7.5.1  Pre-Referral

Referrals for IIS originate from many sources.  While the majority of referrals come from The Children’s Division (CD), others come for The Department of Mental Health, The Division of Youth Services, the juvenile office, and other community resources such as practitioners, hospitals, and schools.  Self-referrals are also received from families experiencing a crisis.  The Children’s Division staff are responsible for assessing the appropriateness of referrals for IIS if recommendation has been made for out-of-home placement of children.  When it has been determined that IIS is the most appropriate service for a family (in those circumstances) the family is referred for services.

A preliminary screening is required in all cases when a Children’s Service Worker plans to recommend the removal of a child(ren) except in the following situations:

• When a child(ren)cannot be adequately protected during the referral and assessment process and must be removed on an emergency basis; or
• When all caregivers have indicated that they will not cooperate with IIS.

The preliminary screening is defined as a conference between the Children’s Service Worker and Supervisor to determine if the case is appropriate to refer for Intensive In-Home Services.

7.5.2  Referral

All families referred for IIS are received on first-come, first-serve basis.  At the referral phase, families that do not meet the referral criteria or in instances where specialists have no available openings (IIS specialists provide services to only two families at a time), families are not accepted for services.  Waiting lists are not maintained for IIS referrals based on the rationale that responding to an immediate crisis can not be postponed to a later date.  When a family is not accepted into IIS, out-of-home placement may occur.

7.5.3  Screening

Screenings occur within twenty-four (24) hours of receipt of a referral. A screening is an opportunity for specialists to meet face-to-face with the family, assess the initial criteria, and explain the service to the family.  Specialist should be flexible enough to respond to the referral within an hour if the family’s presenting problems or safety needs indicate such a need. If possible, the referral agent accompanies the specialist during the initial screening visit.  At this first meeting, specialists are responsible for developing, with the family, a plan for safety.

7.5.4  Assessment

Once it has been determined that IIS is appropriate for the family, the assessment phase is initiated.  This phase refers to an identified period where information is gathered with the family to assist in understanding family functioning and existing factors that place the child(ren) at risk.  If at any time during the intervention it is determined that it is no longer reasonably safe for the child(ren) to remain in the home, a recommendation for immediate removal of the child(ren) is made.

7.5.5  Service Plan/Treatment Plan

Service plans guide the course of the IIS intervention.  The focus of service planning is the development of solutions that will remove the risks placing the child(ren) in jeopardy of out-of-home placement.  Also, issues that are indirectly related to the child(ren) being at risk of placement are addressed in the family service plan.  For example, a father who is unemployed may physically abuse his child, in part, due to the stress experienced by unemployment.  Therefore, a goal of his treatment plan may address employment.  Family members are strongly encouraged to be active participants in the service planning process.  Family Support Team Meetings (FSTM) are a mechanism used in the service planning.

Related Subject:  Section 4, Chapter7.2  Family Support Team Meetings

7.5.6  Service Delivery

After the needs of the family are established, the specialist delivers services uniquely designed to address the needs identified.  Service delivery is psycho-educational in orientation, providing necessary information and skill-building opportunities for family members.  Specialists teach families problem-solving and other life skills, focusing on assisting in crisis management and the specific issues placing the child at risk of removal from the home.  Depending on the needs of the family, the specialist may also provide concrete services and assist the family in establishing linkages with formal and informal community services.

7.5.7  Follow-up/Aftercare

Follow-up is a process that begins at referral.  A follow-up plan is established prior to the termination if the IIS intervention.  Follow-up focuses on assisting families in maintaining the benefits of the IIS intervention and addressing issues that were not addressed during the intervention due to specific time frames and prioritization.  At this phase, IIS specialists clearly communicate recommendations (a written plan is preferred) for continued services for the family.

7.5.8  Termination

Planning for this phase begins early during the intervention. On-going progress assessment throughout the intervention provides a basis for determining a family’s readiness for IIS termination.  When the goals outlined in the service plan have been accomplished and safety issues for the family have been decreased to eliminate risk of placement for the child(ren), termination of IIS may occur with the family remaining intact.