4.1.12  Determining the Level of Intervention

Assess level of risk to the child.  In a large part, the level of intervention will be determined based on the degree of risk to the child.  Complete the risk assessment portion of the CPS-1 within 30 days of the CA/N report date.

• Carefully review the factors related to the family.
• Determine the overall level of risk and summarize supporting observations.

Related Subject:  Section 2 Chapter 9.4, Assessment of Risk

Removal of a child may be necessary in those situations where the child is in danger of future life threatening abuse/neglect.  However, in the vast majority of cases, services may be provided to rectify the problems, which contributed to the investigative conclusion and prevent future abuse/neglect.

• All cases which are found by a “preponderance of evidence” that physical abuse or neglect exists will be opened for Family-Centered Services unless the victim is otherwise protected from future abuse/neglect.
• “Unsubstantiated" cases will be closed unless the family requests services to improve family functioning and such services are available through the Division or community resources.
• Case opening and services are voluntary for those families where the worker has concluded a report to be "Unsubstantiated-Preventive Services Indicated."  However, as the worker has identified indicators that could contribute to potential abuse/neglect, an effort should be made to encourage the family to accept services by:
  • Asking the family to give their perceptions of problems they may be experiencing and possible solutions;
  • Advising the family of problems which the worker identified during the investigative process;
  • Advising the family of services available through the Division and community resources which will help to alleviate the stated problems;
  • Offering to refer the family for preventive services or community services;
  • Offer them time to reconsider and contact you at a later date if the family is hesitant to accept or resistive to services.

The worker should thoroughly document in the case record, the family's response to an offer of services and the basis for the decision to open/close the case.

Structured decision making guidelines regarding opening or closing a case, based on risk assessment level, should be adhered to. Any time a decision is made to close a case, the reason must be documented in the record narrative, and a supervisor must sign the narrative to approve the case closing.  The documentation should leave a reader with no doubt as to the thinking that went into the decision.

Related Form and Instructions:  CPS-1 and CPS-1 Instructions

4.1.12.1   Ex-Parte Issues

When a circuit court or client contacts the county office regarding the issuance of an ex parte order of protection:

• Assess the need for direct and/or purchased services;
• Determine if purchased services are available;
• Immediately, verbally inform the court that the Division commits to providing appropriate services, indicating limitations;
• Provide the court with a written statement of commitment within five (5) working days from the commitment.

4.1.12.2  Community Involvement

This approach will promote the safety of children and the integrity and preservation of the family.  Community agencies/individuals and the Division are to collaborate in providing support, assistance, and services to children and families.  This collaboration is to result in the identification of comprehensive local services and to assure access to those services for children and families where there is a risk of abuse or neglect.  This collaboration of interdisciplinary team members will involve local law enforcement in conducting investigations.  Other interdisciplinary team members could include the juvenile court, city/county health department, etc.

Multidisciplinary service teams are composed of a variety of local resources that work together in providing treatment services.  Law enforcement, juvenile officers and school personnel are examples of multidisciplinary team members.  The public school district liaison (or principal of a private school) is considered a member of both the interdisciplinary investigation team and multidisciplinary service team.  The Division will initiate contact with the school district liaison when a report is received by the Division in which the victim(s) is enrolled in that school district.  Ongoing communication between CD staff and the school liaison will facilitate the sharing of information to enhance services provided to children and their families.

Each county should have a comprehensive and current list of available resources in order to initiate treatment services for families within 48 hours of service need identification.  Each county should consider developing written agreements, describing procedures for accessing and delivering services, with agencies/individuals utilized on a regular basis.

Each county should have procedures in place to address:

• Process for making referrals for services;
• Plan for following up with community resource to determine if services are appropriate and are meeting the family’s needs; and
• Plan to ensure information is shared with the appropriate school district liaison, including the status of the report upon completion, when the victim(s) of the report is enrolled in the school district.

4.1.12.3  Referral to Early Childhood Intervention

In all instances that a “preponderance of evidence” determination is made regarding a child victim less than three (3) years old, a referral will be made to the Department of Elementary and Secondary Education (DESE) First Steps Program pursuant to the federal mandate of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 et seq.), who provides early intervention services funded under part C of the Individuals with Disabilities Education Act.  The CD-21C (First Steps Cover Letter) with attached Missouri First Steps Early Intervention System Referral Form shall be used for this purpose.

Related Subject:  CD-21C and Forms Instructions.

The referring worker shall remain available for continued collaboration with the First Steps provider as necessary in order to facilitate the screening process to assist in leading to an adequate level of care for the child.

NOTE:  Staff should be sure to complete form SS-6, Release of Information, as required, in order to continue communications with the First Steps provider.  If the parent/legal guardian refuses to sign the release, the CSW should document the refusal in the case record.  If the worker is subsequently contacted by First Steps, the worker shall inform the First Steps staff person that an authorized release was not obtained, and discontinue any further communication.