NORTH CAROLINA’S MULTIPLE RESPONSE SYSTEM POLICY TRAINING 2006

1. NORTH CAROLINA’SMULTIPLE RESPONSE SYSTEM POLICY TRAINING2006 Note that portions of this slideshow are interactive through the use of hyperlinks.

2. North Carolina Department of Health and Human Services Division of Social Services Family Support and Child Welfare Section Holly McNeill – MRS Policy Consultant 828.757.5672 Office holly.mcneill@ncmail.net R. Patrick Betancourt – MRS Program Coordinator 919.733.4622 Office patrick.betancourt@ncmail.net

3. MRS is child welfare system reform through the application of family centered principles of partnership. During SFY 2004- 2005 the 100 county Departments of Social Services conducted CPS assessments on 111,581 children 96,938 (about 87%) of these children were reported for neglect or dependency issues

4. Why Reform? • Our practice has become inconsistent • We focus on “incidents” and are not able to see the underlying needs of the family • We need to move from the “We gotcha!” to the “How can we help?” attitude • “One size does not fit all” in assessing the needs of 111,581 children • We need to adequately utilize our resources by spending the most time on the highest risk cases

5. Six Principles of Partnership • Everyone desires respect • Everyone needs to be heard • Everyone has strengths • Judgments can wait • Partners share power • Partnership is a process

6. Seven Strategies of MRS • Collaboration between Child Welfare and Work First • A strengths-based structured intake • Choice of two approaches to reports of child abuse, neglect, or dependency • Coordination between law enforcement agencies and Child Protective Services during the Investigative Assessment • Redesign of mandatory CPS In-Home Services • Child and Family Teams during the provision of in home services • Shared Parenting meetings within the first 7 days of placement out of the home

7. approach every call…every interview...every interaction with a child, parent, reporter, collateral contact, foster parent, and community partner using the six family centered principles of partnership EVERYTHING YOU DO… Starting with Structured Intake all the way through to Permanency is MRS

8. Safety of the child is the first concern Children have the right to their family The family is the fundamental resource for the nurturing of children. Parents should be supported in their efforts to care for their children. A crisis is an opportunity for change Family members are our colleagues Families are diverse and have the right to be respected for their special cultural, racial, ethnic, and religious traditions; children can flourish in different types of families Inappropriate interventions can do harm Families who seem hopeless can grow and change It is our job to instill hope “Stepping Stones” of Family Centered Practice

9. An easy way to remember it is to always consider: “how would I want to be treated if this was me and my family?” The MRS Golden Rule?

10. Legislative History of MRS in North Carolina Session Law 2001-424 (Senate Bill 1005):effective July 1, 2001… • no fewer than two and no more than ten demonstration counties • selected reports of suspected child neglect • data collection processes • no state funds

11. Legislative History of MRS in North Carolina (cont’d.) Session Law 2002-126 (Senate Bill 1115):effective July 1, 2002… • expanded to include suspected reports of dependency, • required a report on the effectiveness of MRS no later than April 1, 2003,

12. Legislative History of MRS in North Carolina (cont’d.) Session Law 2003-284 (House Bill 397): effective July 1, 2003… • no fewer than 10 and no more than 33 demonstration areas • exceed max number if a county specifically requests inclusion and resources are available • original pilots continue • family-centered approach to CPS • continue the evaluation of MRS • report by April 1, 2004 • recommendations for statewide implementation must be included in the report

13. N.C.G.S. §7B-302 to specify that the director or director’s designee may not enter a private residence for investigation purposes without specific criteria being met N.C.G.S. § 131D-10.6A(b) to specify that each child welfare social worker must receive training on family centered practices and state and federal law regarding the basic rights of individuals Session Law 2003-304 (Senate Bill 421):effective July 4, 2003 amended… Legislative History of MRS in North Carolina (cont’d.)

14. 4 Criteria for Home Entrance • The reasonable belief that a juvenile is in imminent danger of death or serious physical injury. • The permission of the alleged victim child’s parent or person responsible (adult) for the juvenile’s care. • The accompaniment of a law enforcement officer who has legal authority to enter the residence. • An order from a court of competent jurisdiction.

15. Session Law 2005-55(House Bill 277) • Defines both Family Assessment Response and Investigative Assessment Response. • States that each county of the state shall use either the Family Assessment or Investigative Assessment response in response to reports of abuse, neglect and dependency. • Leaves the assignment of the response to the county DSS Director • Removes the requirement to make a home visit in child care related CPS investigative assessments

16. ensures that children and adults are protected from abuse, neglect, exploitation enables citizens to maintain or achieve maximum self-sufficiency and personal independence through employment if possible ensures that every family and individual has sufficient economic resources to obtain the basic necessities of life strengthens family life in order to nurture our children so that they may become productive,healthy, and responsible adults assists disabled and dependent adults, while ensuring they live in the most independent setting feasible with the least possible intrusion from public agencies Work First – Child Welfare Collaboration Mutually supporting activities designed to fulfill the Division’s Mission of ensuring safety, permanence, and well-being for North Carolina’s children and self-sufficiency for North Carolina’s families:

17. Enhancing Work First and Child Welfare Collaboration: • Use one another as collateral contacts • Attend each other’s staff meetings • Make joint home visits • Maintain regular communication • Create complimentary plans • Involve Work First at the point of initial Child Welfare contact • Consider which is the best service case manager • Check mutual histories at first contact • Cross train staff

18. MRS does not change the intake process Continue using DSS-1402 Consult manual material, forms, laws and policy Mandates to notify reporters, LEA, DA, DCD, etc. remain Confidentiality of reporters remains Limitation on contact with non-reporters (no extended intake) Agency’s “response clock” begins ticking at time of intake Intake and Screening Reports of Suspected Child Maltreatment

19. Intake and Screening Reports of Suspected Child Maltreatment (cont’d.) Strengths Based Structured Intake does: • Focus on family strengths in an effort to ensure the safety of children • Respectfully allows reporters to be heard, supported, and encouraged • Encourage the identification of collaterals and supportive agencies • Improve the quality and consistency of information • Screen for DV, substance abuse, medical insurance coverage, and “medical home” 100% of the time • Provides the foundation for the delivery of family centered services

20. Assignment of Reports for Assessment That action is to respond using one of two approaches. In both responses (Family Assessment and Investigative Assessment) the DSS: Codes 210 on Day Sheets (DSS-2203) Initiates contact within mandatory time frames Invokes the jurisdiction of the court if needed the ensure child safety If, through structured intake, DSS determines that a valid CPS report has been received it must take action through protective services to ensure the safety of the child

21. “Switching Responses”(Investigative Assessment  Family Assessment) • No abuse, abandonment, or “special types” of report that remains as reported throughout the assessment may be completed as a Family Assessment • An Investigative Assessment may be switched to the Family Assessment response if it becomes obvious that it could have been assigned as such if the true situation was known at intake

22. “Switching Responses”(Family Assessment  Investigative Assessment) • Any neglect or dependency report may be assigned initially and initiated as an Investigative Assessment • Any report initially initiated in the Family Assessment response may be switched to an Investigative Assessment if it becomes obvious it should have been assigned as such if the true situation was known at intake.

23. Key Points about “Switching Responses” • should not be done frequently • should not be done without a thorough discussion of the case between the social worker and the supervisor • must be done with supervisory approval and documentation in the record should also clearly show why such a decision was made, and how it helped ensure the safety of the child

24. Reports Appropriate for the Family Assessment Approach Those reports of: • neglect (except abandonment and other special types of reports) • dependency that meet the statutory definition of: N.C.G.S.§7B-101

25. These include allegations a juvenile… • does not receive proper care • does not receive proper supervision • does not receive proper discipline • is not provided necessary medical care • is not provided necessary remedial care • lives in an environment injurious to his/her welfare

26. Also included are allegations that a juvenile… • has been placed for care or adoption in violation of law • lives in a home where another juvenile has been subjected to abuse or neglect by an adult who regularly lives in the home • is in need of assistance or placement because he/she has no parent, guardian, or custodian responsible for the juvenile's care or supervision • whose parent, guardian, or custodian is unable to provide for the care or supervision and lacks an appropriate alternative child care arrangement • is involved in a situation where one DSS is conducting a reciprocal (conflict of interest) assessment on reports of neglect or dependency

27. Reports Appropriate for the Investigative Assessment Approach Those reports of: • abuse • abandonment • certain “special types” of reports that meet the statutory definition of: N.C.G.S.§7B-101

28. These include allegations a juvenile… • has been physically abused • has been sexually abused • has been emotionally abused • has been involved in moral turpitude • “special” types of reports

29. “Special” Types of Reportsincludes any report involving: • a child fatality when there are surviving children in the family • a child in custody of local DSS, family foster homes, residential facilities, and child care situations, and reciprocal investigative assessment on abuse reports • a child taken into protective custody by law enforcement officer or a physician, pursuant to N.C.G.S.§7B-308 and N.C.G.S. § 7B-500 • the medical neglect of disabled infants with life threatening condition, pursuant to Public Law 98-457 (Baby Doe) • a child hospitalized (admitted to hospital) due to suspected abuse / neglect • abandonment • suspicion or actual presence of a methamphetamine lab • child under one year of age shaken or subjected to corporal punishment.

30. What’s different in how DSS responds? First…what does not change is the county department’s mandate to comply with all laws and administrative codes during the provision of child protective serves.

31. Conducting an Assessment using the Family Assessment Response • Initiate within mandatory standard times frames (immediately, 24 hours or 72 hours from intake) • DSS decides with whom to initiate initial contact • Recommended first contact is with the parents • Most of the time first face-face contact will be with the parents and child • Interview children (with permission of parent) in private as necessary to ensure safety • In DV cases, never force adult victims or children to be interviewed or develop plans in presence of the perpetrator of violence • Take an MRS brochure and explain the process of the assessment

32. Conducting an Assessment using the Family Assessment Response (cont’d.) • Conduct the Safety Assessment using the DSS-5231 to document findings • Develop safety responses with the family if “Not Safe” or “Conditionally Safe” • Allegation is never used to warrant a safety response…only address identified safety issues • Introduce other structured decision making tools as appropriate to help engage and inform family of the Family Assessment process • Contact every collateral named by reporter • Parent chooses level of involvement with professional collaterals • Protect the safety of non-professional collaterals as needed

33. Conducting an Assessment using the Family Assessment Response (cont’d.) • Ask parents for collaterals and contact them prior to case decision / finding • Use the CME / CFE (CMHE) programs as outlined in policy • Involve families in completion of all structured decision making forms as appropriate • Complete the assessment within 45 days or document inability to do so and notify parents • Case decision / finding focuses on the level of need for services, not identification of a perpetrator • Case decision / finding is made by worker and supervisor, or staffing team • Document findings on DSS-5104

34. “Ceasing” the Family Assessment If the agency responds to a neglect or dependency report using a Family Assessment response and determines that there is clear evidence the allegations do not constitute neglect or dependency as defined in N.C.G.S. §7B-101, the agency can cease conducting that Family Assessment as long as the Safety Assessment (DSS-5231), Risk Assessment (DSS-5230) and Family Strengths and Needs Assessment (DSS-5229) reflect no issues of frequency or severity of maltreatment, no current safety issues and no future risk of harm.

35. “In Need of Services” Case Finding • safety issues and future risk of harm is so great that the agency must provide involuntary services (the safety and risk of harm is so great that you can not “walk away” from this family) • reported to the Central Registry with no perpetrator information entered

36. “Services Provided, No Longer Needed” Case Finding • safety of a child and future risk of harm are no longer issues because the agency had been successful in “frontloading” necessary services during the family assessment • continued involuntary CPS supervision is no longer needed to ensure the child’s safety • reported to the Central Registry with no perpetrator information entered • document any service referral deemed appropriate to meet the family's non-safety connected need • use services codes 122 or 330 to provide services under this finding, if this is available

37. “Services Recommended” Case Finding: • safety of a child is not an issue and future risk of harm is not an issue • not appropriate if agency feels it needs to monitor compliance due to safety and future risk of harm • DSS may have begun "plugging" services in during the assessment or will make the recommendation for services at the point of the finding for any service referral deemed appropriate to meet the family's non-safety connected need • use services codes 122 or 330 to provide services under this finding, if this is available • also used when the agency makes referrals to community partners • reported to the Central Registry with no perpetrator information entered

38. “Services Not Recommended” Case Finding: • appropriate for cases in which the safety of a child not an issue • there is no concern for the future risk of harm to the child • the family has no need for other non-safety related services • reported to the Central Registry with no perpetrator information entered

39. Family Assessment Cases Key Points: • In all things, at all times, ensure the safety of the child • Make the process as transparent as possible so the family can “see” what is happening to them and their children • Respect the family and partner with them to safely resolve issues of safety, permanence, and well being

40. Family Assessment Central Registry Issues: • No perpetrator name or relationship entered on DSS-5104 • No maltreatment code will be reported • “In Need of Services” will be reported in Field 21 as 05 • “Services Recommended” as 06 • “Services Not Recommended” as 07 • “Services Provided; No Longer Needed” as 08

41. Conducting an Assessment Using the Investigative Assessment Response • Conducted according to the current CPS investigation process (Sections 1408, 1416, and 1418 in the Division’s current CPS manual) • Develop a close working relationship with law enforcement • Memorandums of Agreement developed to ensure an effective working relationship. • Goals are to hold perpetrators accountable for harming children, reduce the number of interviews for children; and enhance the evidence gathering process for law enforcement

42. CPS In-Home Services • Involuntary CPS for cases “Substantiated” or found to be “In Need of Services” • Coded 215 on Day Sheets (DSS-2203) (as long as Risk Ratings = Intensive, High, and Moderate) • Family seen within 7 days of decision to begin service planning • In cases involving DV never force adult victims of violence or children to meet with, develop plans with, or be in the presence of the perpetrators of violence

43. CPS In-Home Family Service Agreements (DSS-5239) • Serves as the foundation for working with families • Completed within 30 days of case decision • Updated every 3 months, as often as circumstances warrant a change, or within 30 days of removal • Based upon Strengths / Needs and Risk Assessments as documented with structured decision making tools

44. In-Home Services Foundations for Practice: • Families are unique and distinctive. • Families have their own culture and set of norms and all function differently. • Social workers can better address risk, support and engage families in the process to promote planning and achieve positive change for children and families. • In using this methodology, the three of the four core outcomes of safety, permanence and well being will be addressed within families with whom we work (self-sufficiency can be achieved through coordination with Work First’s Mutual Responsibility Agreement)

45. CPS In-Home Services in NC: • CPS In-Home Services • Intensive/High Risk • Moderate Risk • Family Support (Low Risk) Voluntary Services provided by the DSS or an agency in the community

46. are “reasonable candidates for Foster Care in the absence of preventive services.” CPS In-Home Services provided to North Carolina children who…

47. Case Contacts in Intensive / High Risk Cases: • Weekly Face-to-Face Contacts with the Family • All “Substantiated” or “In Need of Services” children and their caregivers twice per month • Children who were “Unsubstantiated” or found not to need mandatory services at least once per month • “Off Weeks” with as many significant family members as necessary to ensure the safety of the children • “Significant family members” are those people in the home who can ensure the safety of the children • Two contacts with service providers per month (Mental Health, Educators, Daycare, Work First, Eligibility Services, etc.) • Contacts may be made at the CFT Meetings • SW-SW Supervisor staff frequently enough to ensure safety…best practice suggests weekly but this is not a requirement

48. Case Contacts in Moderate Risk Cases: • All “Substantiated” or “In Need of Services” children and parents twice per month • Two contacts with service providers per month (Mental Health, Educators, Daycare, Work First, Eligibility Services, etc.) • Contacts may be made at the CFT Meetings • SW-SW Supervisor staff enough to ensure safety…best practice suggests monthly but this is not a requirement

49. Child and Family Team Meetings (CFT) A CFT is a group of persons identified by and with the family who are committed to the child and family and are invested in helping them change. It utilizes a team decision making approach to: • improve the agency’s decision making process • encourage the involvement, support and “buy-in” of the family, extended family, and the community to the agency’s decisions • develop specific, individualized, and appropriate interventions for children and families. • specific documentation of CFT is critical

50. Child and Family Team Rule #1! In all cases, at all times, the CFT meeting is WITH the family, not ABOUT the family. ENGAGE…ENGAGE…ENGAGE!!! Seek the family’s input and ideas!!! They are the experts!!!