to step #4 Staffing (pre- placement)(pre-placement change) which then follows the flow of Direction #1, direction b.

Direction #3 starts with SSCC Placement Change Referral which can go in two different directions: a) The first going to step #3 Emergency with the option of going to step #4 Staffing (pre-placement) (pre-placement change) going to step #5 Service Planning Meetings (every 90 days) going to step #6 Child Service Plan Reviews going to step #7 Court Hearings going to step #8 Transitional Living Services or step #9 Adoption Services and finally to step #10 Discharge Planning (from paid placement). . b) The second going to #3 Non-emergency and then to step #4 Staffing (pre-placement)(pre- placement change) going to step #5 Service Planning Meetings (every 90 days) going to step #6 Child Service Plan Reviews going to step #7 Court Hearings going to step #8 Transitional Living Services or step #9 Adoption Services and finally to step #10 Discharge Planning (from paid placement).

This concludes the description of the flow chart.

Foster Care Redesign Operations Manual Page 45 of 94 Visual Diagram of Regions 2 and 9 Foster Care Redesign Case Flow Chart

Initial Child Service Plan

optional

Child Service Plan Reviews

Foster Care Redesign Operations Manual Page 46 of 94 New Placement Referral Flow Chart (Emergency/Non-Emergency Placements) Description: the flow chart below describes the process for requesting new emergency and non- emergency placements from Providence Service Corporation (PSC). Direction #1 Emergency Placement 1. Is the placement Emergency or Non-Emergency? 2. Emergency Placement 3. Staff with supervisor for approval to request placement from PSC. 4. Contact PSC at intake number and provide: • CPS worker contact information • CPS back-up contact information • Establish PSC worker to be assigned as secondary • Provide child’s placement information (can be verbal)* *All child’s placement information may be given verbally to PSC with the exception of form 2087ex and General Release of Information, which must be sent via email to PSC within 2 hours of referral. 5. Within in 4 hours: • Enter referral information in IMPACT • Make PSC Staff secondary 6. By 5pm the next business day, document in IMPACT and in external documentation. 7. Continued on Page 50. 8. End of flow chart direction #1 Direction #2 Non-Emergency Placement 1. Is the placement Emergency or Non-Emergency? 2. Non-Emergency Placement 3. Staff with supervisor for approval to contact PSC for placement. 4. Coordinate with appropriate parties to identify scheduling options for staffing. 5. Complete IMPACT data: • Update person characteristics • Update Education Log • Update medical/dental page 6. Within 72 hours of identifying placement need, complete referral in IMPACT. Send child’s placement information and email to Providence with the title, "DFPS Non-Emergency Placement" with times available for staffing and placement. 7. Make PSC Staff secondary 8. Participate in Pre-Placement Staffing 9. Continued on Page 52. 10. End of flowchart direction #2

Foster Care Redesign Operations Manual Page 47 of 94 Visual Diagram of New Placement Referral Flow Chart (Emergency/Non-Emergency Placements)

Foster Care Redesign Operations Manual Page 48 of 94 Foster Care Redesign Operations Manual Page 49 of 94 Emergency Placement Process Flow Chart

Description: the flow chart below describes the emergency placement process.

1. Within 4 hours of receipt of CPS notification of emergency placement need, PSC takes possession of child 2. CPS and PSC decide on meeting location and transportation of the child with consideration of child's best interest. 3. CPS worker will provide PSC with: • 2085fc • Medical Consenter form* • Education Decision-Maker form • Secondary assignment on the SUB stage within 4 hours of the Emergency Placement Referral *For a child's initial placement (brand new removal or other emergency placement), when a placement has not been identified, DFPS will remain medical consenter until a placement is identified. 4. No later than 7 hours of receipt of notification of need of emergency placement, PSC will provide CPS: • Recommended placement by phone or electronically (IMPACT) • The name of the sub-contractor • Name and location of recommended placement • Potential medical consenter 5. Was a placement found within 7 hours? 6. Yes or No 7. If Yes: 8. Within 1 hour, CPS worker approves placement in IMPACT.* *If a sub-contractor has not been named & PSC has taken possession of the child, verbal approval of the placement, medical consenter and education decision-maker can be given. CPS worker must follow-up with written approval by: • Approving the placement option and medical consenter in IMPACT; and • Providing the signed medical consenter and education decision-maker forms to PSC via email with subject line, "CPS Emergency Placement-Medical Consenter/Education Decision-Maker." *If there are concerns about placement option, caseworker must get supervisor and PD approval to deny recommendation. FCR Administrator must also be notified. 9. Did the documentation of the placement occur within 12 hours of receiving the referral? 10. Yes or No 11. If No, then: 12. If CPS worker has not received the placement information in IMPACT within 12 hours, CPS will call PSC Intake Worker/Supervisor. CPS Caseworker will also notify supervisor and FCR Administrator. 13. If Yes, then: 14. Approve Placement in IMPACT. 15. Within 30 days of placement referral, CPS worker will: • complete the Common Application (form 2087; excluding level of care information) in IMPACT; and • notify PSC that Common Application (form 2087) is complete and accessible in IMPACT 16. Going back to step #5 "Was placement found within 7 hours?” If no then, 17. PSC will notify CPS with status and strategy for finding a placement.

Foster Care Redesign Operations Manual Page 50 of 94 18. CPS worker will notify supervisor that no placement has been found. Supervisor will notify the FCR Administrator. 19. End of flow chart.

Foster Care Redesign Operations Manual Page 51 of 94 Visual Diagram of Emergency Placement Process Flow Chart

Foster Care Redesign Operations Manual Page 52 of 94 Non-Emergency Placement Process Flow Chart

Description: the flow chart below describes the non-emergency placement process.

1. CPS identifies a non-emergency placement is needed. 2. CPS worker will seek supervisor approval before contacting PSC for placement. 3. Within 72 hours of identifying the need for placement, CPS will: • Complete referral documentation in IMPACT • Send an email to PSC titled, "DFPS Non-Emergency Placement," including available times for pre-placement staffing o Include information about current PSC staff assigned as secondary and request information regarding revision of the assignment o Include contractually required child placement information, along with any other documents not in IMPACT • Coordinate with all appropriate parties (CASA, GAL, ad litems, current provider) to identify scheduling options for staffing according to jurisdictional addendum • Complete IMPACT data and assign PSC secondary staff • Update person characteristics, education, medical/dental prior to pre-placement staffing • Discuss referral and staffing information with PSC based on child(ren) needs and circumstances. 4. Pre-Placement Staffing 5. CPS will coordinate and facilitate the pre-placement staffing as outlined in Pre-Placement Staffing. 6. No later than 3 days prior to placement needing to occur, PSC will notify CPS, through IMPACT and follow-up email, of recommended placement and medical consenter. 7. Within 24 hours of receipt of placement option and medical consenter, CPS caseworker reviews and approves placement option.* *If CPS has concerns about placement option, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified. 8. CPS and PSC will decide on the designated location to exchange the completed placement documentation (including signature pages) and physical transfer of child.* *Decision is based on the child's best interest and to minimize transitions with the child. *CPS will arrange for transportation for the child if current provider is unable to transport. PSC will not be expected to transport child from current placement. 9. Within 12 hours of placement occurring, PSC will provide required placement documentation in IMPACT. This includes placement approval, placement information, and the time child was taken to the placement. 10. Within 30 days of placement referral, CPS worker will: • complete the Common Application (form 2087; excluding level of care information) in IMPACT; and • notify PSC that Common Application (form 2087) is complete and accessible in IMPACT. 11. End of flow chart.

Foster Care Redesign Operations Manual Page 53 of 94 Visual Diagram of Non-Emergency Placement Process Flow Chart

Foster Care Redesign Operations Manual Page 54 of 94 Foster Care Redesign Operations Manual Page 55 of 94 Placement Change Referral Flow Chart

Description: the flow chart below describes the placement change referral process.

1. Is the child currently placed with PSC? 2. Yes or No 3. If Yes, then: 4. Staff with supervisor and PD prior to contacting PSC (draft summary email to PSC while staffing) 5. Email PSC with subject, "DFPS Non-Emergency Placement-Placement Change" and include in email: • Reason for desired change • Timeframe for change • CC supervisor, PD, and FCR Administrator • Update IMPACT 6. Coordinate and facilitate the pre-placement change staffing as outlined in Pre-Placement Staffing, if needed. 7. No later than 3 days prior to placement needing to occur, PSC will notify CPS through IMPACT and follow-up email, of recommended placement and medical consenter. 8. Within 24 hours of receipt of placement option and medical consenter, CPS caseworker reviews and approves.* *If CPS has concerns about placement option, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified. 9. CPS will provide placement notification according to jurisdictional differences. (Refer to Jurisdictional Addendum.) 10. Within 12 hours of placement occurring, PSC will provide required placement documentation in IMPACT. This includes placement approval, placement information, and the time child was taken to the placement. 11. Back to step #1 “Is the child currently placed with PSC? Yes or No.” If No, then: 12. See New Placement Referral Flow Chart (Page 48) 13. End of flow chart.

Foster Care Redesign Operations Manual Page 56 of 94 Visual Diagram of Placement Change Referral Flow Chart

Foster Care Redesign Operations Manual Page 57 of 94 SSCC Initiated Placement Referral Flow Chart (Emergency/Non-Emergency Placements)

Description: the flow chart below describes the SSCC initiated placement referral process.

Direction #1 Emergency Placement 1. Is this a request for Emergency or Non-Emergency Placement? 2. Emergency Placement. 3. Receive notification from PSC via phone and email. 4. Update IMPACT and assign PSC secondary to case. 5. Within 1 hour, CPS worker will approve the placement selection (can be verbal). 6. By 7 PM the next day, check to ensure PSC has entered placement information. 7. Approve placement in IMPACT within 24 hours. 8. Participate in an Emergency Placement Change staffing if needed. 9. End of flow chart direction #1.

Direction #2 Non-Emergency Placement 1. Receive e-mail from PSC regarding request for placement. 2. Participate in Non-Emergency Pre-Placement Staffing (coordinated by PSC). Update person characteristics, education, medical/dental prior to staffing. 3. No later than 3 days prior to placement needing to occur, receive placement option from PSC. 4. Within 24 hours of receipt of placement option and medical consenter, CPS worker reviews and approves placement option.* *If CPS has concerns about placement option, supervisor and PD approval must be granted before denial of placement. FCR Administrator must be notified. 5. Within 12 hours of placement occurring, PSC will provide required placement documentation in IMPACT. This includes placement approval, placement information, and the time child was taken to the placement. 6. End flow chart direction #2.

Foster Care Redesign Operations Manual Page 58 of 94 Visual Diagram of SSCC Initiated Placement Referral Flow Chart (Emergency/Non-Emergency Placements)

Foster Care Redesign Operations Manual Page 59 of 94 Foster Care Redesign Operations Manual Page 60 of 94 Regions 2 and 9 Court Jurisdictional Differences

REGION 2

Brown County - Judge Rob Hofmann Judge Hofmann expects us to do what is necessary in emergencies to ensure that the children are safe. He expects the attorneys, especially the Attorney Ad Litem and CASA, to be advised of moves. He has also begun to require youth attendance at court, or at least make every attempt to have the youth in court if the youth wishes to attend. No different requirements outside those required by law. Judge Hofmann has begun to have more frequent review hearings in some cases.

Comanche County – Judge Robertson No exceptional requirements. Notify parties of moves.

Coleman and Callahan Counties – Judge Weeks No exceptional requirements. Notify parties of moves

Taylor County – Judge Aleta Hacker No exceptional requirements. Notify parties of moves. Generally there are no additional requirements. However, in some cases involving court-ordered placements, the judge will put in the court order that the child(ren) cannot be moved without a hearing. If that is not in the court order, placement changes may be made according to needs of the child, but all attorneys need to be notified. In Taylor County, there is not yet CASA, but plans are being made for CASA to come to Taylor County. At the present time, generally the same attorney acts as both the Attorney Ad Litem and the Guardian Ad Litem, unless there is a conflict in roles. In those cases, another attorney is appointed to act as Guardian Ad Litem.

Runnels County – Judge Ben Woodward No exceptional requirements. Notify parties of moves.

Nolan County – Judge Harris No exceptional requirements. Notify parties of moves.

Fisher and Mitchell Counties – Judge Harrison* *Judge Harrison is the District Judge in Nolan, but does not hear our cases there No exceptional requirements. Notify parties of moves.

Scurry County – Judge Armstrong No exceptional requirements. Notify parties of moves.

Kent, Throckmorton, Haskell and Stonewall Counties – Judge Hardaway No exceptional requirements. Notify parties of moves.

Wichita, Clay, Archer, Jack, Montague, Young, and Stephens Counties – Judge Bondurant No exceptional requirements. Notify parties (particularly Attorney Ad Litem and CASA) of moves and set a hearing prior to moving if the placement is Court ordered and there is not an immediate safety requirement.

Wilbarger, Foard, Hardeman Counties – Judge Bird Baylor, Cottle and Knox Counties – Judge Heatly Eastland County – Judge Herod Jones and Shackelford Counties – Judge Hagler No exceptional requirements. Foster Care Redesign Operations Manual Page 61 of 94 REGION 9

Tom Green County - Judge Weatherby Requires the CPS Caseworker complete a Change of Placement Form (that the Judge created) and submit the form to all parties (AAL, GAL, CASA, attorney’s etc…). This is done in planned and emergency placement changes. If emergency placement change is made, form is still completed and sent to all parties. If it’s a planned placement change, form is completed, sent to all parties and staffings held to discuss move. IF the parties do not agree on the placement change, Judge Weatherby holds a hearing for all parties to discuss in Court.

Crockett, Reagan, Sutton Counties - Judge Gomez There is 1 primary CASA staff who represents these counties (Connie Gauwain) and a handful of attorneys. There is no formalized process regarding changes of placement and notifications. Generally, the CPS Caseworker notifies all the parties by phone and/or email and discussion ensues.

Coke, Schleicher, Sterling, and Irion Counties- Judge Walther There is no formalized process regarding changes of placement and notifications. Generally, the CPS Caseworker notifies all parties by phone or email and discussion ensues.

Concho County - Judge Woodward There is no formalized process regarding changes of placement and notifications. Generally, the CPS Caseworker notifies all parties by phone or email and discussion ensues.

Mason, McCulloch, Menard, Kimble Counties - Judge Rob Hofmann Judge Hofmann expects us to do what is necessary in emergencies to ensure that the children are safe. He expects the attorneys, especially the Attorney Ad Litem and CASA, to be advised of moves. He has also begun to require youth attendance at court, or at least make every attempt to have the youth in court if the youth wishes to attend. No different requirements outside those required by law. Judge Hofmann has begun to have more frequent review hearings in some cases.

Midland, Ector, Winkler, Andrew and Howard Counties - Judge Sylvia Chavez FAX ALL COURT REPORTS TO THE JUDGE

Judge Chavez requires notification of the following:  A child is moved, by letter.  A child is hospitalized (medical and psychiatric).  There is a change in the permanency plan of a case.  If a child has emergency surgery or is scheduled for surgery. *Please remember to cc’ all parties on any correspondence with the Judge.

-Unless all parties are in agreement, Judge Chavez requires that a court hearing can be held to move a child to a non-licensed placement. She usually will specify this in the court order.

-All children under the age of 3 must be referred to the Early Childhood Intervention program for assessment of developmental delays.

-Judge Chavez will also typically order foster youth that are 12 and above, and not in a permanent placement to attend their court hearings. At times she will also order foster youth 12 and above who are in their permanent placement to attend their court hearings. Highly advisably to check the court orders.

All contact will be through: Court Coordinator: Diana Valadez

Foster Care Redesign Operations Manual Page 62 of 94 432-688-4395 432-688-4932 fax

Reeves, Ward, Gaines and Dawson Counties - Judge Jay Gibson DO NOT FAX REPORTS TO JUDGE GIBSON *The court reports should be filed in the District Clerk's office with the court file. If he wants to read them, he will do that in court. Judge Gibson does not want anything faxed to him

Judge Gibson does not require notice of change of placement or hospitalizations.

Gaines and Dawson Counties

All contact will be through: Court Coordinator: Jana Furlow 806-872-3740 806-872-7810 fax

Reeves & Ward Counties:

All contact will be through Judge's Assistant/Court Coordinator: Cathy Adams 432-943-2749 432-943-5718 fax Email - [email protected] (I don't know how often this gets checked so don't rely on it in emergencies)

Upton and Pecos Counties - Judge Pedro Gomez FAX ALL COURT REPORTS TO THE JUDGE

Judge Gomez does not require change of placement or hospitalizations.

All contact will be through: Court Coordinator: Kathy Carson 325-392-5225 (phone) 325-392-3434 (fax)

Foster Care Redesign Operations Manual Page 63 of 94 Quick Reference Guide

Single Source Continuum Contract (SSCC): Contract for a full continuum of residential child-care services for children and for services to their families. Providence Service Corporation (PSC) is the SSCC in regions 2 and 9.

Initial Coordination Meeting (ICM): Convened by CPS and held within 7 days of referral to the SSCC for placement and/or services to a child or youth (Stages I-III) and/or family (Stages II-III). Purpose of ICM is to review child or youth/family history and identify service needs to be included in the child or youth and/or family plan(s) of service.

Catchment Area: Geographic area determined by CPS with input from the Public Private Partnership (PPP). The minimum number of new entries per year has been determined to be 500 to be a fiscally viable model.

Blended Foster Care Rate: Foster care rate paid to the SSCC for each day of service provided to a child or youth in paid foster care, equal to the weighted average rate paid across all placement types.

Legacy System: Current paid foster care system that utilizes the service level system as the method in which to pay for residential services for children and youth in CPS conservatorship or who voluntarily agree to remain in care. In addition, current purchase of service funding mechanisms to access Family services that are coordinated and authorized through CPS.

Performance Based Contracting: A system of contracting where providers are evaluated based on achievement of outcomes. There is less concern with how the providers achieve outcomes and more concern with what they accomplish.

Child’s Placement Information: CPS shares information about a child with PSC in order for PSC to assess and make recommendations for the child’s placement in a paid foster care setting. Placement information may vary between CPS and SSCC initiated placement referrals, but, in general, the following placement information is shared with PSC based on timeframes set within the Operations Manual:  Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information);  Common Application (form 2087; excluding level of care information);  Court orders/affidavit  Visitation plans with siblings, parents, or other family member and fictive kin (if established);  Birth verification/certificate;  Social Security card (if available);  Education portfolio (if applicable);  Medicaid/Star Health card;  Any relevant external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child;  Signed Placement Authorization (2085fc);  Signed Medical Consenter (2085b);  Most recent Child Service Plan (if applicable);  General Release of Information (any & all information and records about the child)

Email Encryption: All CPS staff must follow the DFPS email encryption policy when communicating electronically with Providence Service Corporation.

Foster Care Redesign Operations Manual Page 64 of 94 See: http://intranet.dfps.txnet.state.tx.us/Toolbox/Software/Office_2010/Outlook/Email_Encrypti on/default.asp

Email Types/Subject Line Headings

“CPS Emergency Placement-Child’s Placement Information” – Used when sending emergency placement referral information to PSC via email.

"CPS Emergency Placement-Medical Consenter/Education Decision-Maker" – Used during emergency placement process when CPS needs to send the signed/approved medical consenter form (2085b) and education decision-maker form (2085e) to PSC via email.

"CPS Non-Emergency Placement-Child’s Placement Information” – Used when sending a non- emergency placement referral information to PSC via email.

"CPS Non-Emergency Placement-Placement Change" – Used when sending non-emergency placement change referral information to PSC via email.

“Life Skills Assessment” – Used when PSC is sending a youth and caregiver’s Ansell-Casey Skills Assessment results to CPS via email.

“Life Skills Training” – Used when PSC is sending a monthly report to CPS regarding the status and progress of a youth’s PAL training.

“NYTD Survey Participant” - Used when CPS informs PSC of the youth who will participate in NYTD surveys via email.

“Court Hearing Notice” – Used when CPS notifies PSC of scheduled court hearings via email.

“Court Alert” – Used when PSC notifies CPS of any service of legal process (i.e. subpoena, summons, discovery notices) related to performance under contract.

“Court Documents” – Used when CPS is sending all available court-related documents to PSC via email.

“Court Report Information” – Used when PSC is sending CPS the completed Court Report Template prior to a scheduled hearing.

“Foster/Adoptive Inquiry” – Used when CPS is sending a completed Foster/Adoptive Parent Inquiry Form to PSC via email.

“Adoption Referral” – Used when CPS is sending a completed Adoption Referral Form to PSC via email.

“Approved Adoptive Home” - Used when CPS is sending approval of PSC’s match recommendation via email.

“Adoptive Family Refusal” – Used when PSC needs to inform CPS that the selected family elects to not accept a child for adoption.

“Denial of Adoptive Home” – Used when CPS is sending the denial of PSC’s match recommendation via email.

Foster Care Redesign Operations Manual Page 65 of 94 “Dispute Resolution” - Used during dispute resolution when the escalating party sends an email with supporting documentation to the Foster Care Redesign Administrator and PSC Administrator.

“Dispute Resolution Appeal Decision” – Used when the written decision about a dispute is emailed to the PSC Administrator and distributed to the appropriate staff and management.

Providence Service Corporation (PSC) Staff Information

Intake and Placement (includes referrals, placement packets, ICM notifications, pre-placement staffing notifications): Intake phone number: #855-488-1046 Email address: [email protected]

Utilization Management (includes copies of court related documents such as reports, child planning related communication, adoption inquiry, PAL related communication, and anything that is not directly related to placement request): Email address: [email protected]

Foster Care Redesign Operations Manual Page 66 of 94 Providence Service Corporation Intake Form

Child Information Name: Sex: Male Female DOB: Age: ICWA Case: Yes or No

Race: Ethnicity: Language: White Hispanic or Latino Declined Black or African American Not Hispanic or Latino English American Indian or Alaska Native Other Asian Spanish Native Hawaiian or Other Pacific Islander Unknown Unknown

Child’s PID: ______

Removal Location: Street: City: Zip:

Living Situation: Adoptive Home PMIC Birth Home Relative Detention Runaway Foster Home Shelter Group Home Suitable Other Hospital

Is this the child’s first time to be placed into family foster care? Yes or No

School Name: School District: Grade: IEP: Special Ed? Yes or No Academic Behavioral None Unknown

Strengths:

______

Likes/Dislikes: ______

______

Foster Care Redesign Operations Manual Page 67 of 94 Interests:

______

Attends Church? Yes or No Drives Self? Yes or No

Child Attributes (optional but preferred) Please circle the appropriate level using this scale:

1-None child does not display this behavior/special need 2-Child may have or has a very mild level of this behavior/special need 3-Child has a mild/moderate level of this behavior/special need 4-Child has a moderate/severe level of this behavior/special need 5-Child has a very severe level of this behavior/special need

Special Needs ADHD 1 2 3 4 5 Allergies 1 2 3 4 5 Aspergers Syndrome 1 2 3 4 5 Autism 1 2 3 4 5 Bi-Polar Disorder 1 2 3 4 5 Depression 1 2 3 4 5 Drug Affected 1 2 3 4 5 Fetal Alcohol Syndrome 1 2 3 4 5 HIV 1 2 3 4 5 Medically Fragile 1 2 3 4 5 Mental Health Issues 1 2 3 4 5 Mentally Retarded or Developmental 1 2 3 4 5 Disabled Physically Challenged 1 2 3 4 5 Post Traumatic Stress Syndrome 1 2 3 4 5 Respiratory Impairment 1 2 3 4 5 Sexually Reactive 1 2 3 4 5 Special Dietary Needs 1 2 3 4 5 Special Medical Needs 1 2 3 4 5 Special Needs Narrative:

Behaviors Conduct Disorder 1 2 3 4 5 Developmental Disorder 1 2 3 4 5 Oppositional Defiance Disorder 1 2 3 4 5 Refuses to go to school 1 2 3 4 5 Run Away From Home 1 2 3 4 5 School Expulsion 1 2 3 4 5 Serious Behavioral Issues 1 2 3 4 5 Sexually Active 1 2 3 4 5 Sibling or Peer Relations 1 2 3 4 5 Substance or Alcohol Abuse 1 2 3 4 5 Behavior Narrative:

Transportation Needs What are the transportation need for the child relating to School Activities HealthCare Other

Visitation Expectations Birth family/foster family interaction Birth Family Significant relatives/friends Siblings Other Risk Management What are the characteristics of other children that this child should NOT be placed with?

What are the characteristics of potential match family you would not consider for this child?

Foster Care Redesign Operations Manual Page 68 of 94 Is Child part of a sibling group? Yes or No If yes, are the siblings living together? Yes or No If yes, are the siblings transitioning together? Yes or No

DFPS Information (required) DFPS Worker Name: Phone: DFPS Worker Office:

Providence Service Corporation (PSC) Organizational Chart

Providence Service Corporation of Texas Text description of organizational chart

Executive Director • Community Advisory Committee • Provider Council

Executive Director manages: • IT Network Tuscon Office • Provider Network Administrator • Business Analyst

IT Network Tuscon Office manages: • Five Points and Associates, Software, Data Collection, Reporting and Analysis

Provider Network Administrator (COO) manages: • Administrative Assistant • Quality Assurance Director • Utilization Management Director • Intake Director • Director of Contract Management and Provider Relations

Business Analyst manages: • LCPAA for Providence Kids

Quality Assurance Director manages: • 2 Quality Assurance Specialists • 2 Data Entry Specialists

Utilization Management Director manages: • 3 Utilization Specialists

Intake Director manages: • 3 Intake Coordinators

Director of Contract Management and Provider Relations manages: • 2 Contract Specialists

Foster Care Redesign Operations Manual Page 69 of 94 Visual Diagram of Providence Service Corporation (PSC) Organizational Chart

Foster Care Redesign Operations Manual Page 70 of 94 Child Service Plan Matrix

Foster Care Redesign Operations Manual Page 71 of 94

Foster Care Redesign Emergency Placement Job Aid (Emergency Placements = A placement needed within the next 7 hours)

When Who What At the time of emergency or non- CPS Worker Staff with your supervisor for approval to request a emergency removal, or at the time any placement from PSC child requires immediate (within the next 7 hours) paid foster care placement. After receiving approval from CPS Worker Contact PSC #855-488-1046 and provide: supervisor  CPS worker contact information  CPS Back-up worker / supervisor information  Provide as much information regarding the child as possible

Don't hang up until you have received information regarding the PSC worker to be assigned as secondary on the IMPACT case.

Within 2 hours of referral call CPS Worker or Complete the 2087ex with as much information as possible Supervisor and email to PSC ([email protected]) with the subject line: CPS Emergency Placement

Within 4 hours of referral call CPS Worker or Things to do in IMPACT: Supervisor  Update Person information and open FSU and SUB stages  Enter referral information in each child's SUB stage  Assign PSC worker as secondary on each child's SUB stage Within 4 hours of referral call CPS and PSC PSC has four hours to take possession of the child whether Worker or not a physical placement has been located. Meet the PSC worker at the agreed upon location with the child. This location might be an office or some other location but best practice will always be that a physical placement has been located and you meet with PSC worker at the physical placement with the child. At the time of placement with PSC CPS Worker Complete Form 2085fc with the PSC Worker. The name of the caregiver for this form is "Providence Service Corporation" If you are meeting PSC at the physical CPS Worker Complete Form 2085b Medical Consenter and 2085e placement Education Decision-Maker. The Medical Consenter cannot be PSC and must be a foster parent, etc. Please see the Medical Consenter Chart. If physical placement was not PSC Worker The PSC Worker will call or email you back with the name located within the first 4 hours: and other information regarding the proposed physical placement and medical consenter Within 7 hours of referral call

Foster Care Redesign Operations Manual Page 72 of 94 If physical placement was not CPS Worker Once PSC has provided you with the name and other located within the first 4 hours: and Supervisor information for the proposed physical placement, you have 1 hour to verbally approve these choices. Within 1 hour of PSC providing you with the name of the physical placement and medical consenter Within 12 hours PSC Worker PSC worker will enter the placement and medical consenter into IMPACT

Within 24 hours of placement with CPS Worker CPS must approve the placement in IMPACT and send it PSC the CPS Supervisor for Secondary Approval. The worker also approves the medical consenter in IMPACT

If 2085b and/or 2085e was not CPS Worker Worker will send the approved / signed 2085b and 2085e to completed at the time of placement PSC at: [email protected]

Within 24 hours The subject line should be: CPS Emergency Placement-Medical Consenter

By 5:00 the next business day after CPS Worker Forward additional external documents to PSC, Birth placement Certificates, Medicaid and SS Card, Affidavit, Court Orders, school records, etc. Scan and email these documents to: [email protected]

The subject line should be: CPS Emergency Placement

Include the date and time of the ICM in this email Within 7 days of Emergency Placing CPS The placing CPS worker and CVS worker must participate Placement Worker and in the ICM within 7 days of placement. The placing CPS CVS Worker worker will complete the first page of the ICM / Post Removal Staffing Form (Form K 908-1502).

The CVS worker will complete the remainder of the form at the ICM and Scrub / Cut / Paste this as the first contact in the FSU stage.

Foster Care Redesign Operations Manual Page 73 of 94 Case Name: Date of Removal:

REMOVAL CHECKLIST

** This checklist reflects contractual and procedural protocol for emergency and non-emergency removals in Regions 2 and 9 as per the Foster Care Redesign project.

DATE COMPLETED DAY 1 (within 24 hours) – DUE DATE: 1. Obtain supervisor/PD approval prior to the removal. Discuss with supervisor who will/will not be offered a visit within the first 3 days; for parents who will not be offered a visit, why the visit is not in the child’s best interest. 2. Give the Notice of Emergency Removal and the booklet titled While Your Child is in Care to the parent/caretaker. 3. Complete with parents/caretakers the Child Caregiver Resource Form (2625). Leave 1 copy with the parents/caretakers.  Ask about American Indian heritage. If a child MAY be of Native American heritage, review and follow policy 2812.4 Person Race and Ethnicity. If a child IS of Native American heritage, review and follow policy 1225 Indian Child Welfare Act, Appendix 1226-A and 1226-B.  Request information on absent parent. Attempt to get absent parents name, address, last address, relative/friends names, last known work place, etc. Attempt to contact absent parents to give a Notice of Removal (form 2231es) and a copy of While Your Child is in Care.  If the parents/caretakers do not complete the form at the time of removal, ask them to sign the blank form. Encourage parents/caretakers to complete the form and return as soon as possible. Leave 2 copies of the form with the parents/caretakers (1 for the parent/caretaker & 1 for them to complete and return). 4. If the child is not a US citizen, follow policy 6700 and notify the appropriate consulate using Letter to Foreign Consulates (form 2650). Follow guidelines in Questions and Procedures for Working with Foreign Born Children in Foster Care (form 2013). 5. If a child will be placed with or remain in the home of a kinship caregiver (relative or fictive kin) at the time of removal, initiate the Preliminary Home Assessment (form 6587). The Preliminary Home Assessment must include a criminal history and IMPACT background check, and a visit to the home of the kinship caregiver to assess the home environment. Complete placement forms (2085’s) as appropriate. 6. Schedule a visit between the parents and children to occur within 3 days of the Department being named Temporary Managing Conservator. 7. Request child’s birth certificates, social security cards, Educational Records, immunization records, citizenship or immigration status, and Medicaid Card from the parent/caretaker. If not obtained by the parent/caretaker, request records/documents according to regional procedures. 8. Obtain as much information about the child’s Medical/Developmental history as possible from the parent/caretaker in order to complete the Medical/Developmental History Form in IMPACT:  Includes information about the child’s current medical, dental, vision, school and behavioral health history and treatment.  Document the name, dosage, frequency, prescribing physician and time the caretaker last administered any medication to the child.  If possible, gather medications and medical supplies/assistive devices, such as eyeglasses, dental retainers, leg braces, wheelchairs, etc.  Contact the regional eligibility specialist if the pharmacy refuses to refill any Foster Care Redesign Operations Manual Page 74 of 94 medications.  Obtain a list of all known schools for the child, all known doctors/clinics, and location of the child’s birth. 9. For Kinship Placements ONLY, complete Placement Summary Form (2279) with as much information on each child as possible. A copy of Form 2279 is given to each child’s kinship caregiver at placement or within 72 hours of placement.  The caseworker must share all known information about each child’s immediate and special needs at the time of placement. This section must be initialed and dated at the time of placement  Signatures of the child (if appropriate), the caregiver, and caseworker on the last page signify that all known information about the child was given to the caregiver at placement 10. Request daycare for the kinship placement, as needed. 11. Complete conservatorship/removal in IMPACT:  Update INV/FBSS stage prior to completing Conservatorship Removal in IMPACT (see page 4, item #10);  Open Subcare/Family Subcare Stages (see page 5, item #12) 12. If paid foster care placement is needed, contact Providence Service Corporation (PSC) Intake Unit to request a placement for the child. Official request for placement can be made verbally (note the date & time of referral). At a minimum, provide PSC with the following information about the child:  Caseworker’s contact information  Caseworker’s back-up contact (i.e. supervisor);  Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information)  Therapeutic needs  Social needs  Court orders/affidavit  Medical, dental, and mental health records (only needed if specific care instructions are required for the child’s care)  Visitation plans with siblings, parents, or other family member and fictive kin (if established)  General Release of Information (any & all information and records about the child). *All child’s placement information above may be given verbally to PSC with the exception of form 2087ex and General Release of Information, which must be sent via email to PSC within 2 hours of referral; email subject title, “CPS Emergency Placement-Child Placement Information.”

*Within 4 hours of initial contact with PSC (referral):  Complete conservatorship/removal in IMPACT (see #11 above);  Enter placement referral information in IMPACT;  Make PSC staff secondary on subcare stages. 13. Evaluate and approve PSC’s recommended placement option and medical consenter within 1 hour of receipt of notification from PSC in IMPACT (approval can be verbal).

*If verbal approval of the placement option and medical consenter is given to PSC, then:  approval of the placement option and medical consenter must be documented in

Foster Care Redesign Operations Manual Page 75 of 94 IMPACT the next calendar day; and  approved medical consenter form (2085b) and education decision-maker form (2085e) must be sent to PSC Placement Unit mailbox the next calendar day. The subject line of the email titled “DFPS Emergency Placement-Medical Consenter/Education Decision-Maker.”

**Ensure the medical consenter has his or her correct IMPACT PID in order to verify that s/he is the medical consenter when contacting STAR Health and to register for the Health Passport.

**Generate Form 2096 from IMPACT within 5 business days to notify court of medical consenter designation. 14. Follow regional procedures to notify Family Group Conference staff, Conservatorship staff, Investigation staff, Eligibility staff, Legal, and, if needed, Disability Specialist & Educational Specialist.

DATE COMPLETED DAY AFTER REMOVAL – DUE DATE: 1. Contact District Attorney/County Attorney to inform them of removal. Complete legal paperwork as required for each county. 2. Complete Affidavit for removal. 3. File legal documentation as required by each county. (Remember all legal work needs to be filed within 24 hours of the removal or the first working day following a weekend or a court holiday). 4. Participate in Ex-Parte hearing as appropriate for each county. 5. Update the IMPACT Medical Consenter Detail to reflect the court authorization of medical consenter the same day or no later than 7pm on the next day.

If the medical consenter changed after the court hearing, issue a new form 2085b and/or 2085c as appropriate, and generate form 2096 from IMPACT within 5 business days to notify court of medical consenter designation. If the medical consenter did NOT change after the court hearing, it is not necessary to issue a new Form 2085-B and/or C or notify the court. 6. Obtain copies of all legal paperwork. 7. For paid foster care placement: All child placement information must be sent to PSC Intake Unit by 5:00 p.m. the next business day. Complete child placement information will be attached to an email titled "DFPS Emergency Placement-Child’s Placement Information."  Email must include date and time of the Initial Coordination Meeting (ICM)  Copy all appropriate CPS staff on ICM date/time notification Child placement information includes:  Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care information)  Court orders/affidavit  Visitation plans with siblings, parents, or other family member and fictive kin (if established);  Birth verification/certificate;  Social Security card (if available);  Education portfolio (if applicable);

Foster Care Redesign Operations Manual Page 76 of 94  Medicaid/Star Health card (if available); and  Any external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child.  Signed Placement Authorization (2085fc). PSC will always be the placement.  Signed Medical Consenter (2085b)  Signed Education Decision-Maker (2085e)  Most recent Child Service Plan (if applicable)  General Release of Information (any & all information and records about the child). 8. If Child Caregiver Resource form is completed at the time of the removal, initiate the home assessment process (see 4520 Placing a Child with an Unverified Kinship Caregiver). 9. Exercise due diligence to identify and notify in writing all adult grandparents and other adult relatives of the child by providing them with Form 2624 Notification to Relatives About a Child's Removal.

The search for relatives should be ongoing but is required to take place within the first 30 days after the removal of the child. For more details see 2540 Notification to Relatives Following a Removal. 10. Update the following information in INV/FBSS stage prior to completing Conservatorship Removal in IMPACT: a) Ensure all parties are listed on Maintain person. This includes all persons in home not previously listed, relative resources, collaterals, etc. b) Enter person characteristics for each principal. Make sure no person characteristics apply before marking N/A. c) Update address/phone number for each person on the Maintain person list. Be sure to add Medicaid address for each child removed from the home. (This should be marked as the primary address for the child. Do NOT “invalidate” the previous removal address for the child.) d) Complete person detail for each principal. e) Update Person ID’s – social security number, driver’s license, etc. for each principal. f) Enter Income and Resource for each principal. g) Update education log for each child h) Complete criminal history and IMPACT check for each principal, including potential relative placements. i) Complete Person Detail CVS/FA home – be sure to add in citizenship and mother’s marital status at time of birth. 11. Complete the Family Tree in IMPACT.

See 2537 Establish Relationships in Family Tree in IMPACT When Children Are Removed. 12. Open Subcare/Family Subcare Stages a) From Assigned Workload, highlight case and click on the Tasks push button. b) From the Tasks list window, highlight Conservatorship/Removal task and click on the Add push button. This will take you back to the Person List. c) Highlight the child’s name to be removed. d) Click on the Continue button. The Conservatorship/Removal window displays. e) Fill in the removal date (actual date of removal) and reason for removal. If person characteristics have not been updated for parent/caretaker, mark those that are appropriate. f) On the same window, click on Persons in the Home and click on all persons Foster Care Redesign Operations Manual Page 77 of 94 living in the home at the time of the removal. g) Click on the Save button. h) For additional children, click on the Add push button. i) Follow the above steps for each child. 13. Ensure Placement is in IMPACT in each child’s SUB stage. Ensure that the placement is an actual placement instead of a planned placement. This will be done by PSC, however, worker is responsible to confirm. 14. Notify the eligibility worker that child has been removed and placed in foster care. 15. Enter Legal Actions in each child’s SUB stage (Be sure to identify the Medical Consenter). See 5240 Documenting Legal Status and Legal Action. 16. Enter Legal Status (be sure to enter as Temporary Managing Conservatorship) in each child’s SUB stage. Make sure the Legal County of removal is correct. 17. Maintain role of the child to “self” and any principal to their appropriate role. 18. Maintain role for each principal in the FSU stage. 19. Inform youth 16 or older of their right to request a court determination of their ability to consent to some or all of their own medical care. Review Notice of Your Right to Request the Court to Consent to Your Own Medical Care (form 2092) with the youth.

DATE COMPLETED WITHIN 5 DAYS OF REMOVAL – DUE DATE: 1. Complete Foster Care Eligibility for each child (in IMPACT), or provide documentation to Eligibility Specialist, per regional protocol. 2. Ensure placement has scheduled TX Health Steps medical and dental check-ups and any other appropriate appointments for each child. 3. Start the Education Portfolio and ensure either Providence Service Corporation (PSC) or kinship caregiver receives it within 5 days of initial placement.

See 15381 Creating the Education Portfolio. 4. Ensure the child has been referred to ECI (ECI Screening Referral Form 0789) within 2 business days of the need being identified, if the child is under 3 and suspected of having a disability or developmental delay as a result of exposure to illegal substances, or the disability or developmental delay requires evaluation prior to their scheduled TX Health Steps check-up.

*PSC will issue with ECI referral within 3 days of placement if the child is in paid foster care.

DATE COMPLETED WITHIN 10 DAYS OF REMOVAL or PRIOR TO 14 DAY ADVERSARY HEARING – DUE DATE: 1. Follow up with the regional FGDM Specialist to identify whether a Family Group Conference or Permanency Conference will be held with the family. 2. Complete Page 1 ONLY of ICM/Post-Removal Staffing Form  Attach a copy of the removal affidavit.  Remainder of the form will be completed during the ICM/Post-Removal Staffing. 3. Attend ICM/Post-Removal Staffing and ensure the form is completed at the staffing. 4. Develop a temporary visitation schedule with each parent, and complete the Temporary Visitation Schedule (form K-908-2640) with each parent. *Prepare to present the temporary visitation schedule with the court at the Show Cause/Adversary Hearing. See PSA 14-013. 5. Complete the Risk Assessment in IMPACT. This must be completed in order for the CVS unit to initiate the Family Service Plan. 6. If the whereabouts of any parent is unknown, complete the following steps:

Foster Care Redesign Operations Manual Page 78 of 94  Request a Certificate of Service or Non-Service from the U.S. Military’s data center, and attach form 2068 (See 6417 Working with Military Families)  Complete form 2068 (Affidavit Regarding Military Service), and submit it to the Court.  Immediately notify the attorney representing DFPS of any active military status of the parent. 7. Complete court report for Show Cause/Adversary Hearing, if required. Seek information for the court report from PSC as needed. 8. Contact Ad Litem for child to discuss case. Provide copy of court report, if required.

DATE COMPLETED WITHIN 14 DAYS OF REMOVAL – DUE DATE: 1. If not previously completed, designate an appropriate person to be identified as the Education Decision-Maker:  If not previously completed, complete Designation of Education Decision- Maker (form 2085e).  File the most current and correct copy of form 2085e with the court.  Ensure a copy of the completed form 2085e is provided to the child’s school, caregiver or facility director, parents, managing conservator, attorney ad-litem, guardian ad-litem, and any other person named by the court to have an interest in the child’s welfare. 2. If not previously completed, complete the Temporary Visitation Schedule with each parent and present to the Court at the Show Cause/Adversary Hearing. 3. Attend Show Cause/Adversary Hearing. Ensure conservatorship caseworker is aware of the court orders from this hearing. 4. Complete the Communication Plan with the Attorney Ad Litem and/or Guardian Ad Litem (form 2071) if one has been appointed. (Obtain input from the conservatorship caseworker regarding communication with the AAL and/or GAL). 5. Update Legal Actions in each child’s SUB stage. 6. If not authorized during the Ex Parte Hearing, update the IMPACT Medical Consenter Detail to reflect the court authorization of medical consenter the same day or no later than 7pm the next day.

If the medical consenter changed after the court hearing, issue new forms 2085b and/or 2085c as appropriate and generate form 2096 from IMPACT within 5 business days to notify court of medical consenter designation. If the medical consenter did NOT change after the court hearing, it is not necessary to issue new Forms 2085b and/or 2085c or notify the court. 7. If the education decision-maker changes as a result of the Show Cause/Adversary Hearing, or prior to case transfer, update the Designation of Education Decision Maker (form 2085e) and distribute to all required parties within 5 days of the change. 8. Complete transfer summary in IMPACT. 9a. Complete Request for Diligent Search (form 2277), if there are absent parents with unknown locations. Check the boxes for “Court of Continuing Jurisdiction” and “Paternity Registry” when using this Form. This Form is sent to: [email protected] 9b. If all parents locations are known:  Submit Bureau of Vital Statistics Form VS 168 “Inquiry on Court of Continuing Jurisdiction for a Child”  Submit this Form to the Bureau of Vital Statistics – Texas Department of State Health Services 9c. If Paternity has not been established:

Foster Care Redesign Operations Manual Page 79 of 94  Submit Bureau of Vital Statistics Form VS 134 “Paternity Registry Inquiry Request”  Submit this Form to the Bureau of Vital Statistics – Texas Department of State Health Services 10. Organize case file. 11. If the investigation can be completed by the time of case transfer, it should be included in the case file documentation. 12. Plan to attend the Family Group Conference or Permanency Conference.

CPS Handbook 6138 External Documentation – Substitute care documentation requirements state the following forms must be included in the paper case record. This list is not all-inclusive. Your region or county may have additional requirements for documentation that must be included in the case file. The removal caseworker needs to ensure that any of the documentation below that has been obtained are in the case record, either in IMPACT or the paper file, with copies of certain documents filed in the child’s Education Portfolio.

 Birth/citizenship records

 Health records, including a copy of a recent medical exam

 School records

 A copy of the signed foster care assistance application

 Copies of signed court orders, affidavits, and other court documents

 The court’s determination that CPS made reasonable efforts to prevent removal, reunify the family or seek other permanency goals for a child

 CPS notice to caretaker of court hearings, PPMs/administrative review. Caretakers include relatives, foster parents, and pre-consummated adoptive parents

 Placement and medical authorizations including medical consenter forms

 Designation of education decision-maker

 Temporary Visitation Schedule

 Correspondence

 Other possible documents, such as photographs, authorizations, and letters

Foster Care Redesign Operations Manual Page 80 of 94 Initial Coordination Meeting/Pre-Placement Staffing Schedule

Day Time Region Counties Covered Office Number Contact Person

877-402-9757 Vickie Ryan Monday 1:30 2 Wichita, Montague, Archer, Clay, Jack Code: 651-7659 325-691-8123 [email protected] 877-402-9757 ate.tx.us Tuesday 1:30 2 Taylor, Eastland, Young, Stephens Code: 651-7659 Hardeman, Cottle, Ford, Wilbarger, Knox, Baylor, Kent, Stonewall, Haskell, Throckmorton, Scurry, Fisher, Jones, Shackelford, Mitchell, Nolan, Callahan, Runnels, Coleman, Brown, 877-402-9757 Tuesday 8:30 2 Comanche. Code: 651-7659 Sandy Ochoa Ector, Gaines, Andrews, Ward, Crane, 432-368-2436 Pecos, Terrell, Loving, Winkler, 877-336-1831 [email protected] Monday 9:30 9 Reeves Code: 8945077 tate.tx.us Mary Alice Hudson Tom Green, Coke, Sterling, Irion, 325-657-8945 Concho, McCullough, Mason, Menard, 888-557-8511 [email protected] Tuesday 9:00 9 Kimble, Sutton, Schleicher, Crocket Code: 4614259 tate.tx.us Sandy Ochoa Midland, Howard, Borden, Dawson, 432-368-2436 Martin, Glasscock, Reagan, Upton, 888-273-3658 [email protected] Thursday 9:00 9 Crane Code: 1395826 tate.tx.us

Invitations to participate should be sent to those on the removal d-list for the respective areas, Providence Service Corporation at [email protected], and the FCR Administrator, [email protected].

Initial Coordination Meeting (ICM) Form (Post-Removal Staffing)

Foster Care Redesign Operations Manual Page 81 of 94 Date: ______

Participants: Name Relationship to the Child/Youth

Case Name: Case ID: Adversary Hearing: Status Hearing: Court: Cause Number: Date due to Conservatorship Unit:

Parents/Caretakers: Name Relationship Address/Phone Race/Ethnicity

Child(ren): Name Placement Type Date Placed Age Race/Ethnicity

Relatives & Significant Others: Name Relationship Address/Phone Race/Ethnicity

Primary language of children and family: ______

INVESTIGATION AND REMOVAL:

Foster Care Redesign Operations Manual Page 82 of 94 Removal Date: ______

Emergency ☐ Non-Emergency ☐

What are the safety threats/risk factors that lead to the child’s removal? ______

Discussion of prior CPS history of family: ______

Discussion of any criminal history of family members: ______

LEGAL ACTIONS:

Have all parties been served? Yes ☐ No ☐ If no, please explain: ______

Has 1702 referral for Paternity Testing been completed? (CVS staff is responsible for this task.) Yes ☐ No ☐ N/A ☐ If no, please indicate when the referral will be submitted: ______

Attorneys Name Phone Number CPS Attorney Attorney for Mother Attorney for Father Attorney Ad Litem Guardian Ad Litem/CASA Other: Other:

CHILD(REN)'S SERVICES:

Child Permanency Goal Concurrent Permanency Goal

Foster Care Redesign Operations Manual Page 83 of 94 Child’s Service Plan due to Supervisor by: ______(30th day)

CHILD:______Needs & concerns (include TB test, educational, medical, mental, behavioral, therapeutic, developmental, dental, vision, hearing needs, etc.): ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

CHILD:______Needs & concerns (include TB test, educational, medical, mental, behavioral, therapeutic, developmental, dental, vision, hearing needs, etc.): ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

CHILD:______Needs & concerns (include TB test, educational, medical, mental, behavioral, therapeutic, developmental, dental, vision, hearing needs, etc.): ______

Foster Care Redesign Operations Manual Page 84 of 94 ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

CHILD:______Needs & concerns (include TB test, educational, medical, mental, behavioral, therapeutic, developmental, dental, vision, hearing needs, etc.): ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

Does any child need daycare or afterschool care? Yes ☐ No ☐ If yes, please explain: ______

Does an ISY worker need to be requested for any child? Yes ☐ No ☐ If yes, please explain: ______

Describe any placement needs the child(ren) may have: ______

Foster Care Redesign Operations Manual Page 85 of 94 Describe the visitation plans with the parents or other family members/kin: ______

SERVICES TO PARENTS:

Family Service Plan to be approved in IMPACT and filed with the Court by: ______(45th day)

Services/referrals recommended for Parents/Caregivers: ______Does a courtesy worker need to be requested for any parent? Yes ☐ No ☐ If yes, please explain: ______

Referral submitted for: Family Group Conference ☐ Permanency Conference ☐ **Must be held within 45 days of removal- all removals must be at least referred for an FGC

RELATIVE/FICTIVE KIN INFORMATION :

Discussion of relatives identified on the Child Resource Form(s): ______Grandparents and other known relatives notified of removal? Yes ☐ No ☐ If no, please explain: ______

Does a Home Assessment need to be requested? Yes ☐ No ☐

ACTION ITEMS: YES NO N/A COMMENTS Form 2085’s (Placement, Medical Consenter, Education Decision-Maker) completed with signatures Copies of signed Education Decision-Maker form provided to the:  PSC: school, foster care provider or facility director;  CPS: school (if child placed with kin),

Foster Care Redesign Operations Manual Page 86 of 94 kinship caregiver, parents, managing conservator, attorneys, any other person named by the court to have an interest in the child’s welfare. Kinship Placements ONLY: Placement Summary Form 2279 complete (w/in 72 hours for ER placments) Copy of Rights of Children (form 2530) Given to child, caregiver, and parent Temporary Visitation Schedule (form K-908- 2640) developed with parents Orientation Discussion (form 2654) w/in 7 days While You Are In Care Pamphlet Given Placements Entered & Approved Medical Consenter entered Foster Care Application Completed Risk Assessment Completed Birth Certificate Birth Verification from DHS Social Security Card Shot records Education Portfolio started and given to PSC Common Application (form 2087) completed and sent to PSC within 30 days of paid placement referral

Additional action items, if any, needing follow up by CVS worker or PSC staff: ______

Date of initial service planning meeting: ______

Foster Care Redesign Operations Manual Page 87 of 94 Pre-Placement Staffing Form (Non-Emergency Placements and Placement Changes)

Date: ______

Participants: Name Relationship to the Child/Youth

Case Name: Case ID: Adversary Hearing: Status Hearing: Court: Cause Number: Date Placement Needed:

Parents/Caretakers: Name Relationship Address/Phone Race/Ethnicity

Child(ren): Name Current Placement Type Date Placed Age Race/Ethnicity

Relatives & Significant Others: Name Relationship Address/Phone Race/Ethnicity

Primary language of children and family: ______

Foster Care Redesign Operations Manual Page 88 of 94 CHILD(REN)'S NEEDS:

Child Permanency Goal Concurrent Permanency Goal

CHILD:______Needs & concerns: ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

CHILD:______Needs & concerns: ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

Foster Care Redesign Operations Manual Page 89 of 94 ______

CHILD:______Needs & concerns: ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

CHILD:______Needs & concerns: ______

Services received or needed (ARD, ECI, therapy, medical/dental, vision, hearing, extra-curricular, medications to address identified needs; include progress/barriers): ______

Does any child need daycare or afterschool care? Yes☐ No☐ If yes, please explain: ______

Describe any placement needs the child(ren) may have: ______Foster Care Redesign Operations Manual Page 90 of 94 ______Describe current visitation with the parents or other family members/kin: ______

RELATIVE/FICTIVE KIN INFORMATION

Discussion of possible relative or fictive kin resources (include resources for possible placement, visitation, or other support; efforts to locate and engage relatives/fictive kin): ______Does a Home Assessment need to be requested? Yes☐ No☐

Placement Options: Name Placement Type Address/Phone Race/Ethnicity

Does a pre-placement visit need to be set up? Yes☐ No☐ Does an ISY worker need to be requested for any child? Yes☐ No☐ If yes, please explain: ______

Action items: WHO WHAT WHEN

Foster Care Redesign Operations Manual Page 91 of 94 Date of service planning meeting: ______

Foster Care Redesign Operations Manual Page 92 of 94 Regions 2 and 9 Foster/Adoptive Parent Inquiry Form

Date:

Name:

Address:

Phone:

CPS Staff:

CPS Contact Information:

Comments:

Foster Care Redesign Operations Manual Page 93 of 94 Regions 2 and 9 Adoption Referral Form

This is a Private Agency home referral for adoption (Complete Section A). This is an FPS request for home study (Complete Section B). Home study(s) attached for consideration for specific child. Names of families submitted: ______

Name(s) of Child(ren): CURRENT placement name: CURRENT placement address: CURRENT placement home phone: Is the child already placed in the home as a foster or kinship placement? ______Placement Date: ______

Caseworker Name: ______Phone: ______Additional Information: ______

Attachments: CRIMINAL CHECK IMPACT CHECK/PERSON SEARCH KINSHIP ASSESSMENT or HOMESTUDY

Foster Care Redesign Operations Manual Page 94 of 94