ICWA Addendum for CFSR

Category/Item Question Response Face Sheet 1. This child has been identified in FACIS as Yes No Indian. Does ICWA apply to this particular child?

If no, list reason(s)

Were immediate efforts made to contact the tribe Yes No or Indian relatives at the point the child was removed from the home?

Is there a 1270 form for each parent in the case record? Mother Yes No Father Yes No

If yes, date completed? Were all replies received? When?

An Indian child is one who meets the following criteria: 1) Is under 18 and unmarried, 2) Is a member of a federally-recognized Indian tribe OR, 3) If not a tribal member, is the child eligible for membership AND the biological child of a tribal member.

Revised: 4/4/2018 Page 1 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc Category/Item Question Response Safety – 2 2. What efforts were made to avert the breakup of Item 3, P. 8 the Indian family?

Was there a court finding that active efforts were Yes No made to prevent the breakup of the Indian family?

Was there a tribal recommendation that an active Yes No effort finding be made? N/A (not involved)

Were imminent risk criteria met if there was a Yes No removal?

ICWA requires any party considering the removal of an Indian child from the home of his parents or Indian custodian to engage in “active efforts” by providing remedial and/or rehabilitative services to avoid removal of the child. Active efforts require the removing party to go beyond the reasonable efforts standard outlined in ASFA.

Revised: 4/4/2018 Page 2 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc Category/Item Question Response Permanency – 1 3. Were each of the following notified of each Item 6, P. 15 change in the child’s placement? * (Justify N/A)

Child’s tribe (or BIA if child’s tribe is unknown) Yes No N/A Child’s mother Yes No N/A Child’s father Yes No N/A Child’s Indian Custodian Yes No N/A * N/A:

Permanency – 1 4. What efforts were made to reunify the child with Item 7, P. 18 his/her parents?

Was there a court finding that active efforts were Yes No made to reunify the child with the parents?

Was there a tribal recommendation that an active Yes No efforts finding be made? N/A (not involved)

ICWA requires that once an Indian child is removed from their home, “active efforts” must be on-going with the goal of providing services to the child and family that will support the safe return of the child to the home of the parent(s) or Indian custodian. Active efforts require the party with care and custody of the child to go beyond the reasonable efforts standard outlined in ASFA.

Revised: 4/4/2018 Page 3 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc Category/Item Question Response Permanency – 2 5. Is the child place with extended family, someone Yes No Item 15, P. 36 from the child’s tribe or in another Indian home?

If no, what specific efforts have been made to maintain family, community and cultural connections for the child?

Utilizing Family Decision Models (FDM) or other culturally-relevant approaches for case planning creates unique family specific service plans. The plans often specify certain tasks to be done by family members. If those tasks directly affect the reunification and a family member has not completed the task, the Department will actively assist and support the family in completing the tasks and document all efforts to do so.

Revised: 4/4/2018 Page 4 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc Category/Item Question Response Well Being – 1 6. At the permanency hearing, did the court find Yes No Item 17, P. 41 that active efforts were made to finalize a N/A (there has not permanent plan? been a permanency hearing) Services Needed But Services Provided Not Provided

If the agency has moved to a permanent plan for Yes No the child, does the child’s Tribe agree with the plan?

Item 18, P. 45 8. Was the tribe included in planning for the child? Yes No

Who was the tribal consultant?

Item 22, P. 56 9. Were any health and dental services provided Yes No culturally appropriate?

Did the family feel comfortable with the provider? Yes No

Item 23, P. 58 10. Were any mental health services provided to the Yes No child culturally appropriate?

Did the family feel comfortable with the provider? Yes No

Revised: 4/4/2018 Page 5 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc ICWA Standards Not Covered in CFSR Instrument 11. Were notification of ALL court hearings sent to the following: Child’s tribe (or BIA if child’s tribe is unknown) Yes No N/A Child’s mother Yes No N/A Child’s father Yes No N/A Child’s Indian Custodian Yes No N/A Why N/A

12. Did a qualified expert witness testify at the shelter hearing? Yes No N/A (child returned home at shelter care or adjudicatory hearing)

13. Did a qualified expert witness testify in court at the jurisdictional Yes No N/A hearing?

15. Did a qualified expert witness testify in court prior to the Yes No N/A termination of parental rights on either or both parents?

Revised: 4/4/2018 Page 6 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc Summary of ICWA Findings 16. Review of information regarding ICWA compliance entered and Yes No updated in the FACIS, i.e., ICWA screen, narrative about tribal contact and involvement in the case. Is information missing? If so, what is missing?

Has the worker inquired about any specific cultural norms specific Yes No to this child and his/her family?

Any additional observations:

Revised: 4/4/2018 Page 7 D:\Docs\2017-12-15\064376d46189187801bd1a5a5d66f6bf.doc