10.4 Development of the Case Plan/Written Service Agreement for Reunification
The language in the Written Service Agreement shall be clear and understandable to the family. Expectations must be written in simple, behaviorally specific and descriptive terms.
The Written Service Agreement shall be written in a clear, legible manner. If the case manager, parents, child, and placement resource are not located in the same county or state, the family Children’s Service Worker will be responsible for sending the portion of the Written Service Agreement (last page of the CS-1) completed in the service county to the case manager county. The case manager will send a complete copy to each participant. The Written Service Agreement should be typed, if possible, to add a more professional appearance.
Below are five (5) steps that are important in developing an effective Written Service Agreement with the family:
- The Children’s Service Worker shall actively involve the family in the planning process. As in the family assessment process, the Case Plan/Written Service Agreement is developed with the family, not for them.
- Facilitate the development of a therapeutic alliance between the Team members. It provides evidence that the family's feelings and concerns have been heard and considered;
- Promote the family's investment in the reunification process. People who are involved are more likely to change;
- Empower parents to take the necessary actions to change dysfunctional behavior patterns;
- Help ensure that all Team members are working toward the same end; and
- Initially, the members of the Team may have differing perspectives on the reasons for the Division's intervention, which resulted in the child's placement in out-of-home care. This obstacle can be overcome through reframing behaviors, emphasizing strengths and giving Team members an equal voice in identifying problems and solutions.
- The Team shall identify reasonable and achievable goals and tasks that address identified risk factors. Important points to consider when selecting goals and tasks are:
- Goals and tasks should be behaviorally stated so the Team knows when change has occurred;
- Goals and tasks should be phrased in a positive manner. They should specify what change needs to take place, not what should be stopped;
- Goals and tasks should be phrased in a clear and understandable language;
- Tasks should be very specific. All Team members should know exactly what has to be done within the specified time frame; and
- Initial tasks should be meaningful to the person or family. They should be achievable in a two (2) to four (4) week period. These tasks should be viewed as a need and priority by the family member(s).
- The Team shall address the relevant needs and risk factors identified in the assessment. The family's strengths and resources are to be considered when determining the tasks needed to achieve treatment goals. The Team should:
- Consider the environmental and other influences upon the family. Start where the family members are and help them select goals which can realistically be achieved in the time frame;
- Recognize and reinforce family efforts. Acknowledge their achievements.
- Describe what family members, the family Children’s Service Worker, placement provider and any other service providers will do; and
- Identify time frames for accomplishing each task and the overall treatment goals. Treatment plans must not exceed 90 days.
- The Team shall decide how achievements and goal attainment will be measured.
- The Team will review the plan every 30 days, or more frequently, if necessary, to evaluate progress and the need for plan revision.
Family involvement serves to:
NOTE: It should be understood that any significant change in the family's circumstances (i.e., change in household composition) which could increase the risk of abuse/neglect to children would affect the treatment plan.
The Children’s Service Worker shall be able to document what all participants in the plan will do and when. Therefore, the plan should:
10.4.1 Reunification Goals:
- Reunification goals state what the Team intends to accomplish during the treatment process.
- Establishing sound treatment goals requires the Team to have a common understanding of what needs to be accomplished to facilitate reunification. These goals must be relevant to the issues which resulted in the child being placed in out-of-home care, as identified in the family assessment.
- Usually, the CD-14 and CD-14A family assessment will identify several critical areas, or underlying problems, for casework intervention. Focusing upon the underlying problems requires the Team to establish desired outcomes, which will improve family functioning allowing the child to return home. The desired outcome(s) for the casework intervention is the reunification goal. The treatment goals are written on the family treatment plan and serve as a "road map" for the Division's intervention into the family.
- Achievement of the goals should resolve or decrease family problems, which resulted in out-of-home placement and should reduce risk to the children. When risk is reduced and/or eliminated, families should be reunited.
- The Team should limit the number of goals on the treatment plan so that the family will not be overwhelmed. Generally, two (2) goals written on the treatment plan are sufficient at any one time. This allows the family to focus upon one or two critical issues, build upon success and move on. It is important for the family to fully understand the rationale for limiting the number of goals on the treatment plan.
- It is important that the Team clearly identify goals and tasks that cannot, or should not, be pursued at this time. The Team should explain that there may be other identified goals if it appears that more than one treatment period will be necessary. This should help prevent the family from thinking they have accomplished all their goals, only to find they have more goals and tasks added on at a later time.
10.4.1.1 FST’s For Families Reaching TANF Lifetime Limit
For families reaching their sixty (60) month lifetime limit for Temporary Assistance, the format of the plan should include the goal of achieving self-sufficiency. A self-sufficiency component should be addressed in a FST at least six months prior to a family reaching their lifetime limit and in every subsequent FST, until the issue is resolved. The Children’s Service Worker will be responsible for contacting the IM worker to begin the planning process for the FST. After sharing pertinent assessment information, the CS and IM worker will jointly determine how to prepare the family for the team meeting, work with the family to set up the meeting, and provide the necessary support and follow up:
NOTE: In the past, certain responsibilities, i.e., parent/child visits, sharing information with the agency, providing financial support, may have appeared as goals/tasks on a treatment plan. This should only occur if there is a specific behavior that the parent must exhibit in conjunction with this responsibility. (Mrs. Jones will be sober when she visits Paula at the Smith home on Tuesdays at 3:00). Otherwise, the Team should discuss that these responsibilities must be met throughout the child's stay in out-of-home care and the notation can be made under “Additional Information.”
- By establishing goals directly related to an underlying problem and selecting the easiest goals first, the Team can facilitate successful planning.
- Clearly phrased in a concise and understandable manner for all Team members.
- Written in behaviorally specific terms and identify what the family will be doing differently when change occurs. Goals should not be defined as services.
- For instance, rather than having a goal identified as "Mrs. Jones will attend parenting classes," the goal should focus on what needs to be achieved by her attendance at parenting classes.
- Measurable and time-limited. Behaviors which can be measured by frequency within certain time frames will better enable the Team to evaluate progress;
- Realistically obtainable and should recognize minimally acceptable expectations and standards; and
- Mutually agreed upon by the Team. The Children’s Service Worker's skills must be utilized to set goals with the family and not for them.
- The time frames for the number of the goals may vary. Short-term goals will be more easily and quickly obtainable. They provide the family some measure of success within a brief period of time. Long-term goals will require a longer period of time. Generally, they are more difficult and will require more consistent effort on the part of the family. Subsequent treatment periods which build upon previous successes may be required for accomplishment of long-term goals. Accomplishing long-term goals should result in the family's achievement of a minimal level of functioning and the reunification of the family.
The specific goals should be:
10.4.2 Tasks
To achieve a treatment goal(s), the FST must identify tasks that, when completed, will achieve the specific goal(s). Tasks can be specified for the family unit, an individual, Children’s Service Worker, placement provider, or other provider or resource. The FST must limit the number of tasks so as not to overwhelm the family.
Tasks of other FST members should complement the family's tasks. They should encourage family empowerment and enhance the family's ability to solve problems. To ensure success, family tasks should take into account the following:
- The cognitive and social abilities of the family members;
- The family's level of cooperation and motivation;
- The family's ability and willingness to use community resources; and
- Practical limitations, such as transportation, employment and other responsibilities.
10.4.3 Examples of a Goal and Task
Goal
Ms. Anderson will achieve and maintain a clean, rodent-free home by 6/20/01.
Tasks
Ms. Anderson will purchase five mouse traps and set them behind furniture in each room of the house by 5/4/01.
Ms. Anderson will check the traps for mice, dispose of the dead mice and reset the traps daily.
Ms. Anderson will put all food in containers with lids and store them in cabinets or the refrigerator. This includes all food currently in the kitchen, newly purchased foods and food left over from meals.
Ms. Anderson will wash dishes, pots and pans, wipe off the stove and counter, and sweep the kitchen floor every day by 7:00 p.m.
Goal
Mrs. Davis will develop a one month schedule of activities for herself and her children and explain to her Children’s Service Worker how she will supervise the children during that time period. This schedule and discussion will occur by 8/4/01.
Tasks
Mrs. Davis will participate in parenting classes held Tuesday and Thursday at the Goodplace Center from 2:30-3:30 p.m. from 5/23/01 through 8/2/01. Mrs. Davis will get the list of approved babysitters from the Westend Elementary School by 6/13/01. She will interview and select two babysitters that she will use to care for her children by 7/16/01.
Chapter Memoranda History: (prior to 1/31/07)
CS03-32, CD04-79, CD05-68, CD05-72, CD06-63