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SCORECARD FOR PREVENTIVE SERVICES

FINAL
FISCAL YEAR 2013 METHODOLOGY

Office of Research and Evaluation Division of Quality Assurance JULY 2012

FY13 Preventive Scorecard Methodology July 25, 2012

Table of Contents
I. Introduction ................................................................................................................................3 A. Changes to the FY13 Scorecard 4 II. Understanding the Preventive Scorecard....5 A. Scorecard Overview5 B. Scorecard Components ..................................................................................................6 C. Sample Size Calculation ................................................................................................7 D. Scoring...........................................................................................................................8 III. Preventive Scorecard Practice Areas ....................................................................................8 A. Safety ..............................................................................................................................8 1. Immediate/Impending Child Safety Concerns.....................................................8 2. Ongoing Casework Specific to Safety.......12 3. Case Events or Circumstances Specific to Safety .............................................12 4. Casework Contacts ............................................................................................13 B. Assessment....................................................................................................................17 1. Child(ren) Assessment.......................................................................................17 2. Parent/ Caretaker and Child Interaction Assessment.........................................19 3. Family Functioning............................................................................................20 4. Assessment of Home Conditions, Environment and Resources........................21 5. Ongoing Assessments........................................................................................22 6. Supervisory Assessment.23 7. Cultural Competence .........................................................................................24 C. Engagement...................................................................................................................25 1. Efforts to Engage the Family.............................................................................25 2. Strategies for Engagement...27 3. Family Team Conferencing ...............................................................................28 4. Cultural Competence .........................................................................................29 D. Services.........................................................................................................................30 1. Risk ....................................................................................................................30 2. Ongoing Casework Specific to Risk..................................................................33 3. Case Events or Circumstances Specific to Risk ............34 4. Family Involvement...........................................................................................35 5. Cultural Competence .........................................................................................35 E. Productivity ...................................................................................................................36 1. Time to Disposition ...........................................................................................36 2. Utilization ..........................................................................................................37 3. Length of Service...............................................................................................37 4. Family Team Conferencing .......37 Appendix A: APA Roles and Responsibilities ..................................................................38 Appendix B: Case Sampling Process ....................................40 Appendix C: PAMS Case Record Review Scoring ..........................................................41 Appendix D: Cultural Competence Examples...................................................................49 Appendix E: PAMS Preventive Alert Forms....................................................................50

FY12 Preventive Scorecard Methodology July 25, 2012

PREVENTIVE SCORECARD FISCAL YEAR 2013 I. Introduction


The Preventive Scorecard is a comprehensive, annual evaluation of all preventive programs serving New York Citys children and families designed to promote accountability, learning and quality improvement. Conducted by the Office of Research and Evaluation (ORE), the FY2013 Scorecard will evaluate General Preventive, Family Treatment and Rehabilitation, Intensive Preventive and Aftercare Services for Adolescents, Juvenile Justice Initiative Programs, and Family Assessment Programs Levels 2, 2a and 3. Preventive Scorecard is divided into five indicators. The first four indicators measure the following practice areas: Safety, Assessment, Engagement, and Services. The fifth indicator, Productivity, measures performance on specific high priority goals. The information gathered through Scorecard is used with provider agencies by the Agency Program Assistance (APA) teams to help agencies identify their strengths as well as areas in need of improvement in an effort to develop strategies to improve practice and outcomes for children and families. To assess improvement or to fill gaps of information regarding key aspects of an agencys performance, APA conducts additional targeted case record, site and data reviews to ensure that it has a holistic picture of agency performance across all programs. The initiation of these reviews is contemplated in consideration of the PAMS reviews to avoid duplication and usually is designed with direct input from the provider so that the review generates information that informs its quality improvement efforts. APAs systematic monitoring of agency performance throughout the year supports agency improvement on the annual Scorecard. For a more complete view of the monitoring and support role of APA, see Appendix A: APA Roles and Responsibilities. Scorecard is continually reviewed to ensure that it promotes quality practice and is responsive to changing priorities in New York Citys child welfare system. In developing and implementing Scorecard, ORE is committed to the following principles in its evaluation methods. Transparency: Evaluation methods are issued in advance of review periods, are explained in the simplest terms possible, and are comprehensible by the average person familiar with the field. The standards for success are clearly defined. Data is shared with providers in formats that allow replication of results and support ongoing self-monitoring. Validity: High standards of data integrity are maintained. Results provide an accurate picture of performance in the provider community. Agencies are evaluated using the same methodology to ensure consistency and fairness. Changes to the method are limited during the evaluation period and are applied system wide. Functionality: Methods produce results that identify actionable areas for improvement to support performance improvements and best practices. Measures and scores are designed to be utilized for multiple purposes and employ existing data sources whenever possible. Methods are based on contemporaneous practice and results are provided while still relevant.

Childrens Services is responsible for the dissemination of Scorecard findings to provider agencies in a format that is easily understood, accurately depicts information and analysis, and to share lessons learned system-wide. Providers have a responsibility to utilize the information, with support from their APA team, to identify areas of challenge and performance improvement strategies, and to take action to implement practice improvements. Collaboratively, Childrens Services and providers are responsible for achieving the primary goal of Scorecard: improving the preventive services system which serves New York Citys most vulnerable children and families.

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A. Changes to the FY13 Scorecard In an effort to inform and improve the Scorecard evaluation system in FY13, ORE examined the FY12 Scorecard along with system data and incorporated provider feedback received throughout the FY12 review. The following changes have been incorporated in FY13 of the Preventive Scorecard: Family Assessment Program (FAP) and Intensive Preventive Aftercare Program (IPAP) Case Samples: Starting in FY13, ORE will produce a separate sample and scores for FAP cases. However, FAP scores will be included as part of the overall General Preventive scorecard. FAP and GP results will be weighted according to the agency census for an overall score. Additionally, the FY13 Scorecard has been updated to include a shortened length of service requirement for sample inclusion for FAP and IPAP cases. Cases open for any 3 months of the 6 month PAMS review period are now eligible for inclusion in the sample. Please see page 8 for additional information. Supervisory Case Record Reviews: Given the important role that supervision plays in addressing safety and risk and improving outcomes for children and families, questions have been added to the Safety, Assessment, and Services practice areas for FY13. These questions will measure the supervisors ability to identify, address, and provide guidance around all safety and/or risk concerns present during the 6 month PAMS review period. o These questions have been incorporated into the existing Immediate/Impending Child Safety Concerns indicator in Safety and the Risk indicator in Services. A new indicator for Supervisory Assessment was added to the Assessment Practice Area and is weighted at 10%. Ongoing Engagement-Strategies for Engagement Sub-Indicator: The Ongoing Engagement indicator has been replaced with the Strategies for Engagement. Ongoing engagement will no longer be scored as a separate component of the engagement process. The Strategies for Engagement indicator measures frequent and substantive contacts, the case planners response to the familys concrete needs, the inclusion of both parents in the service planning when there is a two parent household, and the discussion with the family about case closure. o Strategies for Engagement will be weighted as 20% of the overall Engagement practice area. o There are five new questions that will be scored in this sub-indicator and one non-scored question. Please see page 32 for more information. Casework Contacts: The FY13 Scorecard has been updated to include the requirement that all children must be seen monthly for General Preventive cases and Family Treatment and Rehabilitation cases in the Baseline and Stabilization phases. FTR cases in the Initial phase will be evaluated according to the weekly standard that all children in the home must be seen. These requirements will make Scorecard consistent with the casework contact standard. Additionally, cases that exceed the casework contact standard will no longer receive extra credit. Please see page 18 for additional information. Changes in Weighting: In FY13, the weighting of Family Functioning Assessment and Assessment of Home Conditions, Environment, and Resources have each decreased from 20% to 10% while Ongoing Assessment has increased from 10% to 20% of the overall Assessment practice area. Additionally, in the Engagement practice area, Family Team Conferencing has decreased from 25% to 20% while Strategies for Engagement will be weighted at 20%. Family Team Conferencing: In the Engagement practice area, question #89 Did provider agency staff discuss what needs to happen in order to close the case? has been removed. This question has been replaced by question E11 in Strategies for Engagement. In Productivity, the data measure for Family Team Conferences will be scored in FY13. This measure will be weighted at 25% of the overall Productivity measure. Please see page 42 for additional information on this measure. Time to Disposition: Consistent with ACS policy effective May 1, 2012 the Time to Disposition measure in Productivity will examine the number of dispositions reached in 10 business days or less in FY13.
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II.

Understanding the Preventive Scorecard

A. Scorecard Overview
The Preventive Scorecard is divided into five indicators. The first four indicators measure the following practice areas: Safety, Assessment, Engagement, and Services. The fifth indicator, Productivity, measures performance on specific high priority goals. Indicator Weight Measure 30% Immediate/Impending Child Safety Concerns 10% Ongoing Casework Specific to Safety Safety 20% Case Events/Circumstances Specific to Safety Casework Contacts 40% 20% Child(ren) Assessment Parent (Caretaker)-child Interaction Assessment 20% 10% Family Functioning Assessment Assessment 10% Assessment of Home Conditions/Environment and Resources 20% Ongoing Assessments 10% Supervisory Assessment 10% Cultural Competence 50% Efforts to Engage the Family 20% Strategies for Engagement Engagement* 20% Family Team Conferencing 10% Cultural Competence 40% Risk 20% Ongoing Casework Specific to Risk Services 20% Case Events/Circumstances Specific to Risk 10% Family Involvement 10% Cultural Competence Time to Disposition 25% (33% for MF) Utilization 25% (33% for MF) Productivity* Length of Service 25% (0% for MF) 25% (33% for MF) Family Team Conferencing *Length of Service is not measured for Medically Fragile (MF) programs, Productivity is not measured for JJI programs, and Family Team Conferencing is not measured for FAP and IPAP programs. If a measure is not applicable the above weighting is redistributed as follows: Weight Measure Safety Indicator 40% Immediate/Impending Child Safety Concerns Safety Ongoing Casework Specific to Safety NA (Ongoing Casework Specific To Safety Is 20% Case Events/Circumstances Specific to Safety Not Applicable) 40% Casework Contacts 40% Immediate/Impending Child Safety Concerns Safety 10% Ongoing Casework Specific to Safety (Case Events/Circumstances Specific To NA Case Events/Circumstances Specific to Safety Safety Is Not Applicable) 50% Casework Contacts 50% Immediate/Impending Child Safety Concerns Safety NA Ongoing Casework Specific to Safety (Ongoing Casework & Case Events/Circumstances Specific To Safety NA Case Events/Circumstances Specific to Safety Is Not Applicable) 50% Casework Contacts

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Engagement Indicator Engagement (FTC Measure Is Not Applicable)

Weight 70% 20% NA 10% Weight 50% 20% NA 20% 10%

Measure Efforts to Engage the Family Strategies for Engagement Family Team Conferencing Cultural Competence Measure Risk Ongoing Casework Specific to Risk Case Events/Circumstances Specific to Risk Family Involvement Cultural Competence

Services Indicator Services (Case Events/Circumstances Specific To Risk Is Not Applicable)

In FY13, Family Treatment and Rehabilitation Programs and General Preventive Programs will be scored separately. Medically Fragile, Intensive Preventive, JJI and Family Assessment programs will be included in the General Preventive Programs Scorecard. Performance Tiers Each indicator of the Scorecard is assigned to a performance tier which represents a range of performance. The below performance tiers are for all program types. Performance Tiers Indicators Safety Assessment, Engagement, and Services Productivity A 95% + 92% + 80% + B 85 to 94% 85 to 91% 68 to 79% C 75 to 84% 75 to 84% 45 to 67% D 65 to 74% 65 to 74% 33 to 44% F < 65% < 65% < 33%

B. Scorecard Components:
The Preventive Scorecard components used to evaluate the practice and outcomes of the five indicators listed above. These components are the Provider Agency Measurement System (PAMS) case review and the Productivity data measures. 1. The Provider Agency Measurement System (PAMS) component is the case record review which is a comprehensive case specific view of practice. The PAMS case record review examines practice through the lens of child safety and risk, and values quality work to strengthen families ability to care well for their children. The contemporaneous nature of the review allows the examination of safety and risk issues that may be presently impacting the family and the actions taken by the case planner to control the safety and minimize the risk to children and families. In FY2012, the PAMS review included extensive reviews of over 1,800 case records. The PAMS review examines the information that the case planner used to make his or her assessment of the family in order to determine whether the case planner utilized enough quality information to make an adequate assessment of the familys circumstances. The review also examines the degree to which the assessment information was used to drive service planning, service provision and decision making. There should be a clear link between the safety and risk issues that the family is faced with, the services provided, and the decisions made regarding the family. Finally, the case record review looks at individual case outcomes to determine whether the services had an impact on the safety of the children, family members behaviors, and the overall strength of the family. 2. Productivity examines data measures that evaluate provider agencies on specific high priority goals including Time to Disposition, Utilization, Length of Service, and Family Team Conference. This measure highlights the importance of agencies efforts to effectively engage families in services while working to
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meet the familys goals in the most efficient timeframe possible. The Family Team Conference is a key component in this process. In FY13, the Family Team Conferences (FTC) productivity measure will evaluate agency performance comparing the number of FTCs held with the number required. ORE will utilize data from the existing FTC PROMIS report. Lastly, the productivity measure allows us to capture how effectively agencies are utilizing their slots. The data source for all Productivity measures is PROMIS.

C. Sample Size Calculation


ORE randomly selects cases that were active during the six month review period, as well as closed cases that were open for at least five months of the review period. Additionally, FY13 Scorecard has been updated to include a shortened length of service requirement to any three of the six month review period for sample inclusion for FAP and IPAP cases. For more information on how the random sample is pulled see Appendix B. The random selection is stratified first by program type. GP programs include all programs that are not FTRs (i.e. Special Medical, IPAP, JJI, FAP). General Preventive programs only are stratified by Advocate Preventive Only cases (ADVPO) and Child Welfare Services (CWS) cases. Please note, housing subsidy only cases are not be included in the sample. The sample size is calculated from each agencys current census of ADVPO and CWS cases that were active or closed during the six month review period, excluding PINS DAS cases. Sample sizes do not exceed 50 cases. The following is a step-by-step guide on selection of the case samples. Step 1: Pull All Cases Pull all active and closed cases for each program within the agency from PROMIS. Step 2: Criteria for Cases Include only cases that have been active for at least five months of the review period (e.g. if the review period is July through December 2011, only cases that have been active from at least July through the end of November will be reviewed). For FAP and IPAP programs, cases that have been active for any 3 months of the PAMS review period will be included. Step 3: Stratifying the Sample Size For agencies with both GP and FTR program types, the proportion of active and closed cases for the GP and FTR program types is calculated. This proportion is then used to determine the number of cases to be reviewed for the GP and FTR program. For agencies with only one program type, the review will be based on that program type alone. For example: Agency A GP Cases FTR Cases Total Cases

# of Eligible Cases 300 100 400

% of Total 75% 25% 100%

# Cases Sampled 37 13 50

Step 4: Pulling the Random Sample The random sample is then pulled from all the active and closed cases pulled in Step 1. Because samples are randomly selected, not all program sites may be represented in the sample for agencies which have more than one GP or FTR program site. The agencys GP and FTR cases will always be represented in the sample. For example, if an agency has three GP program sites, Program A (10% of the agency), Program B (2% of the agency) and Program C (88% of the agency) the random sample may not select any cases from Program B. Additionally, some program sites may only have one case selected for the random sample while other sites have 20 or 30 cases. Agencies receive the list of cases included in the review sample three days prior to the start of the review.

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D. Scoring
Scores are calculated for each individual case reviewed for the following practice areas and the indicators within the practice areas: Safety, Assessment, Engagement, and Services. Each measure is based on one or more case record review questions that are each worth a maximum of 1 point (Yes = 1 point, Some But Not All = .5 Points, and No = 0 points). The score is the number of points received divided by the maximum number of points possible. If there are questions or whole measures that do not apply in a particular case, the case score will be based only on the remaining measures that do apply. Please see Appendix C for detailed information on how individual questions and casework contacts are scored at the case and practice area levels. The appendix also includes information on how diligent efforts and pro-ration of the All Children Seen requirement for contacts is credited.

III.

Preventive Scorecard Practice Areas

A. Safety
The Safety practice area examines the work done by agencies to assess if there are safety factors present and the decisions made to either determine that there are no immediate or impending child safety concerns or the decisions made to address immediate or impending child safety concerns. If there are safety factors identified that place a child in immediate danger of serious harm, the work done to address safety factors is evaluated including the timeliness, appropriateness and specific interventions taken as well as the ongoing assessments of safety, safety decisions, and the safety plans to prevent the recurrence of the safety factors. The quality and completion of casework contacts are also measured. This indicator also examines the case events or circumstances specific to safety that requires action. Any one of the case events or circumstances, without action, can lead to immediate or impending child safety concerns. Safety is scored through the following measures: Any questions that do not apply to an individual case due to the case circumstances will not be scored. All the remaining Safety measures that apply will be scored to account for the work that was done by the case planner (e.g. casework contacts, case events and circumstances, and the assessment, engagement, and services indicators) for those cases. 1. Immediate or Impending Child Safety Concerns The Immediate or Impending Child Safety Concerns measure examines the consistency of the safety Assessment and safety decisions in the FASP with case circumstances, the timeliness of the controlling interventions provided, the adequacy of the safety plan, and the practice provided by the case planner1 after the safety factor was controlled (e.g., immediate and intensive casework counseling). Additionally, the Safety practice area examines the frequency of supervisory case reviews and the assessment of the safety of all children during the review. The Immediate or Impending Child Safety Concerns measure is based on the New York State Office of Child and Family Services (OCFS) Revised Safety Factors2 specific to the Family Assessment and Service Plan (FASP): Based on the present assessment and review of prior history of abuse or maltreatment, the parent/caretaker(s) is unable or unwilling to protect the child(ren) Parent/caretaker(s) currently uses alcohol to the extent that it negatively impacts his/her ability to supervise, protect and/or care for the child(ren) Parent/caretaker(s) currently uses illicit drugs or misuses prescription medication to the extent that it negatively impacts his/her ability to supervise, protect and/or care for the child(ren)
Throughout this document the title case planner is used to represent a variety of agency staff including case aide, case worker, etc. ORE will accept progress notes documented by the case planner, supervisor, case aide, and other agency staff. However, information for questions specifically related to supervision will only be taken from the supervisory review notes. 2 CONNECTIONS Q3-08 (Build 18.10) Appendix B (9/24/2008). DPPM/ORE Page 8 of 59
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Child(ren) has experienced or is likely to experience physical or psychological harm as a result of domestic violence in the household; Parent/caretaker(s)s apparent or diagnosed medical or mental health status or developmental disability negatively impacts his/her ability to supervise, protect, and/or care for the child(ren) Parent/caretaker(s) has a recent history of violence and/or is currently violent and out of control Parent/caretaker(s) is unable and/or unwilling to meet the child(ren)s needs for food, clothing, shelter, medical or mental health care and/or control childs behavior Parent/caretaker(s) is unable and/or unwilling to provide adequate supervision of the child(ren) Child(ren) has experienced serious and/or repeated physical harm or injury and/or the parent/caretaker(s) has made a plausible threat of serious harm or injury to the child(ren) Parent/caretaker(s) views, describes or acts toward the child(ren) in predominantly negative terms and/or has extremely unrealistic expectations of the child(ren) Child(ren)s current whereabouts cannot be ascertained and/or there is reason to believe the family is about to flee or refuses access to the child(ren) Child(ren) has been or is suspected of being sexually abused or exploited and the parent/caretaker(s) is unable or unwilling to provide adequate protection of the child(ren) The physical condition of the home is hazardous to the safety of the child(ren) Child(ren) expresses or exhibits fear of being in the home due to current behaviors of parent/caretaker(s) or other persons living in, or frequenting the household Child(ren) has a positive toxicology for drugs and/or alcohol Child(ren) has significant vulnerability, is developmentally delayed, or medically fragile (e.g., on Apnea Monitor) and the parent/caretaker(s) is unable and/or unwilling to provide adequate care and/or protection of the child(ren) Weapon noted in CPS report or found in the home and Parent/Caretaker(s) is unable and/or unwilling to protect the child(ren) from potential harm Criminal activity in the home negatively impacts parent/caretaker(s) ability to supervise, protect and/or care for the child(ren)

If there are no safety factors that place a child(ren) in immediate danger of serious harm identified, this measure is based solely on question S5, question S5a, question S6, question S21and question S22. The following questions from the Case Record Review (CRR) instrument utilized in the PAMS review determine the score for the Immediate or Impending Child Safety Concerns measure: Question S5: Is there a FASP available during the PAMS review period? Yes indicates there was a FASP available during the PAMS review period. No indicates there was not a FASP available during the PAMS review period. Question S5a: Is the safety assessment in the most recent FASP consistent with the case circumstances? Is the Safety Assessment that is included in the most recent FASP of the review period is consistent with the corresponding progress notes in the case record that are associated with that FASP to determine if the safety assessment in the FASP is consistent with case circumstances. Yes indicates the safety assessment in the most recent FASP is consistent with case circumstances. No indicates the safety assessment in the most recent FASP is not consistent with case circumstances. Question S6: Was the safety decision recorded in the most recent FASP consistent with the case circumstances? This question examines if the safety decision in the most recent FASP of the review period is consistent with the corresponding progress notes that are associated with that FASP as well as the identified safety factors (if any) and the factors that were selected as placing the child in immediate or impending danger (if any) to determine if the safety decision in the FASP is consistent with case circumstances. Yes indicates the safety decision in the most recent FASP is consistent with case circumstances. No indicates the safety decision in the most recent FASP is not consistent with case circumstances.

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Question S8: Was the safety factor(s) explored sufficiently at the time to provide enough information to complete a thorough safety assessment? Is there was information in the case record, progress notes, and/or FASP to sufficiently inform the case planners completion of the safety assessment in the most recent FASP. For ADVPO cases, all case planners should be continually vigilant for the presence or emergence of caretaker behavior and/or home conditions that may place children in immediate danger of serious harm. Yes indicates there was sufficient information in the case record, progress notes, and/or FASP to sufficiently inform the case planners completion of the Safety Assessment in the most recent FASP. No indicates there was not sufficient information in the case record, progress notes, and/or FASP to sufficiently inform the case planners completion of the Safety Assessment in the most recent FASP. Question S11: Were the controlling interventions provided by the case planner implemented without delay upon identification of the safety factor(s)? Were the interventions provided to control the safety factor provided immediately? Safety is always considered in the timeframe of immediate threat of serious harm to a child. The expectation is that when danger has been identified by or is made known to the case planner, s/he will respond immediately. This means that the case planner has determined that one or more safety factors place the child in immediate danger of serious harm due to one or more of the following: the seriousness of the behavior or circumstance in the safety factor identified in the family; the number of safety factors identified; the age of the child; and/or the childs vulnerability. Yes indicates the case planner responded immediately when the safety factor(s) were made known to him or her. No indicates that the case planner did not respond immediately to the safety factor(s). The Controlling Interventions are based on the New York State Office of Child and Family Services (OCFS)s list in the Controlling Interventions and Safety Plan tab of the FASP. Intensive Home Based Family Preservation Services (FPP) Family has been provided Emergency Shelter in order to avoid homelessness Family has been safely moved to a Domestic Violence Shelter Non-offending Caretaker has been moved to a safe environment with the child(ren) Authorization of Emergency Food/ Cash/Goods/Rental Arrears Assistance Judicial Intervention was put in place in order to safeguard the child(ren)s safety Order of Protection Law Enforcement involvement Emergency Medical Services Crisis Mental Health Services have been provided Emergency In-patient Mental Health Services have been provided Immediate Supervision/Monitoring Emergency Alcohol Abuse Services have been provided Emergency Drug Abuse Services have been provided Correction or Removal of Hazardous/Unsafe Living Conditions Placement-Foster Care Placement-Alternate Caretaker Supervised Visitation Use of Family, Neighbors, or Other Individuals in the Community as Safety Resources Alleged perpetrator has left the household voluntarily and current caretaker will appropriately protect the victim(s) with CPS monitoring Alleged perpetrator has left the household in response to legal action Follow-up to verify child(ren)s whereabouts/gain access to the child(ren) Other, (please describe)

Question S12: Was there a safety plan to address the safety factor(s)? Did the case planner develop a safety plan to address safety factors identified in the case record by examining if the case planner formally documented in the FASP or informally documented in the progress notes a set of
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actions, including controlling interventions, taken without delay to protect the child(ren) from the immediate or impending danger of serious harm present during the PAMS review period. The plan should specify any parent/caretaker actions that contribute to protecting the child from the identified danger and the type of controlling intervention(s) needed, why the controlling intervention(s) are needed, who will carry-out the controlling intervention(s), and the timeline of the intervention either in the FASP and/or in the case record. Yes indicates the case planner documented a plan specific to the danger and safety factor(s) present during the PAMS review period. Refer to the criteria above. No indicates the case planner did not document a safety plan specific to the danger and safety factor(s) present during the PAMS review period in the FASP or the case record. Question S12a: If there was a safety plan, is the safety plan consistent with the case circumstances specific to the safety factor? Did the case planner made an accurate assessment of the familys situation to inform the development of the safety plan to control the safety factor? Do the case circumstances from the progress notes and information in the FASP match the safety plan? This question looks to see if: The assessments of the parent/caretakers personal, behavioral, cognitive and emotional characteristics and any aggravating factors that pose threat of serious harm to the child match the parent/caretaker actions component of the safety plan and match the controlling interventions, timeframe, and proposed management of the safety plan and/or The presence or threat of serious harm related to the parent/caretakers capacity to care for the child or the childs behaviors match the controlling interventions, timeframe, and proposed management of the safety plan and/or Conditions (e.g. home environment or other applicable factors) that are present in the case during the review period that exposes the child to immediate danger of serious harm match the controlling interventions, timeframe, and proposed management of the safety plan. Yes indicates the case planner created a safety plan to address the danger and safety factor(s) consistent with case circumstances. No indicates the case planner did not create a safety plan to address the danger and safety factor(s) consistent with case circumstances. Question S14: Did the case planner provide immediate intensive case work counseling specific to the safety factor(s) that placed the child(ren) in immediate or impending danger of serious harm? Did the case planner provide immediate intensive case work counseling specific to the safety factors that place the child(ren) in immediate or impending danger of serious harm? This question considers the targeted conversations between the case planner and the parent/caretaker and/or children regarding the safety factor(s). Yes indicates that immediate and intensive casework counseling was provided by the case planner and addressed the safety factor(s). No indicates that no immediate and intensive casework counseling specific to the safety concern(s) was provided. Question S15: Did the case planner assess the parent(s)/caretaker(s) understanding of how his/her behavior placed the child(ren) in immediate/impending danger of serious harm? Did the case planner assess the parent(s)/caretaker(s) understanding of how his/her behavior placed the child(ren) in immediate/impending danger of serious harm through observations and conversations with the caretaker(s). Yes indicates there is documentation of the case planners assessment of the parent/caretakers understanding of how his/her behavior placed his/her/their child(ren) in immediate/impending danger of serious harm. No indicates there is no documentation which shows that the case planner assessed the parent/caretakers understanding of how his/her behavior placed his/her child(ren) in immediate/ impending danger of serious harm. New Supervision Question S21: Does the case record contain at minimum a monthly supervisory case review for each of the months during the PAMS review period? Yes indicates that the case record contains a monthly supervisory case review for each of the months during the PAMS review period.
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Some But Not All indicates that the case record contains a monthly supervisory case review for some of the months during the PAMS review period but not all. No indicates that the case record does not contain a monthly supervisory case review for any of the months during the PAMS review period New Supervision Question S22: Does the supervisory review during the PAMS review period include an assessment of the safety of each child in the household? Yes indicates that at least one supervisory review during the PAMS review period includes an assessment of the safety of each child in the household. Some But Not All indicates that at least one supervisory review during the PAMS review period includes an assessment of the safety of some of the children in the household but not all. No indicates that the supervisory reviews do not contain an assessment of the safety of any of the children in the household. 2. Ongoing Casework Specific to Safety The Ongoing Casework Specific to Safety measure examines the case planners ongoing assessments and plans following the initial identification of an immediate/impending child safety concern and the application of a controlling intervention to address the safety factor. This measure examines if the case planner is reassessing the safety factor and the plan that is in place to determine that a) the child(ren) are safe and b) either the plan is no longer needed, needs to be updated/adjusted to match the case circumstances or should continue as is. The measure also evaluates if a plan has been developed to prevent the recurrence of the safety factors. Ongoing casework specific to safety is defined as meaning that the case planner reassessed the safety factors at least one additional time following the controlling intervention. The following questions are used to determine the Ongoing Casework Specific to Safety measure: Question S18: Did the case planner continue to reassess the safety factor(s) following the controlling intervention(s)? Did the case planner continue to reassess (informally or formally) the safety factor that posed a threat to the childrens safety following the implementation of the controlling intervention? Yes indicates the case planner reassessed the safety factor(s). Some But Not All indicates the CP reassessed only some of the safety factor(s). No indicates the case planner did not reassess any of the safety factors. Question S19: Did the case planner develop a plan and/or was the case planner involved in the development of a plan to prevent the re-occurrence of the safety factor(s)? This question examines if a plan was made with the family by the case planner or in collaboration with other sources to help prevent the re-occurrence of the safety factor(s) regardless of who implemented the controlling intervention. Yes indicates a plan was made by either the case planner or in collaboration with other sources to prevent the reoccurrence of the safety factor(s). Some But Not All indicates the plan only helped to address some of the safety factor(s). No indicates no plan was made to help prevent the reoccurrence of the safety factor(s). 3. Case Events or Circumstances Specific to Safety The Case Events or Circumstances Specific to Safety measure is based on significant events and/or circumstances identified that if not addressed can lead to safety factors that place children in immediate danger of serious harm. These events/circumstances lead to the issuing of a safety alert when case planners did not conduct thorough assessments to determine the need for the appropriate action to mitigate the circumstances. This section examines the degree to which case planners are paying attention to these events/circumstances when they are present in families. The following are a list of Case Events or Circumstances Specific to Safety: There is a newborn in the home and the family does not have a crib Parent/caretaker has been incarcerated and no alternate form of care has been identified for the child(ren) Death of parent/caretaker and no alternate form of care has been identified for child(ren) Parent/caretakers whereabouts unknown-abandonment
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Known adult perpetrator of abuse or neglect to the child(ren), is residing in the child(ren)s home Child(ren) has recently experienced severe mental health crisis (harm to self/others, suicidal ideation, etc.) Child(ren) has experienced physical harm as a result of violence in the school or neighborhood Safety of family is unknown because case planner has not conducted regular and ongoing face-to-face contact with any family member for an extended amount of time Safety of child(ren) is unknown because case planner has not conducted regular and ongoing face-to-face contact with the child(ren) for an extended amount of time

The following questions are used to determine the score for the Case Events or Circumstances Specific to Safety measure: Question S2: Was the event explored sufficiently at the time to provide enough information to complete a thorough assessment? Is there information in the case record, progress notes, and/or FASP that demonstrates that the case planner explored the case events or circumstances sufficiently to allow them to determine if the case planner needed to implement an appropriate action in response to the event or circumstance and/or to protect the child, family, or neighborhood from the childs behavior. Yes indicates there was sufficient information in the case record, progress notes, and/or FASP that demonstrates that the case planner explored the case events or circumstances sufficiently to allow him/her to determine if the case planner needed to implement an appropriate action in response to the event(s) or circumstance(s). No indicates there was NOT sufficient information in the case record, progress notes, and/or FASP that demonstrates that the case planner did not explore the case events or circumstances sufficiently to allow him/her to determine if the case planner needed to implement an appropriate action in response to the event(s) or circumstance(s). Question S3: Was an action provided by the case planner in response to the event(s) or circumstance(s)? Yes indicates action was provided by the case planner in response to the event(s) or circumstance(s) during the PAMS review period. No indicates no action was provided by the case planner in response to the event(s) or circumstance(s) during the PAMS review period. Question S4: Did the action taken by the case planner address the concerns raised by the event(s) or circumstance(s)? This question examines if the case planner provided documentation in the case record indicating that the action fully addressed the case event(s) or circumstance(s) for the child(ren) and/or family. If the event or circumstance is related to the childs behaviors, the case planner should provide documentation indicating that the action protected the child, family or neighborhood from the childs behavior. Yes indicates the action taken by the case planner fully addressed the event(s) or circumstance(s) No indicates the action taken by the case planner did not fully address the event(s) or circumstance(s). 4. Casework Contacts The Casework Contacts measure in Preventive Scorecard evaluates contacts consistent with the expectations set forth in the Casework Contact Standard for both General Preventive and Family Treatment and Rehabilitation programs. It examines the number of contacts made, the diligent efforts to complete a contact, the number of children seen, and the number of home visits made according to case need as described in the standards. Diligent effort is recognized when two or more attempts are made at the home at varying times of the day, while making adjustments to meet the familys schedule/needs. To be counted as a casework contact, the progress notes must substantiate that there was discussion toward service planning and goals, identified needs and concerns, and an assessment of the home and family. In order to receive full credit for the Casework Contacts measure agencies must meet the standard for every case in the sample during the six month PAMS review period as determined by case need and every child must be seen every month for all GP cases and FTR cases in Baseline and Stabilization Phases and every week for FTR cases in the Initial Phase. Cases where some but not all of the children are seen will receive partial credit. Exceptions will be made for specific case circumstances that are clearly documented in the progress notes (e.g.
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child on vacation, at camp or hospitalized during the month) and the agency will be held harmless. Cases that exceed the standard number of contacts will not receive additional credit. a. General Preventive Standard: The frequency of casework contacts are based on the family members assessed needs. At minimum, the program provides at least 12 casework contacts within each six month period of preventive services with children and/or their families. A group contact includes members of more than one of the families being served by the program, such as a parenting training or an adolescent socialization group. Family members are seen individually or together as frequently as necessary to meet the goals of the service plan. Casework Contact Requirements for General Preventive with NO History of CPS Indication Number of Required Casework Contacts per 6 Month FASP Cycle by Agency Staff
Total Min. # of Contacts* 2 Contacts/ Month (Total of 12) Min. # by Case Planner 6 Contacts Including 2 home visits (1 home visit every 3 months) Max. # by Specialized Rehab Provider (MSW/CASAC) 6 Contacts Max. # by Supportive Service Provider (Parent/Case Aide) 2 of the 6 From the Previous Column

All 6 may be group contacts Both may be group contacts Note: All children in the household must be seen by the A minimum of 4 contacts must be individual (with child and/or case planner at least once per family) month *In all situations in which the specialized or supportive provider does not make the maximum number of casework contacts permissible, the case planner is ultimately responsible for all required casework contacts.

Casework Contact Requirements for General Preventive Cases WITH History of CPS Indication Number of Required Casework Contacts per 6 Month FASP Cycle by Agency Staff
Total Min. # of Contacts* 2 Contacts/ Month (Total of 12) Min. # by Case Planner 6 Contacts Max. # by Specialized Rehab Provider (MSW/CASAC) 6 Contacts Max. # by Supportive Service Provider (Parent/Case Aide) 2 of the 6 from Previous Column

All 6 may be group contacts Including 6 home visits (1 home Both may be group contacts visit every month) Note: All children in the household must be seen by the case planner at least once per month *In all situations in which the specialized or supportive provider does not make the maximum number of casework contacts permissible, the case planner is ultimately responsible for all required casework contacts.

Number of Casework Contacts for First 6 Months After a Newborn Enters the Family
Total Min. # of Contacts* 2 Contacts/ Month (Total of 12) Min. # by Case Planner 1 home visit every month Max. # by Specialized Rehab Max. # by Supportive Service Provider (MSW/CASAC) Provider (Parent/Case Aide) 1 home visit per month may be conducted by a Specialized Rehab or Support Service Provider

Note: All children in the household must be seen by the case planner at least once per month *In all situations in which the specialized or supportive provider does not make the maximum number of casework contacts permissible, the case planner is ultimately responsible for all required casework contacts.

b. Family Treatment Rehabilitation (FTR) Program Standard In FY13, Scorecard will utilize the current casework contact expectations set forth in the May 21, 2012 ACS Revised Policy for Family Treatment and Rehabilitation Providers on Casework Contact Requirements. The
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policy recognizes that families may enter with a range of needs, and that, over the life of a case, variation in the level of service intensity may be required. The policy sets minimum standards, in keeping with the intensive level of service expected of these programs, while allowing providers to adjust the level of services based on an assessment of risk and need made during their work with each family. Providers are expected to document clearly and promptly in progress notes the assessment that leads to a decision to decrease or increase the frequency of casework contacts and home visits in a particular case. At all times throughout the case, the current frequency of contacts deemed to be necessary by the provider should be clearly noted in the progress notes by the supervisor. The provider is expected to monitor child safety and risk throughout the life of the case, and to increase the intensity of contact with the family whenever it is warranted by the current circumstances of the family. The FTR provider is expected to see each child in the household once per week in the initial phase of service, and at least once a month in the baseline and stabilization phases of service. In all situations in which the specialized rehabilitative or supportive service provider does not make the maximum number of casework contacts permissible, the case planner is ultimately responsible for all required casework contacts. If the case planner is unavailable to make the minimum number of contacts, the supervisor is responsible for arranging appropriate coverage. When a child has not been seen within these timeframes, the provider must use alternative mechanisms to assess the childs safety, such as collateral contacts with a school or child care provider. Diligent efforts to meet this expectation should be clearly documented throughout the life of the case. The FTR score is based on the initial, baseline, and stabilization phases identified in the standard. Phase(s) of treatment must be clearly identified in the supervisory notes. Casework contacts will be scored for each week for the initial, baseline, and relapse phases and each month for the stabilization phase during the six month review period for the number of children seen and the number of contacts and home visits made according to the case need as determined by the agency consistent with the standard. Please note the following definitions of treatment phases utilized by PAMS reviewers when assessing an agencys performance on FTR casework contacts: Initial Phase: The initial four weeks of service and/or until a baseline negative urine screening and/or consistent participation in substance abuse treatment and/or mental health services is achieved. If a client experiences a relapse and/or the deterioration of mental health symptoms and/or a lack of participation in necessary services, the treatment should return to the Initial Phase for casework contacts. Baseline Phase: When the family has been receiving services for at least four weeks and the provider assesses that a baseline of sobriety has been achieved and/or there is stability of current mental health symptoms and active participation in mental health treatment. The substance abusing client can be said to have achieved a baseline when s/he: Meaningfully engages in substance abuse treatment Begins to take responsibility for his/her actions Improves patterns of interactions with others, especially children Establishes a pattern over time of negative urine tests. The client with mental health challenges can be said to have attained some level of stability when s/he: Assessed as not a danger to self or others Keeps mental health appointments Observed to have attained a reduction in mental health symptoms Oriented in the three spheres Appears to be accepting of medication as prescribed Improves patterns of interactions with others, especially children Determined to psychiatrically stable by a licensed mental health clinician
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Stabilization Phase: Risks to children have been significantly reduced, significant goal achievements have been attained and the provider assesses that a reduction in intensity of services is appropriate. Services in the Stabilization Phase should not continue for more than six months. The parent/caretaker Understands the impact that substance use and/or a mental health disorder has on his/her parenting and other familial relationships Shows improvement in his/ her ability to care for child(ren) in a safe and age appropriate manner Recognizes triggers that may lead to periods of increased risk to child(ren) and/or Identifies and successfully links to an adult resource(s) in the community for respite care for the child(ren) in case of decompensation or periods of high frustration with caring for the child(ren) Teen/youth(s) Shows improvement in school attendance and ability to engage in school work Involved with healthier peer relationships Responds to parenting Identifies and successfully links to an adult resource(s) in the community for support during periods of decompensation or other concerns in the household as well as ongoing mentoring In instances where the familys circumstances change, and the provider decides not to terminate services as planned, it is expected that the provider will return to the level of contacts required during the baseline phase of service delivery.

Treatment Phase

Total Min. # of Casework Contacts 2 Contacts/ Week

Total Min. # of Home Visits 1 Home Visit/ Week 2 Home Visits/ Week At least 2 Home Visits in a four week period 2 Home Visits/ Month (Both Contacts Must be Home Visits)

Min. # of Casework Contacts by Case Planner

Max. # of Casework Contacts by Specialized Rehab Provider/ Supportive Service Provider (e.g. CASAC, Parent, or Case Aide)

Initial Phase (2 to 3 Contacts/Week as determined by family assessment) Baseline Phase

3 Contacts/ Week

1 Contact/ Week 1 Contact/ Week (must be a home visit) 1 Casework Contact (home, office, or other location) per week by either the case planner, CASAC, Licensed Mental Health Clinician, Nurse, or Supportive Service provider (e.g. Parent Aid, Case Aid) At least 2 Home Visits in a four week period Up to 2 Contacts in a 4 week period

1 Contact/ Week 2 Contacts/ Month (Both Contacts Must be Home Visits)

Stabilization Phase

1 Home Visit/ Month

1 Home Visit/ Month

c. Family Treatment Rehabilitation (FTR) Phase Identification Phase identification is a key component of casework contacts for FTR programs. The casework contacts policy for FTR programs recognizes that families may enter with a range of needs and that over the life of a case and therefore variation in the level of service intensity may be required. When assessing an agencys performance on FTR contacts, PAMS reviewers look for identification of the Initial, Baseline, and Stabilization Phases, as documented by the supervisor. Providers are expected to adjust the level of intensity at certain points in their work with each family based on an assessment of risk and need. It is imperative that the assessment occurs and that the decision to increase or decrease contacts is consistent with case circumstances.

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The following questions are used to inform the score for the Casework Contacts measure for FTR programs: New Question: Was there an assessment by the supervisor that led to a decision to decrease, increase or maintain the frequency of casework contacts and home visits? Yes indicates there was an assessment of the case circumstances that led to a decision to decrease, increase or maintain the frequency of casework contacts and home visits. No indicates there was no assessment of the case circumstances that led to a decision to decrease, increase or maintain the frequency of casework contacts and home visits. New Question: If yes, was the assessment consistent with the case circumstances? Yes indicates there was an assessment made that led to a decision to decrease, increase or maintain the frequency of casework contacts and home visits and that decision was consistent with case circumstances. No indicates there was an assessment made that led to a decision to decrease, increase or maintain the frequency of casework contacts and home visits and that decision was not consistent with case circumstances.

B. Assessment
The Assessment practice area examines the informational base (e.g. observation of the child, observations of the parent and child interaction, conversations with the parents, or information obtained from other individuals and service providers, etc.) that the case planner used to make his or her assessment of the family, particularly in terms of child safety and risk. Assessment also examines the degree to which the information was used to drive service planning and service provision. A clear link is expected between the safety and risk concerns in the family and the services that were provided to the family. Assessment includes the Family Functioning measure which examines the case planners assessment of the family utilizing a holistic approach that includes the assessment of the interactions of all family members, the familys strengths as well as the protective factors of the family. Lastly, Scorecard examines both the initial assessment and the recurrence of the assessments. The following questions from the PAMS Case Record Review instrument (CCR) determine the score for the Assessment practice area. 1. Child(ren) Assessment The Child(ren) Assessment measure examines what child specific assessments were made for each child in the family that reside in the home on their physical health, developmental milestones, cognitive development/ educational, emotional/psychological, and social/behavioral health and how the assessments were obtained (e.g., direct observations by the case planner, conversations with collateral resources). PAMS looks for this information in the Connections progress notes. Question A1: Did the case record include an assessment of the following child factors for each child in the family? 1) Physical Health 2) Cognitive Development/Education 3) Emotional/ Psychological 4) Social/ Behavioral. Did the case planner obtain information regarding each of these assessments, or domains, to inform an assessment for each child? In the absence of a formal child development evaluation, the case planner should use his/her knowledge of developmental stages/milestones to make an assessment and take action to intervene when necessary. This information can be obtained through direct observation of the child, conversations with the parents and children, and from other individuals and service providers. In the case record review, a Yes or No response is provided for each domain for each child in the family. Points are awarded for each assessment for each child. If there are multiple children in the family, each child must receive an individual assessment for each domain or full points value for the question cannot be achieved.
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To receive credit for the assessment of the childs Physical Health there must be at least one of the following in the progress notes, FASP or case record: Up-to-date routine preventive medical report/emergency treatment Up-to-date immunization records Up-to-date Dental records Medical information included in childs IEP Childs need for use of specialized medical equipment e.g., nebulizer/wheelchair Childs need for taking medication or monitoring medication for health problems Observation of childs having adequate nutrition Observation of childs physical care/age appropriate height and weight Observation if child has frequent colds, infections or injuries. To receive credit for the assessment of the childs Cognitive Development/Education Well Being there must be at least one of the following in the progress notes, FASP or case record: Current IEP/School reports/Report cards SBST evaluation Special Needs evaluation (for developmentally disabled children) Academic performance is at /below/above grade level School attendance Identification of educational services e.g., tutoring, summer school Developmental milestones noted (children 0-5) e.g., walking, gesturing, talking, sitting, speech, knowledge of colors/numbers etc. Early intervention assessment (children 0-3) Daycare/universal Pre-K To receive credit for the assessment of the childs Emotional/Psychological Well Being there must be at least one of the following in the progress notes, FASP or case record: Current Psychological/ psychiatric examinations (no later than 2 yrs old) Discharge plans from inpatient psychiatric Hospitals (acute or long term) Observation of behavior that illustrate emotional issues (e.g., isolation, self care skills for older children) Parental Bonding/attachment to others Description of mood/affect To receive credit for the assessment of the childs Social/Behavioral Well Being there must be at least one of the following in the progress notes, FASP or case record: Case planner assessed the child(ren)s behavior in varying environments e.g., home, school Case planner assessed the child(ren)s behavior with adults e.g., parents, teachers Case planner assessed the child(ren)s behavior with peers and/or siblings Case planner assessed the child(ren)s feelings around self-image/self-esteem Question A2: Were these assessments based upon direct observations of the children? Did the case planner working with the family make the assessment through direct observations of the child(ren). This question explores what is typically expected from a child at that age. The case planner must be aware of the child(ren)s emotional, physical, cognitive, social health and development. This question looks for information beyond the supplemental scale in the FASP. Yes indicates an assessment was made of all the children based on observations of the case planner Some But Not All Children indicates only some of the children were observed No indicates that no observations were made of any of the children

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Question A5: Did the case planner obtain information or make contact with other individuals in the child(ren)s life (e.g., teachers, service providers, doctors, etc.) to help make an assessment of the child(ren)? Did the case planner obtained information with other individuals in the child(ren)s life to help make an assessment of the children. Yes indicates that the case planner obtained information from at least one other individual. Some But Not All indicates the case planner obtained some information from other individuals but not all. No indicates that the case planner did not obtain information from any other individuals. 2. Parent/Caretaker and Child Interaction Assessment The parent/caretaker and child interaction assessment examines if there was an assessment of the interaction between the parent/caretaker and the child(ren), and the case planners direct observation of the child(ren)s response to the parent/caretaker and the parent/caretakers response to the child(ren). This information can be found in the Connections progress notes or FASP or in the paper case record reviewed at the agency. The following questions determine the score for the Parent/Caretaker and Child Interaction measure: Question A7: Did the case planner assess the parent/caretaker and child interaction (e.g. childs relationship with parent/caretaker, parental supervision, expectations of child, responsiveness to childs needs, means of discipline, follow through on rules, positive reinforcement, communication, ability to handle childs developmental/emotional/ behavioral needs; response to parent(s), etc.)? This question examines if there was an assessment of the interaction between the parent/caretaker and the child(ren). There should be information in the case record on how each parent/caretaker interacts with the child(ren). For example, documentation should address disciplinary practices, supervision of each child, positive reinforcement, and the parent/caretaker responsiveness to each childs developmental milestones and emotional/behavioral needs. Yes indicates the case planner provided detailed information about any of the areas mentioned above for all children and parents/caretakers in the referred familys household Some But Not All indicates the case planners information was specific to some of the children but not all, and/or one of the parent/caretakers but not all (if applicable) No indicates the case planner did not provide any information about the parent/caretaker and child(ren) interactions Question A8: Did the case planner assess the caretaker(s)-child interaction through direct observations? This question evaluates the case planners direct observation of the child(ren)s response to the parent/caretaker and the parent/caretakers response to the child(ren). This question relates to information in the progress notes where the case planner made an assessment and recorded statements regarding his/her direct observations and not from conversations with the parent/caretaker or child(ren). For example, during contact with the family, the case planner observes the mother setting limits, being affectionate with the child(ren) or the child(ren)s response to the parent/caretaker. Yes indicates the case planners assessment of the parent/caretaker and child interaction was based on his/her observation(s) of both parents/caretaker (or if only one parent) Some But Not All indicates the case planners observation was specific to some of the children but not all, and/ or one of the parent/caretaker but not all (if applicable) No indicates there was no observation of the parent/caretaker and child interaction Question A12b: If there are other adults in the home or frequenting the home, was there information in the case record about the relationship (i.e. level of support/level of involvement) with the family? Did the case planner made an assessment of how the other adult(s) living in or frequenting the home is supporting or involved with the family. This could include child care, transportation, paying a portion of the rent/mortgage, etc. Yes indicates the case planner assessed the relationship the other adult has with the family Some But Not All indicates the case planner assessed the other adults relationship with only some of the family members No indicates the case planner did not assess the other adults relationship with any family members
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Question A12c: If there are other adults in the home or frequenting the home, was there an assessment of their interactions with the child(ren)? Did the case planner make an assessment of the how the other adult(s) living in the home or frequenting the home interact with all of the children in the home. The case planner is expected to document the interactions between household members and the child(ren) whether positive or negative. Yes indicates the case planner assessed the interactions between the child(ren) and all adult household members (relatives or non-relatives) and individuals frequenting the home Some But Not All Adults indicates the case planner assessed the interactions between some of the adults frequenting the home and all or some of the children No indicates the case planner did not assess the interactions between the child(ren) and other adult household members. Please note if there are no other adults living in or frequenting the home questions A12b and A12c are not applicable and would be excluded from the measure. 3. Family Functioning The Family Functioning measure examines the case planners assessment of the family utilizing a holistic approach that includes the assessment of the interactions of all family members, the familys strengths as well as the protective factors of the family. It examines if there is any information in the case record about the parent/caretaker who does not live in the home (if applicable); an overall assessment of the parent/caretaker(s) ability to provide care to his/her child(ren); the assessment of the familys overall functioning including information about the familys problems, strengths and/or assets and how they impact parent/caretaker(s) and child(ren); and how the case planner has built upon the familys strengths. With these assessments, the case planner gains a greater understanding of the functioning of the family unit to help inform the service plan. Question A13: Did the case planner make an assessment of any parent/caretaker who does not live in the home? Did the case planner provide any information about a parent or caretaker who does not live in the home? This question considers any information regardless of detail. Yes indicates some information was found in the case record No indicates no information was found N/A indicates all parents/caretakers are living in the home Question A14: Was an overall assessment made of the parent/caretaker(s)s ability to provide care to the child(ren)? Did the case planner conducted an overall assessment of the parent/caretaker(s)s ability to care for the child(ren)s basic needs (e.g., basic medical or physical needs, hygiene, food and nutritional, education, shelter, and overall safety). Yes indicates the case planner conducted an overall assessment of the parent/caretaker(s)s ability to provide care for the child(ren) Some but not all parents/caretakers indicates the case planners information was specific to only one of the parent/caretakers in the household but not all No indicates the case planner did not conduct an overall assessment of the parent/caretaker(s)s ability to care for the child(ren) and to provide the child(ren) with their basic needs Question A16: Did the case planner assess the overall family functioning? Did the case planner assessed the familys overall functioning via a holistic picture of the dynamics and interactions within the family including information about the familys problems, strengths or assets and how they impact parent/caretaker(s) and child(ren)? This includes, but is not limited to, bonding and communication styles with child(ren), disciplinary and supervision practices with child(ren), age appropriate expectations of the child(ren); social/emotional support from community networks, other family members, friends or neighbors; parent/caretakers relationships/communication with each other; how substance abuse, domestic violence, housing, health, employment and culture affect the family; health, mental health, developmental needs; recurrent patterns of behaviors and response to stressors; past and current support services and the effectiveness of those
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services; parent/caretakers ability to care for the child and make changes; and family relationships and interactions. Yes indicates the case planner made an assessment of the familys overall functioning No indicates the case planner did not make an assessment of the familys overall functioning Question A18: Did the case planner identify the familys strengths? Was an assessment made by the case planner of the familys strengths? Strengths are the personal, family and community characteristics that can be the building blocks of coping, problem solving or positive change. The case record review examines whether the case planner identified certain parent/caretaker/familys characteristics that help strengthen the family. For example, clear parental/caretaker role, good communication skills, family commitment, ability to cope with change, spirituality, etc. Yes indicates the case planner made an assessment of the familys strengths in any of the areas identified above No indicates the case planner did not make an assessment of the familys strengths Question A19: Did the case planner build upon the familys strengths in order to help the family? Did the case planner utilize the strengths identified to enhance family functioning? Yes indicates the case planner built upon the strengths of the family to enhance the familys functioning No indicates the case planner did not build upon any of the parent/caretaker/familys strengths 4. Assessment of Home Conditions, Environment, and Resources This measure specifically focuses on the case planners assessment of the familys physical home environment/ living conditions and financial resources. An assessment of the familys home environment may include descriptive statements about sleeping arrangements, cleanliness of the apartment, furnishings, safety precautions, prevention of poisons, smoke detector, carbon monoxide detector, and utilities. The case planner should also assess the familys resources including clothing, food/nutrition, or housing stability. The familys financial resources may include descriptive statements about the familys ability to manage their income/money such as budgeting for food and rent. It could also include information on employment wages, how much public assistance and/or food stamps the family receives, amount in child support payments, or monetary support from family members or friends, familys housing expenses (specifically rent), access to Medicaid or other health insurance, SSI/SSD, access or eligibility for child care subsidies, etc. This information should be gathered through direct observations (home visits) of the familys physical home environment and living conditions and through conversations with the family. Question A24: Did the case record include an assessment of the physical home environment and conditions? This question examines the case planners assessment of the familys physical home environment and living conditions as well as their resources as described above. Yes indicates that the case record includes at minimum, information on the following three areas: 1. Home Conditions includes at least one of the following Case planner assessed if the home/apartment has adequate space for the children Case planner assessed if the home/apartment is relatively neat and clean Case planner assessed if there is adequate furnishings in the home Case planner assessed if the electricity/heat/gas is working 2. Safety of the Home includes at least one of the following Case planner assessed if the home has a smoke detector installed Case planner assessed if the home has a carbon monoxide detector installed Case planner assessed if poisonous items are kept out of child(ren)s reach Case planner assessed if the home has window guards Case planner assessed the safety of the home Some But Not All indicates the case record contained partial information about the home conditions and environment but did not include all two of the above conditions.

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No indicates the case record does not contain any information about the familys home conditions or environment. Question A25: Did the case record include an assessment of the familys resources? This question examines the case planners assessment of the familys resources as described above. Yes indicates that the case record includes at minimum, information on the following at least one of the following: o Case planner assessed if there is an adequate amount of food in the home o Case planner assessed financial resources No indicates the case record does not contain any information about the resources. 5. Ongoing Assessment The Ongoing Assessment measure examines the ongoing assessments or reassessments of childrens needs, parental behaviors and abilities, parent and child interaction, home environment and resources and other key areas. These assessments can be formal or informal assessments. The ongoing assessments of these areas is important to help guide the case planner and the family regarding safety and risk, family need, the degree to which family functioning has changed, and the provision of appropriate services. Ongoing assessments should provide a framework for the case planner to make any necessary changes or adjustments to the service plan. Ongoing assessment is defined as at least two assessments during the review period providing descriptive statements pertaining to the specific assessments (e.g. child well being, parent/caretaker and child interaction, home conditions, environment and resources). For example, if an assessment of the home conditions and environment was documented in the second month of the review period as well as the fifth month of the review period, this case would receive credit for both the first assessment of the review (question A24) and for the second assessment of the review (question A25). Please note that credit will be given for initial assessments during intake if they happen during the review period. However, if the initial assessment did not occur during the agencys review period, then two additional assessments during the specific timeframe of the agencys FY13 review period must occur in order to receive full credit for Ongoing Assessments. The following questions are used to determine the score for the Ongoing Assessment measure: Did the case planner make ongoing assessments of Child Well Being throughout the review period? This question is directly related to the Child Assessment question Did the case record include an assessment of the following child factors for each child in the family? (physical health, developmental/cognitive, emotional/psychological, and social/behavioral). This question examines if the above domains were reassessed for each child, throughout the review period through formal or informal assessments such as observations and/or conversations with the child and caretaker, and/or through collateral contacts. Yes indicates the case planner made ongoing assessments throughout the review period of each child Some But Not All indicates the case planner made ongoing assessments of only some of the children and/or some of the domains No indicates the case planner did not make ongoing assessments of the child(ren) and each of the above domains Question A11: Did the case planner make ongoing assessments of the parent/caretaker and child interaction throughout the review period? Yes indicates the case planner made ongoing assessment of the parent/caretaker(s)s interaction based on his/her conversation(s) or observations with the child(ren) and parent/caretaker(s) Some But Not All indicates the case planner either made ongoing assessment of some of the childrens interactions with the parent/caretaker(s) if there is more than one child or the case planner made ongoing assessments of only one parent/caretaker when there is more than one parent/caretaker and his/her interaction with the child(ren) No indicates there was no assessment of the parent/caretaker(s) and child interaction any of the child(ren)
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Question A15: Did the case planner make ongoing assessments of the parent/caretaker(s)s ability to provide care to the child(ren) throughout the review period? Did the case planner conducted ongoing assessments of the parent/caretaker(s)s ability to care for and provide the child(ren)s with their basic needs. Yes indicates the case planner conducted ongoing assessments of the parent/caretaker(s)s ability to provide care for the child(ren) Some But Not All indicates the case planners ongoing assessment information were specific to only one of the parent/caretakers in the household but not all. No indicates the case planner did not conduct ongoing assessments of the parent/caretaker(s)s ability to provide care for the child(ren). Question A17: Did the case planner make ongoing assessments of the familys functioning throughout the review period? Did the case planner conducted ongoing assessments of familys function? Was information about the dynamics and interactions within the family including information about the familys problems, strengths or assets and how they impact the parent/caretaker(s) and child(ren) included in the case record? Yes indicates that the case planner conducted ongoing assessments of the familys functioning No indicates the case planner did not conduct ongoing assessments of the familys overall functioning Question A24b: Did the case planner provide ongoing reassessments of the familys home environment and conditions? Refer to Question A24 for details on what this assessment should look like. Yes indicates the case planner reassessed familys home environment and living conditions throughout the review period Some but not all indicates the case planner reassessed either the familys home environment or living conditions but not both throughout the review period No indicates the case planner did not reassess the familys physical home environment or living conditions Question A25b: Did the case planner provide ongoing reassessments of the familys financial resources? Refer to Question A24 for details on what this assessment should look like. Yes indicates the case planner reassessed familys financial resources throughout the review period No indicates the case planner did not reassess the familys financial resources 6. Supervisory Assessment The Supervisory Assessment measure examines the supervisors assessments, discussions, decisions, and guidance provided by the supervisor during the supervisory case reviews. A key role for supervisors in preventive services is to actively guide and support the work of case planners in strengthening families so that they can provide for the safety and wellbeing of their children. Specifically, his measure examines supervisors discussions with case planners about parental behaviors, case progression, case closure, and the provision of guidance consistent with case circumstances. New Supervision Question E7: Does the supervisory review during the PAMS review period provide the case planner with guidance/practice expectations consistent with the case circumstances? Yes indicates that the supervisor provided the case planner with guidance/practice expectations consistent with the case circumstances during the supervisory review. No indicates that the supervisor did not provide the case planner with guidance/practice expectations consistent with the case circumstances during the supervisory review. New Supervision Question E8: Does the supervisory review during the PAMS review period include information about case progression? Yes indicates that the supervisory review contained information about case progression. No indicates that the supervisory review did not contain information about case progression.
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New Supervision Question E9: Does the supervisory review during the PAMS review period include information about case closure? Yes indicates that the supervisory review contained information about case closure. No indicates that the supervisory review did not contain information about case closure. New Supervision Question E10: (FTR Cases Only): Does the supervisory review during the PAMS review period include information about safety and risk issues related to substance abuse and/or mental health in order to identify the FTR treatment phase(s)? Yes indicates that the supervisory review contained information about safety and risk issues related to substance abuse and/or mental health in order to identify the FTR treatment phase(s). No indicates that the supervisory review did not contain information about safety and risk issues related to substance abuse and/or mental health in order to identify the FTR treatment phase(s). 7. Cultural Competence Cultural competence examines if the case planner made substantive efforts to obtain information about the familys cultural practices and beliefs and used the information to gain insight into the familys functioning to inform the assessment and overall service planning. ACS defines culture broadly to include the familys values, traditions, and beliefs with a particular focus on how those value and beliefs influence the reasons behind why they are now engaged in services. These values, traditions, and beliefs may include religion, language, ethnicity/race, gender identity, sexual orientation, disability status as well as a parents upbringing or a familys experience with traumatic events. Agencies should not limit their understanding of a familys culture to one element such as immigration status or fluency in English. In this framework, the case planners understanding of cultural practices and beliefs, particularly as related to parenting practices and disciplinary methods as well as family issues such as culturally-bound gender roles in domestic violence cases, for example, is critical, but it is not the end goal. The goal is for case planners to be able to apply their knowledge of cultural practices and beliefs, as well as utilize a familys resources (such as religious leaders, community groups, etc.), to aid in developing an appropriate assessment of the familys issues and in developing a mutually agreeable, culturally appropriate plan for intervention. The following questions determine the score for the Cultural Competence measure within Assessment: Question A21: Does the case record contain information about the characteristics of the familys cultural background, traditions, resources, or language? Does the case record contain any information about familys cultural background, traditions, resources, or language(s). Documentation about the familys cultural background may include information about the familys values, cultural practices/beliefs, ideas, customs, country or region of origin, language(s), family support or resources, or faith or religious affiliations during the review period. . Yes indicates the case record contained information about the familys culture, background, traditions, resources, or language(s) No indicates the case record did not contain any information about the familys culture, background, traditions, resources, or language(s) Question A23: Did the case planner use his/her knowledge of the familys cultural practices, background, beliefs (relating to parenting) and resources (e.g., religious leaders, community groups, etc) to aid in developing an appropriate assessment of the familys needs/problems/concerns? This question examines if the case planner utilized the information obtained from conversations with the family regarding cultural practices, background and/or beliefs and incorporate it into an assessment of the familys current needs/problems/concerns. Yes indicates the case planner used information about the familys culture or background to inform her/his assessment of the family
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No indicates there was no documentation that the case planner used the familys culture or background to help inform his/her assessment of the family

C. Engagement
The Engagement practice area evaluates the case planners efforts to engage the family, to incorporate the familys perspective when assessing need, to increase or maintain a high level of family involvement, to communicate with the family regarding the effectiveness/helpfulness of the services, and his/her efforts to continue engaging the family throughout the review period. Efforts to Engage the Family Efforts to engage the family examines the case planners efforts to understand the familys needs from their perspective through the documentation of conversations with the case planner and the family regarding their view of the children, the parents/caretakers, of family functioning and of services; and conversations regarding the familys view of the case planners/agencys work with the family. Children five years old and older are considered age appropriate to engage in conversation. This age may vary depending on other developmental factors of the child. The following questions from the case record review determine the score for the Efforts to Engage the Family measure: Question A3: Were these (Child Well Being) assessments based upon direct conversations with the child(ren), if developmentally appropriate? This question is directly linked the Child Well Being assessment questions. It examines if the assessment was based upon conversations with the children if developmentally appropriate. This question looks at the conversations between the case planner and the child(ren) to see if information relative to the Child Well Being domains (physical health, developmental, cognitive/ education, emotional and social/behavioral) were discussed during those conversations to inform the assessment. Yes indicates that the case planner had conversations with all the children, if developmentally appropriate Some But Not All indicates that the case planner had conversations with only some of the children No indicates that there were no conversations with any of the children N/A indicates child was either too young or unable to communicate effectively due to developmental disability Question A4: Were these (Child Well Being) assessments based upon the parent/caretakers stated view of the child(ren)? This question is directly linked the Child Well Being assessment questions. It examines if the assessment was based on the parent/caretakers stated view of the child(ren). This question looks at the conversations between the case planner and the parent/caretaker(s) to see if information was obtained relative to the Child Well Being domains (physical, developmental, cognitive, education, emotional and social health) to inform the assessment. Yes indicates that the parent/caretaker provided the case planner with information on all of the children around the above referenced variables Some But Not All indicates that the parent/caretaker provided the case planner with information on only some of the children around the above referenced variables No indicates that the parent/caretaker did not provide any information about any of the children around the above referenced variables Question A9: Did the case planner assess the parent/caretaker(s) and child interaction through conversations with the parent/caretaker(s)? This question is directly linked to the questions regarding the assessment of the parent/caretaker(s) and child interactions. It examines if the case planners assessment of the parent/caretaker(s) and child interactions were obtained through conversations with the parent/caretaker. Yes indicates the case planner did an assessment of the parent-child interaction based on his/her conversation(s) with the parent/caretaker(s)
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Some But Not All indicates the case planners assessment of the parent/caretaker(s) and child interaction was based on his/her conversation with only one parent/caretaker where there are two parents/caretakers in the home No indicates there was no assessment of the parent/caretaker(s) and child interaction through conversation with any of the parent/caretaker(s). Question A10: Did the case planner assess the parent/caretaker(s) and child interaction through conversations with the child(ren) (when age appropriate)? This question is directly linked to the questions regarding the assessment of the parent/caretaker(s) and child interactions. It examines if the case planners assessment of the parent/caretaker(s) and child interactions were obtained through conversations with the child(ren) (if age appropriate/developmentally appropriate). Yes indicates the case planner made an assessment of the parent/caretaker(s) and child interaction based on his/her conversation(s) with the child(ren) Some But Not All indicates the case planners made an assessment of the parent/caretaker(s) and child interaction based on his/her conversation with only one child where there is more than one child the home No indicates there was no assessment of the parent/caretaker(s) and child interaction through conversation with any of the child(ren) Question RS5: Did the case planner have discussions with the family about how the identified risks are impacting the family? Did the case planner discuss with the family the impact the identified risk(s) had on family functioning or the link between the behavior regarding the risk and the consequences of the risk (i.e., the potential for abuse or neglect of the child(ren))? Yes indicates the case planner discussed the impact the identified risk(s) had on family functioning and the care of the child(ren) No indicates the case planner did not discuss the impact the identified risk(s) had on family functioning and the care of the child(ren) Some but not all indicates the case planner discussed the impact some of the identified risk(s) had on family functioning and the care of the child(ren) Question S17: (Moved from Ongoing Engagement to Efforts to Engage): Did the case planner have ongoing discussions with the parent/caretaker(s) about the impact of his/her behavior(s) that placed the child(ren) in immediate/impending danger of serious harm? Did the case planner make ongoing assessments through conversations with the parent/caretaker(s)s about his/her understanding of how his/her behavior posed a threat of harm to the child(ren). Yes indicates that the case planner had discussions with the parent/caretaker(s) regarding his/her understanding of how his/her behavior posed a threat of harm to the child(ren)s safety Some But Not All indicates that the case planner had discussions with only some of the parent/caretakers regarding his/her understanding of how his/her behavior posed a threat of harm to the child(ren)s safety if there is more than one parent/caretaker No indicates that the case planner did not have discussions with the parent/caretaker(s) regarding his/her understanding of how his/her behavior posed a threat of harm to the child(ren)s safety Please note that when an Elevated Risk Conference (ERC) is held to address risk, the conversations and documentation need to be specific to the identified risk in order to receive credit for this question. Credit is not given if the progress note does not detail the content of the ERC and how it specifically relates to the identified risk. 67 of the CRR: Question RS11: If a referral(s) or service(s) was provided during the review period that was specific to the risk, did the case planner have discussions with the family about the need for these services or referrals? Did the case planner engage the family in discussing the reason(s) around their need for services or referrals that were specific to the risk(s)? Yes indicates the case planner had discussions with all family members (where age appropriate) about their need for services or referrals that are specific to the risk(s).
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Some But Not All indicates the case planner had discussions with only some family members (where age appropriate) about their need for services or referrals that are specific to the risk(s) No indicates the case planner had no discussions with the family about their need for services or referrals that are specific to the risk(s) Question RS16: Did the case planner make substantive efforts to understand the familys needs from the familys perspective? This question examines the documentation of conversations with the parent(s) and any age/developmentally appropriate children about their service needs from the familys perspective. Yes indicates there were conversations with family members (where age appropriate) about their service needs from the familys perspective Some But Not All indicates there were conversations with some family members (where age appropriate), but these discussions were not held with all necessary family members No indicates there was no documentation of conversations with family members (where age appropriate) about their service needs from the familys perspective 1. Strategies for Engagement (Replaces Ongoing Engagement in FY13) The Strategies for Engagement measure evaluates if the case planner is making regular and sustentative contacts with the family, having discussions about the progress or lack of progress made by the family specific to the risks identified in the case record, and how that affects the family throughout the life of the case. In question E1 in Strategies for Engagement, contacts can be made with any family member during the month to receive credit. This question is not based on the minimum expectations set forth in the ACS Casework Contact standard, but is a more general way to examine regular contact with the family to strengthen engagement. Additionally, Strategies for Engagement also examines the case planners response to the familys concrete needs once identified, the inclusion of both parents in the service planning when there is a two parent household, and deliberate, specific discussion with the family about case closure. The following questions are used to measure Strategies for Engagement: New Question E1: Did the case planner make in person contact with the family monthly during the PAMS review period? Yes indicates that the case planner made in person contact with the family every month during the PAMS review period. No indicates that the case planner did not make in person contact with the family any months during the PAMS review period. Some but Not All indicates that the case planner made in person contact with the family for some of the months during the PAMS review period. New Question RS14: Did the case planner discuss during casework contacts the progress or lack of progress made by the family? Yes indicates that there were conversations with the family members about the progress or lack of progress made in services to help minimize safety/risk issues. No indicates that there were no conversations with the family members about the progress or lack of progress made in services to help minimize safety/risk issues. New Question RS21: Did the case planner address the familys concrete needs? Yes indicates that the case planner provided assistance/action to meet the concrete needs of the family. No indicates that the case planner did not provide assistance/action to meet the concrete needs of the family. New Question E2: When there is a two parent household, were both parents included in service planning? Yes indicates that there was a two parent household (mother/father, same sex couple) and both parents were included in service planning. No indicates that there was a two parent household (mother/father, same sex couple) and both parents were not included in service planning.
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NA indicates that there is not a two parent household and/or there is a two parent household and one parent has refused to participate in the service planning. Question E11: (Moved from Family Team Conferencing): During the PAMS review period, was there a discussion with the family about case closure? Yes indicates there was a discussion between family members and the case planner about service completion and/or case closure. No indicates there was no discussion between family members and the case planner about service completion and/or case closure. 2. Family Team Conferencing (FTC) The Family Team Conference (FTC) measure assesses any FTCs which occurs during the PAMS review period including who participated, the safety and risk issues addressed during the conference, the consistency between the issues discussed and the information noted in the progress notes or FASP, and the degree to which issues raised during the conference are followed-up on. Intensive Preventive and Aftercare Services for Adolescents programs and Juvenile Justice Initiative programs will not be scored for this measure for FY13. Closed or approved pending closure cases that had an FTC will only be measured on questions FTC1 through FTC9. Closed or approved pending closure cases that did not have an FTC will not be measured for the FTC measure. Question FTC1: Was there a Family Team Conference held during the review period? Did a Family Team Conference occur during the review period? If a case closed during the review period and an FTC was not necessary, this and the following questions under the FTC measure are not applicable. Yes indicates a FTC was held during the review period and the case was active or pending closure (i.e. submitted for closing and awaiting approval) No indicates there was no FTC held during the review period and the case was active N/A indicates the case was closed during the review period or submitted for closure and no FTC was held during those months of the review period during which the case was active If a FASP due date is at the beginning or end of the review period, PAMS will read progress notes dated eight weeks prior to the FASP due date or four weeks after the due date to determine if an FTC was held. Child Safety Conferences (CSC) are not included as FTCs in Scorecard. Question FTC2: Was the Preventive Planning Conference held during the PAMS review period convened at MOST eight weeks before the FASP due date or at most four weeks after the FASP due date? For all cases referred to preventive services, the preventive provider agency will convene and facilitate a Preventive Planning Conference (PPC) every six months at most eight weeks before the FASP due date or at most four weeks after the FASP due date in order to develop and refine the service plan with the family, address any concerns regarding safety or risk, reach agreement on strategies to reduce risk, assess progress toward achieving service plan goals and examine the need for ongoing preventive services. Information shared and decisions reached at a PPC are used to inform and verify that the FASP addresses the safety factors and risk elements for all children in the family. If a FASP due date is at the beginning or end of the review period, PAMS will read progress notes dated eight weeks prior to the FASP due date or four weeks after the due date to determine if an FTC was held. This question examines when the PPC was held by comparing the date on the FTC Agreement or the date of the PPC in the progress notes, with the date on the FASP. This question is only scored for cases where a Preventive Planning Conference was held during the review period. Yes indicates the PPC was held at most 8 weeks before or 4 weeks after the FASP due date No indicates the PPC was not held at most 8 weeks before or 4 weeks after the FASP due date

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Question FTC3: Was there a conversation with the family about who they wanted to invite to the conferences? The FTC model was designed to engage families and community members in critical child welfare decisions. Decisions are made, and service plans developed by a group (including the family, their supports, community supports and service providers) rather than individually. Asking families who they would like to attend the conference is critical. This question examines if the case planner had a direct conversation with the family about who they wanted to invite to the conference. Yes indicates that the case planner had a conversation with the family about who they wanted to invite to the conference No indicates that the case planner had a conversation with the family about who they wanted to invite to the conference Question FTC6: Does the plan correspond to issues that are evident in the FASP and the progress notes? FTCs are a process for engaging families, community members, and service providers in critical decisions related to safety, risk, well being and service planning. The entire team arrives at a decision which provides the child and family with a more comprehensive continuum of support. Weaving together the familys expertise and the knowledge of professionals produces a partnership that should result in effective services and offers the family a strong network of support. This question examines if the issues identified in the progress notes during the review period as well as the corresponding FASP match the plan developed in the conference. Yes indicates the plan developed in the conference corresponds to the issues/concerns identified in the progress notes and the corresponding FASP Some But Not All indicates the plan developed in the conference corresponds to some of the issues/concerns identified in the progress notes and/or corresponding FASP but not all of the issues/concerns No indicates the plan developed in the conference does not correspond to the issues/concerns identified in the progress notes and the corresponding FASP Question FTC8: For the tasks that were due during the review period, did the case planner follow up on tasks as outlined in the plan by the due date that was agreed upon? Yes indicates the case planner followed up on all of the tasks that came due during the review period Some But Not All indicates that the case planner followed up on some of the tasks that came due during the review period No indicates that the case planner did not follow up on any of the tasks that came due during the review period N/A indicates there were no tasks outlined in the plan Please note that if a task does not have a clearly identified due date or if the due date is ongoing, this question will be answered as no and credit will not be given. Question FTC10: Does the work with the family done after the conference reflect the new information learned from the conference? Does the information learned from the conference reflect the work being done with the family after the conference? This information can be in the Family Agreement Plan in the case record and/or the Connections progress notes or FASPs during the six month review period. Yes indicates that the work with the family done after the conference reflects the information learned from the conference Some But Not All indicates that some of the work with the family done after the conference reflects some of the information learned from the conference No indicates there is no work with the family done after the conference reflects the information learned from the conference 3. Cultural Competence The Cultural Competence measure of the Engagement indicator examines if the agency used their knowledge of the familys culture to engage the family in services and if diligent efforts were made to meet the familys language needs. This information can be found in the Connections progress notes or the FASP.
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The following questions determine the score for the Cultural Competence measure in Engagement: Question A20: Were there diligent efforts to meet the familys language need (e.g., translator, assignment of case to case planner who speaks the same language) for families with limited English proficiency? This question examines if the case planner made diligent efforts or provisions to adequately communicate with the family and to meet their languages needs, such as: The case planner either translating and/or interpreting forms/documents for the family in efforts to facilitate services for the family and/or Assigning a case planner who speaks the same language(s) as the family. Yes indicates the case planner made diligent efforts to meet the familys language needs No indicates the case planner did not make diligent efforts to meet their language needs N/A indicates the family did not have limited English proficiency Question A22: Did the case planner explore or have discussions with the family about their cultural background, traditions, or beliefs? Did the case planner moved beyond routine and simple information gathering (i.e., filling out forms) to having discussions regarding the familys background, traditions, beliefs and/or cultural identity. These conversations should highlight important factors such as how the familys view of their cultural background shapes their decision making, how their religious background/beliefs may play a role in their parenting style(s), and/or to what extent does the family reach out to extended family members. Yes indicates that the case planner had discussions with the family about their cultural background, traditions and/or beliefs No indicates that the case planner did have discussions with the family about their cultural background, traditions and/or beliefs

D. Services
The Services practice area examines the case planners efforts to match the need of the family to the service planning for both the risk concerns and the case events and circumstances that require action. This indicator measures the case planners practice strengths, the appropriateness of the interventions provided, the communication between the agency and each of the service providers involved with the family, the agencys efforts to utilize community groups/individuals to provide culturally appropriate services, actions taken to address risk of future maltreatment or serious harm, case events and circumstances that threaten child well being and require action, and the case planners work to address barriers to services. The Services Indicator also measures the ongoing casework practice provided to families throughout the case. 1. Risk The Risk measure examines the family behaviors and characteristics that contribute to the likelihood that a child will be abused or maltreated in the future as identified in the case record. This measure examines the quality of case practice used to identify how these risk elements are impacting familys functioning, the services provided to address the risk, the work done to address barriers to services, the reassessments of the risk, and the work implemented to prevent the recurrence of risk of abuse or maltreatment in the future so that the case may be closed. The Risk measure is based on the Risk (R) and Elevated Risk (ER) elements included in Risk Assessment Profile (RAP): R1 Indicated CPS report(s) since last assessment and service plan. R2 Child(ren) in RAP family unit is currently or was previously in care or custody of substitute caregivers or foster parents. R3 Child under one year old in RAP family unit at time of the current report, and/or new infant since report R4 Housing with serious health or safety hazards; extreme overcrowding; unstable housing; or no housing R5 Financial resources are mismanaged or limited to the degree that one or more basic family needs are intermittently or chronically unmet R6 Parent/caretaker does not have or utilize reliable and constructive support and assistance from extended family, friends, or neighbors
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R7 Parent/caretaker has been a victim or perpetrator of abusive or threatening incidents with partners or other adults in family/neighborhood R8 Parent/caretakers alcohol use has negative effects on child care, family relationships, jobs, or arrests R9 Parent/caretakers drug use has negative effects on child care, family relationships, jobs, or arrests R10 Parent/caretakers behavior suggests a mental health problem exists and/or caretaker has a diagnosed mental illness R11 Parent/caretaker(s) has very limited cognitive skills R12 Parent/caretaker(s) has a debilitating physical illness or physical disability R13 Parent/caretaker(s) does not demonstrate developmentally appropriate expectations of all children. R14 Parent/caretaker(s) does not attend to the needs of all children and does not prioritize the childrens needs above his/her own needs or desires. R15 Parent/caretaker(s) does not understand the seriousness of current or potential harm to the child(ren), and is not willing to address any areas of concern. ER1 Death of a child as a result of abuse or maltreatment by caretaker(s) ER2 Parent/caretaker(s) has a previous Termination of Parental Rights (TPR) ER3 Siblings removed from the home prior to current report, due to abuse or neglect and remain with substitute caretakers or foster parents ER4 Repeated incidents of sexual abuse or severe physical abuse by parent/caretaker(s) ER5 Sexual abuse of a child and perpetrator is likely have current access to child ER6 Physical injury to a child under one year old as a result of abuse or maltreatment by parent/caretaker(s) ER7 Serious physical injury to a child requiring hospitalization/emergency care within the last 6 months as a result of abuse or maltreatment by parent/caretaker(s) ER8 Newborn child has positive toxicology for alcohol or drugs

New Supervision Question RS6: Does the supervisory review during the PAMS review period include information about the risk issues in the family? Yes indicates that the supervisory review had information about all of the identified risk issues in the family. Some But Not All indicates that the supervisory review had information about some of the identified risk issues in the family. No indicates that the supervisory review did not have information about any of the identified risk issues in the family. New Supervision Question RS7: Does the supervisory review during the PAMS review period include information about parental behaviors that need to change in order to reduce the risk? Yes indicates that the supervisory review contained information about parental behaviors that need to change in order to reduce the risk. No indicates that the supervisory review contained information about parental behaviors that need to change in order to reduce the risk. Question RS8: Did the case planner provide service(s) to address the risk? Did the case planner either refer the family or a family member to services specific to risk(s) identified and/or provided a service to address the risk(s) identified? Yes indicates the case planner provided service(s) to address all of the identified risk(s) Some But Not All indicates that the case planner provided appropriate service(s) to address only some of the identified risk(s) No indicates that the case planner did not provide any service(s) to address any of the identified risk(s) Question RS9: If a referral(s) was provided, did the family receive services specific to the referral at any time during the review period? Were the services received specific to the referrals that were made for the family during the review period? These referrals are specific to the risks identified in the case record. Yes indicates the family received services specific to the risk(s) resulting from the referral(s) made by the case planner during the review period
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Some But Not All indicates the family received services for only some of the referrals made by the case planner during the review period, if there was more than one referral No indicates that the family received no services resulting from the referral(s) made by the case planner during the review period N/A indicates that no referrals were made by the case planner Question RS12: Did the case planner provide referrals and/or services that matched the needs of the family? Were the referrals and/or services that were provided by the case planner appropriate (i.e., the services matched the needs of the family)? Yes indicates the case planner provided referrals and/or services that matched all of the needs of the family Some But Not All indicates the case planner provided referrals and/or services that matched only some of the needs of the family No indicates the case planner provided referrals and/or services that did not match the needs of the family Question RS13: Does the case planner provide information, which indicates that the services the family is receiving are helping the family resolve their problems/concerns? Is there documentation in the case record indicating the services the family is receiving are helping the family resolve their problems/concern? Yes indicates the case planner documented the services the family is receiving are helping the family resolve their problems/concerns Some but not all indicates there was documentation on some of the services the family is receiving are helping the family resolve their problems/concerns No indicates the case planner did not document any information on how the services the family is receiving are helping the family resolve their problems/concerns Question RS22a: Did the case planner coordinate services with each of the service providers involved with the family to address the familys service needs (e.g., conferencing, meetings, letters, reports, telephone contact etc.)? Did the case planner coordinate services (i.e. plan, implement, modify, monitor or evaluate) with other agencies/service providers involved with the family to facilitate an effective service plan? Coordination can be effected through conferencing, meetings, discussions, reports/evaluations, etc. For example, if a child is acting out with his/her teacher, the case planner might have a conference with the school or obtain information such as an Individual Educational Plan (IEP) to ascertain that the child is receiving appropriate services or is placed in the proper school setting. Similarly, if a parent is involved with drug treatment, the case planner is expected to make direct contact with the drug treatment program and obtain toxicology reports from the drug treatment program as well as have conversations with the parents to determine the parents progress with services. If the preventive agency is providing all of the services then they should be coordinating with all the appropriate internal staff who are working with the family. Yes indicates there was coordination of services between the case planner and all agencies/service providers involved with the family Some But Not All indicates there was coordination with only some service providers/agencies or there was diligent effort to coordinate services. Diligent effort is defined as two or more attempts to coordinate with a service provider via face-to-fact contact, telephone contact, or through written correspondence. No indicates there was no coordination between the case planner and service providers/agencies Please note if all services offered to the family are provided exclusively by the case planner, then this question is not applicable and will not be scored. Question E5: Did the case planner explore or discuss these barriers to these services with the family? Did the case planner identify any barrier(s) that hinders the familys ability or willingness to engage in or attend services?
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Yes indicates the case planner explored or discussed barriers that hinder the familys ability or willingness to engage in or attend services with the family Some But Not All indicates the case planner explored or discussed barriers to some services that hinder the familys ability or willingness to engage in or attend services with the family No indicates the case planner did not explore or discuss barriers that hinder the familys ability or willingness to engage in or attend services with the family Question E6: Did the case planner develop possible solutions/alternatives to the identified barriers? Did the case planner develop concrete solutions or alternatives to minimize or eliminate barriers and engage the family into services? Alternatives can range from educating the family around the benefits of specific services/referrals or providing concrete alternative referrals that may better suit their needs. Yes indicates the case planner developed possible solutions and/or alternatives to the identified barriers Some But Not All indicates the case planner developed possible solutions/alternatives for some of the identified barriers No indicates the case planner did not develop possible solutions or alternatives to the identified barriers Please note if there are no identified barriers to services, questions E5 and E6 will not be scored. 2. Ongoing Casework Specific to Risk The Ongoing Casework Specific to Risk measure examines the case planners work throughout the review period regarding the assessments of risk that pose a likelihood of future maltreatment or harm to the child(ren) and the case planners development of a plan to help prevent the reoccurrence of those risks in the future. Ongoing Casework Specific to Risk is defined as at least two instances of documented ongoing casework during the review period providing descriptive statements pertaining to the risks identified. Question RS15: Did the case planner make ongoing assessments of the risk(s) throughout the review period? Did the case planner make assessments of the behaviors and circumstances which were previously identify as risk of future maltreatment of harm to the child(ren) throughout the review period? Ongoing assessments means there are at least two assessments documented in the case record at distinct points of the review period providing descriptive statements regarding the assessment of the identified risk(s) of future harm and maltreatment for child(ren) in the family and/or any emerging conditions that create risk. The case planner should gather sufficient information to make ongoing assessments from: Direct observations of the child(ren) and/or direct observations of the parent(s) Direct observations of parent/caretaker(s) and child interactions Conversations with the child(ren) and/or conversations with the parent/caregiver(s) Conversations with others in the family or other service providers who may be in a position to know Yes indicates the case planner made ongoing assessments of all the identified risk(s) of future harm to the child(ren) Some But Not All indicates the case planner made ongoing assessment of only some of the identified risk(s) of future harm to the children No indicates the case planner did not make ongoing assessments of the identified risk(s) of future harm to the children Question RS17: Did the case planner develop a plan and/or was the case planner involved in the development of a plan to reduce the level of risk(s)? Did the case planner document the development of a formal or informal plan to reduce the level of the risk(s) in the case record? This plan is a set of educational, rehabilitative, and/or supportive activities or services intended to reduce risk, assess underlying conditions and contributing factors, and to bring about long-term and lasting change within the family. Yes indicates the case planner developed or was involved in the development of a plan to prevent the reoccurrence of all the identified risk(s) to the child(ren) Some But Not All indicates the case planner developed or was involved in the development of a plan to prevent the re-occurrence of some of the identified risk(s) to the child(ren) No indicates the case planner either did not develop a plan or was not involved in the development of a
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plan to prevent the re-occurrence of the identified risk(s) 3. Case Events or Circumstances Specific to Risk The Case Events or Circumstances Specific to Risk measure is based on events and circumstances that if not addressed can potentially develop into safety factors and/or risk elements placing children in immediate and impending danger and/or at risk of future harm. These events and circumstances often lead to the issuing of a risk alert because case planners were often not conducting thorough assessments or taking action to address the circumstances. The following questions address the identification, if any, of these case events or circumstances in a case and the action taken by the case planner(s) to address these events or circumstances. If there were no case events or circumstances that required action this measure is not applicable and will not be scored. The following is a list of the Case Events or Circumstances Specific to Risk: Changed family functioning/circumstances due to parent and/or child health concern/illness Non-compliance of court mandated services Other adults frequenting the home and no assessment Truancy Child Mental Health Child has debilitating physical illness or physical disability. Child exhibiting disruptive and/or aggressive behavior and/or practicing unsafe sex Involvement in criminal activity (including gang involvement) Caretaker(s) threatened or caused serious emotional harm to a child Child(ren)s substance abuse Child(ren) involved in criminal activity Child(ren) has been a victim of abusive or threatening incidents with other children in neighborhood/school Case planner/agencys inconsistent contact with the family places child(ren) at risk of future abuse and/or maltreatment Question RS2: Was an action provided by the case planner in response to the event(s) or circumstance(s)? Was action provided in response to the event(s) or circumstance(s) that occurred in the case during the six month review period? Yes indicates action was provided by the case planner in response to the event(s) or circumstance(s) Some But Not All indicates actions were taken by the case planner to address some of the event(s) or circumstance(s) but not all No indicates that no action was provided by the case planner in response to the event(s) or circumstance(s) Question RS2a: If a referral(s) was provided to address the case events(s) or circumstance(s), did the family receive services specific to the referral at any time during the review period? Were services received specific to referrals that were made for the family during the review period? These referrals are specific to the case events or circumstances specific to risk identified in the case record. Yes indicates the family received services specific to all case events or circumstances specific to risk resulting from referral(s) made by the case planner Some But Not All indicates the family received services specific to only some case events or circumstances specific to risk resulting from referral(s) made by the case planner No indicates the family received no services specific to the case events or circumstances specific to risk resulting from referral(s) made by the case planner N/A indicates that no referrals were made by the case planner that were specific to the case event or circumstance specific to risk Question RS3: Did the action taken by the case planner address the threat to child well being posed by the event(s) or circumstance(s)? Yes indicates the action taken by the case planner fully addressed the threat to child well-being posed by the case event(s) or circumstance(s)
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Some But Not All indicates the actions taken by the case planner addresses some of the threats to child well-being posed by the case events or circumstances but not all No indicates the action taken by the case planner did not fully address the threat to child well-being posed by the case event(s) or circumstance(s) 4. Family Involvement The Family Involvement measure examines the familys participation in their service plan and other decisions around services. Question S20: Was the family involved in the development of the plan to help prevent the re-occurrence of the event(s) and/or safety factor(s)? Was the family involved in the creation of a plan to help prevent the recurrence of the safety factors and maintain the safety and protection of the child(ren). This question looks for conversations with family members to identify what they can contribute in order to maintain the safety and protection of the child(ren). Yes indicates all family members (where age appropriate) were engaged in the development of the plan to help prevent the reoccurrence of the safety factors Some but not all indicates some family members (where age appropriate) were involved in the development of the plan to help prevent the reoccurrence of the safety factors No indicates none of the family members were involved in the development of the plan to help prevent the reoccurrence of the safety factors Question RS18: Was the family involved in the development of the plan to help prevent the reoccurrence of the risk(s)? Did the family participate in the development of a plan to help prevent the reoccurrence of the risk(s) in the case record? This question looks for documentation of conversations with family members to identify their service needs and to obtain their input into the plan to help prevent the reoccurrence of the risk(s). Yes indicates all family members (where age appropriate) were involved in the development of the plan to help preventive the reoccurrence of the risk(s) Some but not all indicates some family members (where age appropriate) were involved in the development of the plan to help preventive the reoccurrence of the risk(s) No indicates no family members (where age appropriate) were involved in the development of the plan to help preventive the reoccurrence of the risk(s) Question E3: Was the family involved in the decisions around services? Did the family participate in the key decisions about their service needs? There should be conversations with family members to identify their service needs and to obtain their inputs about the development of their service plan. Yes indicates all family members (where age appropriate) were engaged in decisions around services Some But Not All indicates only some family members (where age appropriate) were engaged in decisions around services No indicates none of the family members were engaged in decisions around services 5. Cultural Competence The Cultural Competence measure in Services examines the agencys efforts to utilize other community groups or individuals to provide culturally appropriate services. Question RS23: Did the case planner explore or have discussions with the family about receiving services that support/connect to the familys cultural background, traditions or beliefs? Yes indicates that the case planner explored or had discussions with the family about receiving services specific to the familys cultural background, traditions, or beliefs No indicates that the case planner did not explore or have discussions with the family about receiving services specific to the familys cultural background, traditions, or beliefs

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Question RS23a: If yes, did the agency make efforts to provide services that support/connect to the familys cultural background, traditions or beliefs? Did the case planner or agency provide services specific to the familys cultural background, traditions or beliefs if it was determined that the family wanted such services? Examples of culturally appropriate services include the agency providing or utilizing additional support services such as community groups, religious leaders or family connections to strengthen family functioning and well being. Credit is given if services are provided by the preventive agency or through external providers. Agencies will not be penalized for any effort to provide culturally competent services to a family that does not prefer culturally specific services or does not comply with the services. Yes indicates the case planner/agency provided services to the family specific to their cultural background, traditions, or beliefs No indicates that the case planner/agency did not provide services to the family specific to their cultural background, traditions, or beliefs NA indicates that either the family did not want to receive services specific to their cultural background, traditions, or beliefs or the Case Planner determine it was not necessary.

E. Productivity
Productivity is the only practice area in Scorecard that does not come from the PAMS case record review. Productivity consists of four outcomes measures that are linked to the start of a familys preventive services to the completion of those services. Time to Disposition examines agencies ability to engage families from the time of referral to the signing of the Disposition (Form 2921) which represents acceptance or rejection of services. Length of Service promotes effective and efficient provision of services to families. Utilization measures agencies ability to serve families throughout the year at capacity. Family Team Conferencing evaluates the percentage of conferences held throughout the fiscal year. All data for the Productivity measures is extracted from PROMIS. General Preventive and Family Treatment and Rehabilitation programs are scored separately. Intensive Preventive programs and Family Assessment Programs will be scored for all Productivity measures except Family Team Conferencing while Medically Fragile programs are not scored for Length of Service. Juvenile Justice Initiative programs are excluded from Productivity measures. Time to Disposition The Time to Disposition measure examines the percentage of dispositions (the familys signed agreement or rejection of services) completed in 10 business days or less to ensure that families are offered services in a timely manner. Below is the range of scores an agency can receive based on the percentage of dispositions completed within 10 business days compared to the number of referrals received. The scores for Time to Disposition are distributed as follows:
% Achieved 96 to 100% 91 to 95% 86 to 90% 81 to 85% 76 to 80% 70n to 75% 0%-69% Score 100% 83% 66% 50% 33% 16% 0%

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Utilization Utilization evaluates how well an agency is filling the total number of preventive slots in their contract (i.e., service capacity). The total number of active cases is determined by adding all active and pending cases, and half of the housing subsidy only cases. This is divided by the program capacity.
Active Cases + ACS Pending Cases + Housing Subsidy Only Cases Program Capacity

GP and FTR scores for Utilization are distributed as follows:


% Achieved 97 to 100%+ 93 to 96% 90 to 92% 0 to 89% Score 100% 70% 50% 0%

Length of Service The Length of Service measure evaluates the time elapsed (in months) between the case responsibility date/signing of the 2921 and the date of the data pull to determine the length of service for a given case. Scorecard determines the percentage of cases open 18 or more months cases open for GP and FTR programs separately based on the Calendar Year 2009 system wide performance. GP points for Length of Service are distributed as follows:
% of 18 Month + Cases 0% to 12% 13% to 17% 18% to 24% 25% to 41% >41% Score 100% 80% 60% 40% 0%

FTR scores for Length of Service are distributed as follows:


% of 18 Month + Cases 0% to11% 12% to 14% 15% to 22% 23% to 34% >34% Score 100% 80% 60% 40% 0%

Family Team Conferencing (FTC) The Family Team Conferencing data measure will be scored in FY13. The FTC data measure supports the use of the FTC model in achieving the permanency goals of each child and family. The measure evaluates the number of Preventive Planning Conferences (PPCs) expected to be held during the year. ORE will use the data from the existing FTC PROMIS report. For Scorecard, the FTC score compares the number of PPCs that are actually held to the number of PPCs that were expected to be held. The resulting percentage will then be used as the agencys annual score for this measure.
# of PPCs that are actually held # of PPCs that are expected to be held

For example, if 50 conferences were expected to be held during the year and 40 conferences were held, the agency will achieve a rate of 80% which will become their score for this measure.

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Appendix A
Agency Program Assistance (APA) Roles and Responsibilities The Agency Program Assistance (APA) teams mission is to help improve the quality of services provided and the outcomes achieved by Childrens Services provider agencies for New York Citys children and families. Located within the Division of Quality Assurance, the Agency Program Assistance (APA) unit is comprised of teams of performance monitors assigned to preventive and foster care providers. The following describes APA responsibilities as well as how APA works collaboratively with both provider agencies and ACS stakeholders to improve performance. Understanding Provider Agency Systems and Structures APA and agencies engage in ongoing dialogue on performance improvement. It is critical that this dialogue, and any improvement strategies developed as a result, occur within the context of each agencys mission, organizational and staffing structure, service array, client characteristics, and current improvement plans or areas of focus. To ensure this, APA teams conduct learning visits to each agency to learn more about the organization on site. Analyzing Agency Scorecard Performance APA analyzes practice and outcome data collected for the annual Foster Care Scorecard to identify areas of strength and areas in need of improvement with each provider agency. To assess improvement or to fill gaps of information regarding key aspects of an agencys performance, APA conducts case record, site and data reviews to ensure that it has a holistic picture of agency performance across all programs. APA reviews are coordinated with the PAMS reviews to avoid duplication and are designed with direct input from the provider so that the review generates information that will direct its quality improvement efforts. Integration of Performance Information from System Participants and Stakeholders Feedback from key system participants, including ACS offices and other stakeholders, is utilized by APA to identify emerging practice trends, enrich ACS and the provider agencys understanding of the agencys performance, and inform improvement efforts. This anecdotal information is balanced against objective performance information. It is not scored, but APA will articulate, as appropriate, action to be taken to address issues that are identified from this information. Setting Expectations for Improvement Utilizing Scorecard information, APA reviews, and system feedback, APA sets expectations for improvement, or benchmarks, throughout the year for each provider agency. Benchmarks are set in the context of an agencys current performance, ACS standards, and system-wide performance. APA communicates these expectations along with a clear timeframe for improvement in writing and in performance meetings held with each provider. APA also describes how assessments of performance improvements will be done utilizing case record or performance data reviews as well as site assessments, etc. Development of Improvement Strategies and Plans APA engages in ongoing and consistent dialogue with each provider agency regarding performance improvements. Performance meetings are held whenever ACS sets new expectations for improvement and later to review an agencys success in meeting those expectations. As part of the meetings and during other regular conversations, APA works with agencies to develop specific improvement strategies and plans. In order to assist in the development of these strategies, APA brings the following to these meetings: Knowledge of the agency, services provided, client population, and its strengths and challenges Clarity about the types of technical assistance available from ACS as well as other sources Knowledge of the agencys performance data Knowledge of promising quality improvement techniques Information about promising practices at other agencies Commitment to help the agency explore creative and innovative strategies
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Commitment to the safety, permanency, and well being of the children and families we collectively serve

Advancing Issues Impacting Agency Performance APA is committed to learning about issues that impact on each provider agencys performance. Part of each performance meeting is dedicated to hearing from the provider agency about how APA can provide assistance, direct action and advocacy with other system participants and stakeholders. APA is committed to responding promptly regarding these requests. Furthermore, APA believes it is its responsibility to provide ACS divisions and critical partners throughout the child welfare system with feedback on the challenges experienced by provider agencies in order to inform ACS improvement efforts. APA also invites agencies to provide feedback about the quality of APAs assistance. In addition to encouraging verbal feedback in meetings, surveys are administered to learn about what aspects of the monitoring system are working and what is not. APA is committed to using its mistakes as opportunities to improve and enhance the impact it has on the performance of NYCs child welfare system. Monitoring Performance Improvements APA conducts assessments tailored to each agency to assess progress in meeting ACSs expectations for improvement. APA shares its method of assessment at the time expectations are set as well as specific timeframes for improvement. Methods of assessment include: Case record reviews Site assessments and interviews with staff, foster parents, and/or youth Administrative assessments of staffing, training and other organizational areas Review of outcomes data In addition to assessing progress in critical areas, APA conducts ongoing monitoring to identify emerging trends by: Conducting a site review of all agency sites on at least an annual basis Reviewing performance data on regular basis (monthly or quarterly depending on indicator) Reviewing regularly information provided by other ACS offices and system participants Utilization of Accountability Mechanisms While accountability mechanisms are not intended to be the primary drivers of agency improvements, APA utilizes these tools whenever performance is considerably or persistently poor. These tools include, but are not limited to corrective action status, probationary corrective action status, intake closure, denial of enhancement dollars and contract termination. Whenever APA intends to take such action, clear verbal and written direction is provided on expectations to resolve the issue and the consequences associated if improvement is not achieved.

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APPENDIX B Case Sampling Process


Proportion x (1-Proportion) x (Z statistic/Confidence Interval)2________ ((Proportion x (1-Proportion) x (Z statistic/Confidence Interval)2)/Census) +1

Proportion = 0.5 Z Value = 1.44 The Z Value is a calculation of the number of standard deviations from the mean to the value of interest. The Z value is an important component of the confidence interval. Using a z-value of 1.44 gives an 85% confidence in the statistical validity of the review. Confidence Interval = 0.1 The Confidence Interval gives an estimated range of values which is likely to include an unknown population parameter, the estimated range being calculated from a given set of sample data. Census = All cases pulled that were active for at least the first 5 months of the review period. Example of the Process: If on October 1st, there are 500 cases that have been active for at least the first 5 months of the review period (March 1st through August 31st) at Agency XYZ, then the sample size for Agency XZY will be 47.
____.5(1-.5)(1.44/.1)(1.44/.1)___ (.5(1-.5)(1.44/.1)(1.44/.1)/500)+1

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APPENDIX C PAMS Case Record Review Scoring


INDIVIDUAL PAMS QUESTIONS
Each scored question is assigned a total possible value of 1 point. However, not all questions are scored. The response for each question determines the point value earned. There are different types of responses and different values for each response. Response types and points values can differ within the same instrument and within the same practice area.

IMPORTANT: All point values, responses, and question logic for all the individual PAMS review questions is included in the FY13 Definitions document. Q# A3 Question Were these assessments based upon direct conversations with the child(ren), if developmentally appropriate? Responses Yes No Some But Not All Children N/A Scoring Yes = 1 point No = 0 points Some But Not All children = 0.5 point N/A = 0/0 points

IMPORTANT: An N/A response is scored differently than a No response. N/A means the question is not applicable to the case being reviewed. Because of this, the agency should not be penalized with a negative score. The question is dropped from cumulative scoring for the agency.

Some questions allow reviewers to select multiple answers but the value does not exceed 1 point total Q# Question Responses Scoring A21 Does the case record contain Yes, Parent/child country of origin Yes = 1 point information about the characteristics of Yes, Parent/child region of origin No = 0 points the familys cultural background, Yes, Parent/caretaker(s)s upbringing or childhood traditions, resources, or language? Multiple Yes Answers experiences Allowed Yes, Family support/resources Yes, Community support/resources Value of this question Yes, Parental disciplinary styles cannot exceed 1 point Yes, Language difficulties total. Yes, Literacy level within the family Yes, Racial, ethnic or nationality background Yes, Religion/Spirituality/Faith Yes, Religious observance/holidays/festivals/weddings Yes, Family adaptation/ adjustment Yes, Family dynamics/relationships Yes, Family values Yes, Cultural practices/traditions/beliefs Yes, Immigration status Yes, Displacement/loss of home Yes, Gender identity Yes, Sexual Orientation Yes, Health/mental health beliefs and healing practices/views of disability Yes, Experience(s) with discrimination or prejudice (sexism, ageism, racism, etc) Yes, Familys language Yes, Disability Yes, Other (Please explain) No

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CHILD ASSESSMENTS
Each child in the family composition must receive 2 types of assessments: an Initial Assessment and an Ongoing Assessment Each assessment is composed of 4 areas or domains: physical health, development/cognitive (education), emotional/psychological, and social/behavioral Initial and Ongoing Assessments are scored separately. The total value of each assessment is 1 point. o Each child is scored separately for each assessment o If a domain is answered YES then the child receives credit for the Initial Assessment o If a domain is answered ONGOING then the child receives credit for the Initial Assessment AND the Ongoing Assessment # of Domains Assessed 4 3 2 1 0 # of Points 1 0.75 0.5 0.25 0

CASEWORK CONTACT SCORING


General Preventive Casework Contacts Scoring
All contacts are assigned to the Safety practice area and the Casework Contacts index Only face to face contacts receive credit for Scorecard No extra credit is given for exceeding the number of required contacts

Scoring Calculation: # Total Contacts Made + # Home Contacts Made + # Children Seen + Diligent Efforts # Total Contacts Required + # of Total Home Contacts Required + # Children Required to be Seen

Points for # of Total Contacts Made


Includes both home contacts & any other type of made contact The requirement is 2 contacts per month (total of 12 contacts per review period) Points per Month 0 0.5 1 Points per Review Period 6 5 4 3

# Contacts per Month Cases with 0 monthly contacts receive no credit Cases with 1 monthly contact receive partial credit Cases with 2 monthly contacts receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD # Months Open Cases open for 6 months Cases open for 5 months Cases open for 4 months Cases open for 3 months

Points for # of Home Contacts Completed


Includes ONLY home contacts The requirement is dependent on History of CPS Indication and whether there is a newborn in the home Newborns are defined as children 6 months old and younger NO History of CPS indication: 1 home visit every 3 months (1 per quarter) IMPORTANT: The presence of a newborn in the home does not change the standard if there is no history of CPS Indication

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# Home Contacts per Month Cases with 0 home contacts during the month receive no credit Cases with 1 home contact during month receive partial credit Cases with 2 or more home contacts during the month receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD History of CPS indication: 1 home visit every month (6 contacts total during review period) # Home Contacts per Month Cases with 0 monthly home contacts receive no credit Cases with 1 monthly home contact receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD

Points per Month 0 3 6 6 Points per Month 0 1 6

History of or Current CPS indication AND a Newborn in the Home: 2 home visits every month (12 contacts per review period) # Home Contacts per Month Points per Month Cases with 0 monthly home contacts receive no credit 0 Cases with 1 monthly home contact receive partial credit 0.5 Cases with 2 monthly home contacts receive full credit 1 TOTAL POSSIBLE POINTS PER REVIEW PERIOD 6

Points for All Children Seen Every Month


All children included in the family composition for the review must be seen every month Points per Month 0 0.5 (1/2) 0.4 (2/5) 0.67 (4/6) 1 Points per Review Period 6 5 4 3 # of Children Seen per Month 0 children seen during the month receive no credit Cases with Some Children seen during the month receive partial credit 1 of 2 children seen during the month 2 of 5 children seen during the month 4 of 6 children seen during the month All children seen during the month receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD # Months Open Cases open for 6 months Cases open for 5 months Cases open for 4 months Cases open for 3 months

Family Treatment & Rehabilitation Casework Contacts


The required number of contacts is based on what Treatment Phase the case is in for the particular time period when the contact is made All contacts are assigned to the Safety practice area and the Casework Contacts index Only face to face contacts receive credit for Scorecard No extra credit is given for exceeding the number of required contacts

Scoring Calculation: # Total Contacts Made + # Home Contacts Made + # Children Seen + Diligent Efforts # Total Contacts Required + # of Total Home Contacts Required + # Children Required to be Seen

Points for Total # of FTR Contacts


Includes both home contacts & any other type of made contact The requirement depends on the Treatment phase for a particular time period

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Initial Phase: 2 contacts per week # Contacts per Week Cases with 0 weekly contacts receive no credit Cases with 1 weekly contact receive partial credit Cases with 2 or more weekly contacts receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD Baseline Phase: 1 contact per week Number of Contacts per Week Cases with 0 weekly contacts receive no credit Cases with 1 weekly contact receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD Stabilization Phase: 2 contacts per month Number of Contacts per Month Cases with 0 monthly contact receive no credit Cases with 1 monthly contact receive partial credit Cases with 2 or more monthly contacts receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD

Points per Week 0 0.5 1 1 Points per Week 0 0.5 1 Points per Month 0 0.5 1 1

Points for # of Home Contacts Completed


Includes ONLY home contacts Points per Week 0 1 1 Points per Month 0 0.5 1 1 Points per Month 0 0.5 1 1 Initial Phase: 1 contact per week # Home Contacts per Week Cases with 0 weekly home contacts Cases with 1 or more weekly home contacts TOTAL POSSIBLE POINTS PER REVIEW PERIOD Baseline Phase: 2 home contacts per month (no more than 3 months) # Home Contacts per Month Cases with 0 monthly home contacts receive no credit Cases with 1 monthly home contacts receive partial credit Cases with 2 monthly home contacts receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD Stabilization Phase: 2 home contacts per month (no more than 3 months) # Home Contacts per Month Cases with 0 monthly home contacts receive no credit Cases with 1 monthly home contacts receive partial credit Cases with 2 monthly home contacts receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD

Points for All Children Seen Every Month


All children included in the family composition for the review must be seen every month The requirement depends on the Treatment phase for a particular time period Points per Week 0 0.5 (1/2) 0.4 (2/5) 0.67 (4/6) 1 1

Initial Phase: All children must be seen each week # Children Seen per Week 0 children seen during the week receive no credit Cases with Some Children seen during the month receive partial credit 1 of 2 children seen during the week 2 of 5 children seen during the week 4 of 6 children seen during the week All children seen during the week receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD

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Baseline or Stabilization Phase: All children must be seen every month # of Children Seen per Month 0 children seen during the month receive no credit Cases with Some Children seen during the month receive partial credit 1 of 2 children seen during the month 2 of 5 children seen during the month 4 of 6 children seen during the month All children seen during the month receive full credit TOTAL POSSIBLE POINTS PER REVIEW PERIOD

Points per Month 0 0.5 (1/2) 0.4 (2/5) 0.67 (4/6) 1 1

Diligent Efforts or Attempted Contacts for BOTH GP and FTR Cases


Agencies receive partial credit if the required number of monthly contacts is not met and diligent efforts were made by the agency to reach the child or family. Diligent efforts only receive credit for 2 consecutive months during the review period. There can be more than 1 period of diligent efforts during a review period. Only Face to Face attempts count toward PPRS diligent efforts Agencies must record that at least 2 attempts were made at different times of day Credit will be awarded for the following locations: Home Other Another Agencys Office Biological Parents Home Foster Home Daycare Hospital Prison School Shelter Credit will not be given for the following locations: Office ACS Borough Office # Attempts 2 or More Method Face to Face Location Home Park Relatives Home Library Restaurant Store Court Time At least 2 different times of day Point per Month 0.25

Pro-Rating Required Contacts for BOTH GP and FTR Cases


Starting in FY13, contacts will be pro-rated for the All Children Seen requirement Reviewers cannot pro-rate to require more contacts or visits than the minimum standard. Contacts are pro-rated by child for the following case specific situations: Vacation Camp Hospitalization Incarceration Other (as appropriate)

Reasons for pro-ration must be clearly documented in the Connections progress notes in order for an agency to receive credit

PRACTICE AREA AND INDEX WEIGHING


All questions have both a practice area and index assigned which determines what bucket the individual questions are scored in Productivity is a data measures only practice area and does not impact the PAMS scoring In FY13, Family Treatment and Rehabilitation Programs and General Preventive Programs will be scored separately. Medically Fragile, Intensive Preventive, JJI and Family Assessment programs will be included in the General Preventive Programs Scorecard.

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Practice Area Safety

Assessment

Engagement

Services

Productivity

Weight 30% 10% 20% 40% 20% 20% 10% 10% 20% 10% 10% 50% 20% 20% 10% 40% 20% 20% 10% 10% 25% (33% for MF) 25% (33% for MF) 25% (0% for MF) 25% (33% for MF)

Index Immediate/Impending Child Safety Concerns Ongoing Casework Specific to Safety Case Events/Circumstances Specific to Safety Casework Contacts Child(ren) Assessment Parent (Caretaker)-child Interaction Assessment Family Functioning Assessment Assessment of Home Conditions/Environment and Resources Ongoing Assessments Supervisory Assessment Cultural Competence Efforts to Engage the Family Strategies for Engagement Family Team Conferencing Cultural Competence Risk Ongoing Casework Specific to Risk Case Events/Circumstances Specific to Risk Family Involvement Cultural Competence Time to Disposition Utilization Length of Service Family Team Conference

Because not all questions apply to every case, a case may have an entire index that is not applicable. If an index is not applicable the above weighting is redistributed as follows: Safety Indicator Weight Index 40% Immediate/Impending Child Safety Concerns Safety Ongoing Casework Specific to Safety NA (Ongoing Casework Specific To Safety Is Not 20% Case Events/Circumstances Specific to Safety Applicable) 40% Casework Contacts 40% Immediate/Impending Child Safety Concerns Safety 10% Ongoing Casework Specific to Safety (Case Events/Circumstances Specific To Safety Is Not NA Case Events/Circumstances Specific to Safety Applicable) 50% Casework Contacts 50% Immediate/Impending Child Safety Concerns Safety NA Ongoing Casework Specific to Safety (Ongoing Casework & Case Events/Circumstances NA Case Events/Circumstances Specific to Safety Specific To Safety Is Not Applicable) 50% Casework Contacts Engagement Indicator Engagement (FTC Measure Is Not Applicable) Weight 70% 20% NA 10% Weight 50% 20% NA 20% 10% Index Efforts to Engage the Family Strategies for Engagement Family Team Conferencing Cultural Competence Index Risk Ongoing Casework Specific to Risk Case Events/Circumstances Specific to Risk Family Involvement Cultural Competence

Services Indicator Services (Case Events/Circumstances Specific To Risk Is Not Applicable)

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Case Scores
A score is calculated by individual case for each of the practice areas and indices: Safety, Assessment, Engagement, and Services Each index is based on one or more case record review questions If there are questions or whole measures that do not apply in a particular case, the case score will be based only on the remaining measures that do apply All the applicable questions for each case reviewed are combined in 1 bucket to determine the case score All points EARNED Immediate or Impending Child Safety Concerns All points POSSIBLE Immediate or Impending Child Safety Concerns 7 Points EARNED / 9 Points POSSIBLE = 78% Case Score Case Score for Immediate or Impending Child Safety Concerns Index 1) Is a FASP available during the 6 month review period? 2) Is the safety assessment in the most recent FASP consistent with the case circumstances? 3) Was the safety decision recorded in the most recent FASP consistent with the case circumstances? 4) Was the safety factor explored sufficiently at the time to provide enough information to complete a thorough safety assessment? 5) Were the controlling interventions provided by the case planner implemented without delay upon identification of the safety factor(s)? 6) Was there a safety plan to address the safety factor(s)? 7) If yes, is the safety plan consistent with the case circumstances specific to the safety factor(s)? 8) Did the case planner provide immediate intensive casework counseling specific to the safety factor(s) that placed the child(ren) in immediate or impending danger of serious harm? 9) Did the case planner assess the parent/caretaker(s) understanding of how his/her behavior placed the child(ren) in immediate/impending danger of serious harm? Total Points Earned Total Points Possible Score Response & Points Yes = 1 point Yes = 1 point Yes = 1 point Yes = 1 point Yes = 1 point Yes = 1 point Yes = 1 point No = 0 points No = 0 points 7 9 78% (7/9)

Practice Area Scores


Practice Area scores are determined by averaging the weighted case scores Case scores are weighted according to the index weight within each practice area Case scores are capped at 100% (case 4)

Safety Practice Area and Indices Immediate/ Impending Child Safety Case Concerns Case 1 88% Case 2 100% Case 3 95% Case 4 100% Case 5 100% Agency Safety Score

Index Weight 30% 40% 30% 40% 40%

Ongoing Casework Specific to Safety 100% N/A 50% 100% N/A

Index Weight 10% 0% 10% 10% 0%

Case Events or Circumstances Specific to Safety 100% 67% NA 78% 100%

Index Weight 20% 20% 0% 20% 20%

Casework Contacts 82% 95% 82% 96% 86%

Index Weight 40% 40% 50% 50% 40%

Case Score 89% 91% 75% 100% 94% 90%

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In Case 1, the following calculation would be done to determine the case level indicator score. (87.50% x 30%) + (100.00% x 10%) + (100.00% x 20%) + (82.03% x 40%) = 89% In Case 3, the Case Events or Circumstances Specific to Safety index is Not Applicable so the remaining indices are re-weighted. (95.00% x 30%) + (50.00% x 10%) + (82.33% x 50%) = 75% All the case level indicator scores are averaged to determine the agencys score for the Safety practice area. (89% + 91% + 75% + 113% + 94%) / 5 cases = 93%

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APPENDIX D Cultural Competence Examples


Question A21: Does the case record contain information about the characteristics of the familys cultural background, traditions, resources, or language? The following is an example of documentation in the Connections progress note that would receive credit for this question: The FASP stated, the mother is African American, the father is Caucasian. The father and mother reside together but are not in a romantic relationship. Mr. G is the father of Christopher (10) but not the father of Marie (15). All are US citizens, and are all Catholics. On 9/23/10 worker reported that Mr. G identifies himself as an Italian American. He was born and raised in Brooklyn NY. Ms. H identifies herself as an African American who was born and raised in Alabama and came to live in New York City when she was an adolescent. Christopher is half Italian and African American and Marie is half African American and Hispanic. Both children were born and raised in New York. Question A23: Did the case planner use his/her knowledge of the familys cultural practices, background, beliefs (relating to parenting) and resources (e.g., religious leaders, community groups, etc) to aid in developing an appropriate assessment of the familys needs/problems/concerns? An example of an acceptable progress note entry is as follows: Case planner asked Ms. J if she thought her experiences growing up in a single-parent household influenced her parenting style or approach to discipline. Ms. J stated that where she comes from and how she grew up, kids did as they were told, no questions asked. She acknowledged being somewhat harsh in her approach to discipline but stated that she was open to learning how to improve communication with her children. Ms. J also stated that she feels isolated at times and does not receive a lot of emotional support from family members. Case planner will work with Ms. J on a parenting approach that will allow both her and the childrens feelings and opinions to be expressed in a respectful way and case planner will work with Ms J in identifying other resources that could provide emotional support for her. Question RS23a: If yes, did the agency make efforts to provide services that support/connect to the familys cultural background, traditions or beliefs? The following is an example of an acceptable progress note that describes the case planners discussion with her client: Ms. J stated that she and her children have been having a difficult time since relocating to Brooklyn. Her mother and three sisters live in the Bronx and she expressed feeling alone and isolated as she has lost connection with her family, community, and church. Case planner asked Ms. J what her religious affiliation was and offered to provide her with a list of churches in her community. She also talked to Ms. J about ways in which she could stay connected with her family, including visiting the Bronx when possible. Case planner suggested that Ms. Js mother and sisters join their next meeting so that they could discuss ways in which the family could continue to support her and her children, despite the fact that she has moved away.

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APPENDIX E PAMS Preventive Alert Forms


PAMS PREVENTIVE SERVICE SAFETY ALERT/CLOSED CASE CONCERNS
Provider Agency: Program Name/Site: Agency Case Planner: (First name, Last) CWS: X Active: Closed: Date Case Closed: Primary Birth Parent/Caregiver Name: (First name, Last) Case Name: (First name, Last) Reviewer: Manager: APA Supervisor: FTC Held During 6-month Review Period: Yes BP/Caregiver DOB: CNNX ID#: Reviewer Telephone #: Managers Telephone #: APA Sup Telephone #: No WMS/ACS #: ADVPO: Date Agency Notified: Date Alert Submitted:

Preventive Service Program Type


Family Treatment Rehabilitation (FTR) Beacon General Preventive (GP) Intensive Preventive Aftercare Program (IPAP) Deaf and Hearing Impaired Medically Fragile
Juvenile Justice Initiative (JJI) Family Assessment Program (FAP)

Documents/source(s) of concern
Concern identified in progress notes Concern identified in other case document Concern identified in both progress note and other case document Concern identified through discussion/interview with staff and/or stakeholder

Critical case status information


Currently under SCR investigation Child/ren currently on Trial Discharge from foster care Family has foster care history Immediate Safety Concern: Definition and subcategories on page 2. Circumstances of Immediate Safety Concern on page 3. Please be advised that a follow up phone interview may be conducted with client stakeholders to confirm the timely occurrence of face to face contact and that the identified issue has been adequately addressed/resolved.

Immediate Safety Concern


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Definition: An Immediate Safety Concern Alert is generated when the reviewer 1) cannot determine the current safety of the child(ren) due to a lack of substantive or consecutive contacts with the child(ren) that continues through the current date and/or; 2) identifies an issue in the case record, or through interviews conducted, that poses an immediate safety concern with no controlling intervention, i.e. there is immediate or impending danger of serious harm to a child(ren)s life or health, or substantial threat of injury. Each of the Immediate Safety Concern Subcategories below are directly related to the Immediate or Impending Child Safety Concerns and the Case Events or Circumstances that Require Action from the PAMS Case Record Review. The Immediate or Impending Child Safety Concerns are based on the OCFS Revised Safety Factors specific to the FASP and the Case Events or Circumstances that Require Action are based on significant events and/or circumstances identified in a large percent of cases read during the Year 1 Preventive PAMS review. These events/circumstances lead to the issuing of a safety alert when case planners did not conduct thorough assessments to determine the need for the appropriate action to mitigate the circumstances. Expected Action for Active Cases: ACS will notify the agency about the issuance of an alert(s). Upon receipt of such an alert, the agency is expected to: 1. immediately develop a safety plan and intervene with the family to resolve the current safety issue; 2) communicate with the APA supervisor acknowledging receipt of the alert within 48 hours. APA will review the plan, actions taken and communicate with the provider in regard to the appropriateness and correspondence of the action(s) taken to address the identified concern. Documentation of CWS cases: documentation of all outreach, the safety plan, assessments, and interventions with the family is to be made in Connections within 2 business days of the alert. Documentation of ADVPO cases: documentation of all outreach, the safety plan, assessments, and interventions with the family is to be made on progress note template and filed in the hard copy case record within 2 business days of the alert. Documentation of outreach: For both CWS and ADVPO cases, all contacts and/or attempted contacts should be entered in PROMIS within 2 business days of the alert and continued thereafter until the identified issue is addressed/resolved. APA will monitor both Connections and PROMIS systems for appropriate documentation. For ADVPO cases, APA will either: 1. Return to the agency within a prescribed timeframe to review the progress note documentation in the hard copy case record or; 2. Confirm actions by telephone with the Program Director. As APA cannot view case activities via Connections for ADVPO cases, if the provider assesses that the identified risk poses an immediate safety concern that cannot be addressed in necessary timeframes to ensure child safety, the provider should communicate with APA, FSS, or the appropriate ACS division. In all cases, if there is suspicion that a child is at imminent risk of abuse/neglect or maltreatment the provider agency is mandated to contact the SCR. A discussion on the alerts will be included in the PAMS exit conference. Expected Action for Closed Cases: The purpose of issuing a Closed Case Concern is to notify agencies of closed cases that, had they been open, would have received an alert. These concerns are issued based on unattended safety issues that warranted action(s) prior to case closure and there was no appropriate action(s) taken. These cases may be used by APA and OPTA as a learning tool or as a vehicle for technical assistance for future case closing decisions. Because these cases are closed, Children Services expects your agency staff to review their action(s) and decisions and take steps to ensure the safety and well being of the children and families in these cases as well as work closely with APA and OPTA to develop strategies to improve your agencys practice and decisions in closing cases.

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Immediate Safety Concern Subcategories 1. Safety of family/and or child is unknown because case planner/agency has not conducted regular and
ongoing face-to-face contact for an extended amount of time [CE9, CE10]* 2. Current physical health and/or mental health related circumstances within the family (either on behalf of the child(ren) and/or caretaker(s)) places child(ren) in immediate or impending danger and case planner/agency has not provided appropriate action(s) or intervention(s) [CE8, SF5, SF16] 3. The familys physical home environment (or lack of), living conditions, or financial resources places child(ren) in immediate or impending danger and case planner/agency has not provided appropriate action(s) or intervention(s) [CE2, CE1, SF13] 4. Child(ren) currently needs an alternate form of care or substitute caregiver(s) and case planner/agency has not provided appropriate action(s) or intervention(s) [CE3, CE4, CE5] 5. Known adult perpetrator of abuse or neglect to the child(ren), is residing in the child(ren)s home and case planner/agency has not provided appropriate action(s) [CE7] 6. Child(ren)s whereabouts cannot be ascertained and/or there is reason to believe family is about to flee and the case planner/agency has not provided appropriate action(s) or intervention(s) [SF11] 7. Criminal activity occurring in the home and/or weapon found in the home and caregiver(s) is not providing adequate protection for the child and case planner/agency has not provided appropriate action(s) or intervention(s) [SF17, SF18] 8. Child(ren) has a positive toxicology for drugs and/or alcohol and the case planner/agency has not provided appropriate intervention(s) [SF15] 9. Caretaker(s)s substance abuse (either alcohol, illegal drugs or prescription medication) places child in immediate and impending danger (e.g. negatively impacts his/her ability to supervise, protect, and/or care for the child(ren)) and the case planner/agency has not provided appropriate action(s) or intervention(s) [SF2, SF3] 10. There is evidence or suspicion of child(ren) being physically and/or sexually abused and the case planner/agency has not provided appropriate action(s) or intervention(s) [CE6, SF9, SF12, SF14] 11. Caretaker(s) is not providing adequate care, protection and supervision of child(ren) to the degree that it places child(ren) in immediate or impending danger and the case planner/agency has not provided appropriate action(s) or intervention(s) [SF1, SF7, SF8, SF10] 12. Parent(s)/Caretaker(s) has a recent history of violence and/or is currently violent and out of control the case planner/agency has not provided appropriate intervention(s) [SF6] 13. Other (Describe in detail)

*Required information for Alert #1 [CE11] : Safety of family/and or child is unknown because case planner/agency has not conducted regular and ongoing face-to-face contact for an extended amount of time. Please list all children in the family, and for each child enter the date the child was last seen and the number of times seen during the review period. Child(ren) in Family Household Dates of Contact During PAMS Review Period

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Required information for all alerts: Circumstances of Immediate Safety /Closed Case Concern PAMS Review Period: 1. Safety Concern Subcategory: 2. Family Composition: 3. Reason for PPRS involvement and relevant background information : 4. Attended safety and risk issues/interventions. . 5. Unattended Safety Issues and Rationale for Alert(s)/Closed Case Concern(s): 6.Reason for Case Closure (Closed Cases only): 7. Additional Information (Optional) Agency Response on Closed Case Only:

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PAMS PREVENTIVE SERVICE SERIOUS RISK ALERT/CLOSED CASE CONCERNS

Provider Agency: Program Name/Site: Agency Case Planner: (First name, Last) CWS: Active: ADVPO: Closed: Date Agency Notified: Date Case Closed: Date Alert Submitted:
BP/Caregiver DOB:

Primary Birth Parent/Caregiver Name: (First name, Last)

Case Name: (First name, Last) Reviewer: Manager: APA Supervisor: FTC Held During 6-month Review Period:

CNNX ID#: WMS/ACS #: Reviewer Telephone #: Managers Telephone #: APA Sup Telephone #:

Yes

No

Preventive Service Program Type


Family Treatment Rehabilitation (FTR) Beacon General Preventive (GP) Intensive Preventive Aftercare Program (IPAP) Deaf and Hearing Impaired Medically Fragile
Juvenile Justice Initiative (JJI) Family Assessment Program (FAP)

Documents/source(s) of concern
Concern identified in progress notes Concern identified in other case document Concern identified in both progress note and other case document Concern identified through discussion/interview with staff and/or stakeholder

Critical case status information


Currently under SCR investigation Child/ren currently on Trial Discharge from foster care Family has foster care history

Immediate Serious Risk Concern: Definition and subcategories on page 2. Circumstances of Serious Risk Concern on page 3.
Please be advised that a follow up phone interview may be conducted with client stakeholders to confirm the timely occurrence of face to face contact and that the identified issue has been adequately addressed/resolved.

Immediate Serious Risk Concern


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Definition: A Serious Risk Case Concern alert is generated when the reviewer observes through any aspect of his/her review, behaviors or circumstances or underlying conditions present that may place a child(ren) at risk (or likelihood) of future abuse or maltreatment, and the documentation does not suggest that the agency, birth parent/caregiver or community resource acted effectively to minimize that risk. Each of the Serious Risk Concern Subcategories below is directly related to the Services to Address Risk and the Case Events or Circumstances that Threaten Child Well-being and Require Action from the PAMS Case Record Review. The Services to Address Risk are based on the OCFS Risk Assessment Profile specific to the FASP and the Case Events or Circumstances that Threaten Child Well-being and Require Action are based on significant events and/or circumstances identified in a large percent of cases read during the Year 1 Preventive PAMS review. These events/circumstances lead to the issuing of a risk alert when case planners did not conduct thorough assessments or taking action to address the circumstances. Expected Action for Active Cases: ACS will notify the agency about the issuance of an alert(s). Upon receipt of such an alert, the agency is expected to: 1) immediately develop a safety plan and intervene to minimize the risk to the child(ren); 2) assess any other potential risks; 3) communicate with the APA supervisor acknowledging receipt of the alert within 48 hours. APA will review the plan and the action(s) taken, and communicate with the provider in regards to the appropriateness of the action(s) taken to address the identified concern. Documentation of CWS cases: documentation of all outreach, assessments, safety plan and actions taken by the provider with the family is to be made in Connections within 2 business days of the alert. Documentation of ADVPO cases: documentation of all outreach, assessments, safety plan and actions taken by the provider with the family is to be made on progress note template and filed in the hard copy case record within 2 business days of the alert. Documentation of outreach: For both CWS and ADVPO cases, all contacts and/or attempted contacts should be entered in PROMIS within 2 business days of the alert and continued thereafter until the risk to the child(ren) is eliminated/minimized. APA will monitor both Connections and PROMIS systems for appropriate documentation. For ADVPO cases, APA will either 1. Return to the agency within a prescribed timeframe to review the progress note documentation in the hard copy case record or; 2. Confirm actions by telephone with the Program Director. As APA cannot view case activities via Connections for ADVPO cases, if the provider assesses that the identified risk poses an immediate safety concern that cannot be addressed in necessary timeframes to ensure child safety, the provider should communicate with APA, FSS, or the appropriate ACS division. In all cases, if there is suspicion that a child is at imminent risk of abuse/neglect or maltreatment the provider agency is mandated to contact the SCR. A discussion on the alerts will be included in the PAMS exit conference. Expected Action for Closed Cases: The purpose of issuing a Closed Case Concern is to notify agencies of closed cases that, had they been open, would have received an alert. These concerns are issued based on unattended Serious Risk issues that warranted action(s) prior to case closure and there was no appropriate action(s) taken. These cases may be used by APA and OPTA as a learning tool or as a vehicle for technical assistance for future case closing decisions. Because these cases are closed, Children Services expects your agency staff to review their action(s) and decisions and take steps to ensure the well being of the children and families in these cases as well as work closely with APA and OPTA to develop strategies to improve your agencys practice and decisions in closing cases.

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Serious Risk Concern Subcategories


1. Adults in the home (either caretaker or other adult(s)) involved in ongoing risk taking behaviors (criminal activity and/or substance abuse) places child(ren) at risk of future abuse or maltreatment and case planner/agency has not provided appropriate action(s) or intervention(s) [CE10, R8] 2. Child/Youth involved in risk taking behaviors (i.e. gang activity, substance abuse, practicing unsafe sex, criminal activity, truancy, etc) and case planner/agency has not provided appropriate action(s) or intervention(s) [CE6, CE9, CE12, CE13] 3. The familys physical home environment, living conditions, and/or financial resources places child(ren) at risk of future injury or harm and case planner/agency has not provided appropriate action(s) or intervention(s) [CE1, R4, R5]

4. Current cognitive skills (caretaker) and/or physical health and/or mental health related circumstances within the family (either on behalf of the child(ren) and/or caretaker(s)) places child(ren) at risk of future abuse or maltreatment and case planner/agency has not provided appropriate action(s) or intervention(s) [CE2, CE7, CE8, R9, R10, R11]
5. Case planner/agencys inconsistent contact with the family places child(ren) at risk of future abuse and/or maltreatment.. [CE15] 6. Case planner/agencys poor follow up around services places child(ren) at risk of future abuse and/or maltreatment. [CE14] 7. Ongoing negative/detrimental family dynamics and/or interactions (unrelated to physical abuse and/or sexual abuse) places child(ren) at risk of future abuse or maltreatment and case planner/agency has not provided appropriate action(s) or intervention(s) [CE3, CE11, R6, R7, R12, R13, R14] 8. Child(ren) in the referred familys household has experienced or is likely to experience physical and/or xual abuse and case planner/agency has not provided appropriate action(s) or intervention(s). [ER4, ER5, RER6, ER7] 9. Death of a child as a result of abuse or maltreatment by the caretaker(s) and case planner/agency has not provided appropriate intervention(s). [ER1] 10. Newborn child has positive toxicology for alcohol or drugs case planner/agency has not provided appropriate intervention(s) [ER8] 11. Non-Compliance of court mandated services and case planner/agency has not provided appropriate action(s) [CE4]

12. Other adults frequenting or residing in the home and case planner has not conducted appropriate assessment [CE5] 13. Duplicated/repeated information in progress notes; cutting and pasting of complete or partial notes within the case by a particular worker or worker creates doubts as to the authenticity of the event/s. 14. Other: (Describe in detail)

*Required information for Alert #5 [CE15] : Serious Risk of family/and or child is unknown because case planner/agency has not conducted regular and ongoing face-to-face contact for an extended amount of time. Please list all children in the family, and for each child enter the date the child was last seen and the number of times seen during the review period. Child(ren) in Family Household Dates of Contact During PAMS Review Period

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Required information for all alerts: Circumstances of Immediate Serious Risk /Closed Case Concern PAMS Review Period: 1. Risk Concern Subcategory: 2. Family Composition: 3. Reason for PPRS involvement: 4. Attended risk issues/interventions: . 5. Unattended Risk issues and Rationale for Alert(s)/Closed Case Concern(s): 6. Reason for Case Closure (Closed Cases only): 7. Additional Information (Optional) Agency Response on Closed Case Only:

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PAMS PREVENTIVE SERVICE TREND ALERT OPEN AND CLOSED CASES

Provider Agency: Program Name/Site: Date Agency Notified: Manager: APA Supervisor: Date Alert Submitted: Managers Telephone #: APA Sup Telephone #:

Preventive Service Program Type


Family Treatment Rehabilitation (FTR) Beacon General Preventive (GP) Intensive Preventive Aftercare Program (IPAP) Deaf and Hearing Impaired Medically Fragile
Juvenile Justice Initiative (JJI) Family Assessment Program (FAP)

Documents/source(s) of concern
Concern identified in progress notes Concern identified in other case document Concern identified in both progress note and other case document Concern identified through discussion/interview with staff and/or stakeholder

Trend Alert
Definition: A Trend alert is generated when the PAMS review team observes through any aspect of the review patterns in documentation of progress notes/FASPS across several cases in all or some preventive programs that bring into question the integrity of the events, reflects substantial gaps between entry date and event date of progress notes in the system of record and contradiction of information. This alert is intended to apprise preventive agencies of documentation patterns that appear in the case sample. Although these issues will not place children at risk they reflect case practice that requires attention and corrective action plans. The Subcategories below represents some of the issues identified during the first three years of the PAMS review. Expected Action: ACS will notify the agency about the issuance of the alert. Upon receipt of such an alert, the agency is expected to: 1) develop a corrective action plan to address the documentation issue identified. 2) Communicate with the APA supervisor acknowledging receipt of the alert within 48 hours. APA will review the plan and the action(s) taken, and communicate with the provider in regards to the appropriateness of the action(s) taken to address the identified concern. A discussion on the alert will be included in the PAMS exit conference.

Subcategories
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1. Substantial delay between event date and entry date of progress notes 2. Duplicated/repeated information in FASP

3. Duplicated/repeated information in progress notes; cutting and pasting of complete or partial notes within the case by a particular worker or worker creates doubts as to the authenticity of the event/s. 4. Other: (Describe in detail)

Required information for all alerts: Circumstances of Trend Alert PAMS Review Period: 1. Risk Concern Subcategory: 2. Explanation of current trends across CWS and ADVPO cases . 3. Rationale for Alert(s) OR Rationale for Closed Case Concern(s): 4. Additional Information (Optional)

Agency Response

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