Positive Outcome Measures for Children (Exit Plan)

Appendix

Research Questions, Logic, Measurement Elements and Identified Variables for Revised Exit Plan of July 1, 2004

Outcome Measure 1: Commencement of Investigation  DCF shall assure that at least 90% of all reports of children alleged to be abused, or neglected, shall be prioritized, assigned and the investigation shall commence within the timeframes specified below.    If the report of child abuse or neglect is determined by the DCF Hotline to be… A. A situation in which failure to respond immediately could result in the death of, or serious injury to a child, then the response time for commencing an investigation is the same calendar day Hotline accepts the report.  B. A non-life threatening situation that is severe enough to warrant a 24 hour response to secure the safety of the child and to access the appropriate and available witnesses, then the response time for commencing an investigation is 24 hours.  C. A non-life threatening situation that, because of the age or condition of the child, the response time for commencing an investigation is 72 hours.

Case Review is not required to verify compliance status with this measure.  LINK Reporting will be used to capture compliance with the timing requirement for commencement of investigations.  Initial quarterly reporting will be available August 15, 2004. The logic established by the DCF to be used by the LINK system to capture this measurement is in the process of development based upon pending changes indicated below :

Commencement of Investigation: Currently pending changes to existing LINK functions.  Modifications to be made in phase one (Summer 2004) are:  

  • Removal of “Extension” button and functionality
  • Addition of Response time information button
  • Change in layout of the LINK window to include Response Time Compliance information, as well as the current Commencement date, and the new Commencement Time fields.
  • LINK e-help to provide guidance and nuances related to Compliance Time Frames.

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the timing requirement for completion of investigations within 45 days.  The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Investigation Completion
Data Source: LINK

A query of the LINK database will be conducted to determine all investigations completed during the period.  For each investigation completed during the period, the CPS report accept date will be subtracted from the investigation completion date to determine the number of days the investigation was open. (Completion of the Investigation occurs when a Supervisor Approves the Investigation in LINK). 

In addition, a qualitative review shall be conducted by the Monitor’s Office on the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).  A review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  At these junctures, the following research questions will provide the basis for data collection and analysis: 

  1. Did the investigation commence within the stated time frame established at the Hotline?
  2. Was an additional report accepted and merged with seven days of the initial accepted report?
  3. Were any additional reports accepted after seven days from initial acceptance, but prior to the completion of that investigation?
  4. Was the investigation completed in 45 days from acceptance at Hotline?
  5. Was the initial investigation interview with the alleged perpetrator and identified family members conducted in their primary language?
  6. Was the investigation conducted per policy with adherence to the required protocol DCF 2074: with all identified case participants interviewed, all required collateral contacts made, (or documentation provided for the social worker’s inability to contact) and all safety factors, and needs assessed?
  7. Were services identified to maintain a child in the home where applicable?
  8. If applicable, was the alleged perpetrator asked to leave the home so that the child (ren) could be maintained in the home during the course of investigation?
  9. Did the investigator document his/her attempts to identify relative resources through the course of interview with the family members in the event that removal would be required?
  10. Were identified services provided to maintain a child in the home where applicable?
  11. Did the SWS document his/her discussion with the investigator related to the investigation assessment and subsequent findings of substantiated/non-substantiated abuse or neglect?
  12. Was the 10-day treatment plan developed by the Social Worker to document any family service needs and identify subsequent referrals to community providers in order to address those needs/build upon strengths?

The case review tool will be developed by December 2004 to meet the data collection needs of the research questions above.  This will allow the Department to make any desired changes to protocol and policy prior to measurement of qualitative performance.

LINK will not be used to produce reporting on this measure.  The measurement of Outcome Measure 3 requires a case review to determine compliance.  The QID quarterly case reviews will include the following items in its data collection instruments: 

  1. To what extent are clinically appropriate treatment plans documented and developed in conjunction with parents, children, providers and others involved in the case and approved by a DCF SWS within the timeframes specified within the treatment plan document (or six months if the plan does not specify)?  Elements a-h below:
    • Is there a SWS approved treatment plan in LINK less than 7 months old at the point of review?
    • Was the most recent treatment plan in compliance with the timing requirement set in policy (within 60 days of case opening or child placed out of home, or within six months of the prior approved treatment plan?
    • Has there been a TPC or ACR in the last 7-month period?
    • Who was invited to participate in the most recent ACR/TPC?
    • Does this invitee list include all active providers and case participants in the case during the six-month period preceding the ACR (60 days for the TPC)?
    • Who participated at the ACR/TPC and by what means did they participate (written report, in person, teleconference, prior verbal report to SW or SWS)
    • Was the DCF 553/553-F completed– identifying points of views of all participants and required revisions noted by the SWS or ACR Coordinator at the point of the conference?
    • Did the final approved treatment plan include those required revisions documented on the 553/553-F?

2. To what extent do clinically appropriate treatment plans approved by the DCF SWS include the following?  (Elements a-o as identified in the Exit Plan are placed into meaningful categories established by DCF as follows:)

Background Information

    • A clear description of household members and each identified member’s status
    • Prior relevant case history
    • Reason for most recent case opening Assessment Information
    • Presenting issues and problem areas as identified by DCF or provider assessment
    • Family issues as perceived by the parent/caretaker/child (if over 12)
    • Family or child’s strengths
    • Family or child’s needs (medical, dental, mental health, educational, other service needs – housing, childcare, employment, transportation, etc.)
Treatment
    • Reasonable efforts as determined by the court, to prevent out of home placement or reunify documented
    • Clearly stated case goal/permanency plan goal 
    • Proposed services and identified responsible parties
    • Parental & sibling visitation schedules

Progress Toward Case Goals

    • Responsibilities of children, parents, caretakers, service providers and DCF for reaching the identified case goals (tasks required during the planning period)
    • Identification of the measurement of participants’ progress toward and achievement of stated goal (for those adolescents where applicable, this includes the attachment of a completed Independent Living Plan DCF-2091) 
    • Timelines for completing tasks/expectations related to the case goal
    • Legal activity and status during the preceding treatment planning period.
3. To what extent did DCF meet the language requirements of the clients during the treatment planning process? Elements a-b below:
    • Was the ACR conducted in the primary language of the client?
    • Was the treatment plan document prepared (or subsequently translated) in the primary language of the client?

Methodological Notes:

  1. The Department’s Quality Improvement Division will conduct quarterly LINK case reviews, so that a representative sample, including all area offices, will be reviewed annually.
    • The universe includes all in-home and out-of-home cases except probate, interstate, and subsidy only cases, having an Administrative Case Review scheduled during each quarter beginning January 2004.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004.
  2. DCF and the Court Monitor’s Office will jointly conduct a quarterly review, utilizing the protocol of the Quality Improvement Division for outcome measure 3.  A minimum of 40 cases (representing all area offices) will be randomly selected each quarter.  Additionally, this team will attend the treatment planning conferences, to collect data for analysis on this outcome measure and to report on the quality of the treatment planning process itself.
Additionally, a qualitative review shall be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).  This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

Upon completion of proposed LINK enhancements in late 2004, the LINK system will be able to generate a report indicating the percentage of children for whom a social worker has documented a search for relatives for the purpose of placement, respite, visiting resource, or other supportive resource.  LINK enhancements  include the following items:
  • A new Placement Resource Search window will be created from the Create/Casework functionality for each child in the case.
  • Development of a new icon to lead to the Resource Search window which will include: case name, child name, removal date, a resource search question “relative resource search” question, a “no resources found check box”, and a running narrative document.
Until such time that the enhancement is tested and verified, the following research questions will be the source of information related to Outcome Measure 4.
  1. If a child was removed from home on or after January 1, 2004, did any of the following occur, which documents that DCF conducted an active search for relative and/or other resources (extended formal/informal networks, friends of the child or family, former foster parents or others known to the child):
    • Did the worker document his discussions with the parent/guardian regarding possible resource?
    • Did the worker document his discussion with the child (if age appropriate) regarding possible resource?
    • Did the search include contact with the person(s) identified as possible resource?
    • Did the search include background checks on the person(s) identified as possible resource?
    • Did the record indicate the reasons for DCF determination of appropriateness or non-appropriateness of the person(s) identified as possible resource?
    • Was a special study request made of FASU regarding any person identified as a possible resource?
    • Did the worker document that they had exhausted all identified resources, or was he successful in achieving placement known to child, respite resource, visiting resource or other supportive resource for the child?
    • Was the child placed with a relative or special study foster home?

Methodological Notes:

The Department’s Quality Improvement Division will apply these questions to a
quarterly sample of cases representing all area offices.

    • The universe includes all children coming into care during each quarter beginning January 1, 2004 forward.  Voluntary Services Cases will be excluded from this universe.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of the calendar quarter.  Initial reporting is expected August 15, 2004.

These questions will also be included in the joint quarterly reviews conducted by DCF and the Court Monitor’s Office.  The size of the quarterly samples will not be statistically valid but rather, are intended to provide a snapshot/indicator until such time that the LINK enhancements will be available to measure quantitative compliance on the full population.

Additionally, the Monitor will include these elements in the qualitative reviews to be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).    This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the required percentage of repeat maltreatment for children in DCF involved families in the in-home caseload. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Repeat Maltreatment 

Data Source: LINK

Every six months, the Department will determine if this outcome has been achieved through applying the federal reporting logic to produce a six-month outcome report:

    • Query the LINK database to retrieve all investigations completed during the 6-month period to then determine all associated, substantiated allegations (including type), substantiated victims and designated worker and office. 
    • For each substantiated victim, look forward 8 to 183 days to determine if the victim had another substantiated allegation during the period using the CPS Report Incident Date or CPS Report Received Date if there is no valid Incident Date. 
    • Compare the two datasets to determine the substantiated victims contained in both extracts. 
    • Divide the number of repeat victims by the number of total victims to determine percentage of repeat maltreatment. Note: CPS Reports that contain the same child(ren) and are less than or equal to 7 days apart are considered as the same incident and would not be counted as Repeat Maltreatment should they fall into both periods of measure.

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the percentage requirement for repeat maltreatment of children in out of home placement. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Neglect/Abuse in Custody

Data Source: LINK

Query the LINK database to retrieve all investigations completed during the period to then determine all associated, substantiated allegations (including type), substantiated victims and the date of the associated reports.

Query the LINK database to retrieve all Juan F. Children in open placement during the period. Compare the two datasets to identify the children contained in both extracts to then compare the CPS Report date to the child’s placement begin and end date. Divide the number of children involved in instances where the CPS report date fell within the placement dates by the total number of Juan F. Children in care during the period. 

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the timeliness of reunifications. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Reunification

Data Source: LINK

Query the LINK database to retrieve all discharges from care during the period where the discharge reason is reunification (using AFCARS discharge methodology).

Subtract the child’s most recent removal form home date from the discharge date.
Divide the number of children whose length of time to reunification was 12 months or less by the total number of children reunified with their parents or primary caretakers during the period.
Note: There is a six-month lag beyond the end of the reporting period required to determine children discharged during the period.  First quarter 2004 data will be available November 15, 2004.

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the timeliness of reunifications. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Adoption

Data Source: LINK Query LINK to retrieve all children who were adopted during the reporting period by determining the Effective Date of the Adoption Court Disposition.

Subtract each child’s most recent removal from home date from the Effective date of adoption to determine the months elapsed to adoption.

Divide the number of children adopted within 24 months of entry into care by the total number of children adopted during the reporting period.

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the timeliness of transfer of guardianship. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Transfer of Guardianship

Data Source: LINK

Query the LINK database to retrieve all instances of a recorded Court Disposition where the effective date of the transfer of legal guardianship falls within the reporting period.
Subtract each child’s most recent removal from home date from the effective date of the transfer of guardianship to determine the number of months between removal and custody transfer.

Divide the number of children whose custody transfer occurred within 24 months of their entry in to care by the total number of children whose custody was transferred during the period.
Upon completion of proposed LINK enhancements in late 2004, the LINK system will be able to generate a report indicating the percentage of siblings entering out of home placement who are placed together unless there are documented therapeutic reasons for separate placements.  LINK enhancements  include a new pop up window documenting sibling placement information and both therapeutic/clinical reasons and non-clinical reasons for separation where applicable.

Until such time that the enhancement is tested and verified, the following research questions will be the source of information related to Outcome Measure 10.  

  1. To what extent are siblings entering out of home placement placed together when there is no documented therapeutic reason (term used in LINK will be “clinical reason”) for the separation of the sibling group? (Elements a-f below)
    • Was the child a member of a sibling group in which one or more siblings were removed from the home and required DCF placement?
    • Were all siblings removed during this incident, placed together?
    • Were all siblings placed initially in a Safe Home setting together and then moved to other placements separately or together?
    • If the siblings entered placements that did not accommodate all siblings in the group, was there a therapeutic reason for the separation of siblings?
    • If initial placement did not maintain the sibling group, and barring any documented therapeutic reasons for separation, were siblings reunited into one placement location?
    • As of the date of this review, is the sibling group placed together?

Methodological Notes:

The QID will apply these questions to a quarterly sample of cases representing all area
offices.

    • The universe from which the sample will be drawn will include all children entering care each quarter beginning January 1, 2004 forward.  Voluntary cases will be excluded, as will children with a legal status of TPR.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004.

The size of the quarterly samples will not be statistically valid but rather, are intended to provide a snapshot/indicator until such time that the LINK enhancements will be available to measure quantitative compliance on the full population.  

These questions will also be included in applicable cases sampled via the joint quarterly reviews conducted by DCF and the Court Monitor’s Office.

Additionally, the Monitor will include these elements in the qualitative reviews to be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).    This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the required percentage for re-entry into out of home care. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Re-entry in to DCF Custody 

Data Source: LINK

DCF will query the LINK database to retrieve all children entering care during the period of measurement.

DCF will query the LINK database to retrieve the most recent discharge date (prior to the date of entry in step indicated above) if there is any.

DCF will subtract the most recent discharge date from the entry date to determine time between discharge and re-entry.

DCF will divide the number of children re-entering care within twelve months by the number of children entering care during the period.

There will be a six-month lag beyond the end of the reporting period required to determine children discharged during the period.  The first quarter 2004 report will be available October 2004.

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting using AFCARS logic will be used to capture compliance with the percentage of multiple placements requirement. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Multiple Placements 

Data Source: LINK

Number of Placements is calculated by determining all children in care during the reporting period and, including the current placement, counting the number of placements each child has experienced during the most recent twelve months using the following criteria:

    • Count the number of placements with different Providers. Do not count the same
Provider number twice.
    • If the service type for a placement is 174 (medical) or 323 (psychiatric), only count as a placement setting if the length of that placement is greater than 7 days. 
    • If service type 603 appears with a placement, it represents a CJTS placement and is not to be counted

Note: Approximately 10% of the children currently in placement have no Removal From Home date in LINK and, therefore, number of placements cannot be calculated for these children.

The Department will provide quarterly aggregate reports upon which the assertion of compliance with the requirement to offer/hold post licensure training modules in sufficient numbers to meet foster parent needs in each of the area offices will be determined.  Quarterly reporting will begin May 15, 2004.  However, compliance cannot be determined until one full year has transpired to allow for inclusion of the full spectrum of DCF approved trainings across the state.

At such time that the Department asserts compliance with Outcome Measure 13 based upon the aggregate area office information provided quarterly, the Monitor’s Office will conduct a case review on the LINK provider records to answer the following qualitative research question:

  1. To what extent did the DCF offer necessary training to meet the 45- hour post licensure training requirement or 9-hour subsequent year training requirement for the non-relative DCF foster parent? (Elements a below)
    • What was the requirement for training for this foster parent during the period of review?
    • Was there documentation in LINK of the offer of training modules available to the foster parent during the time period of the review?
    • Did the number of hours offered each quarter meet the stated annual requirement for this foster parent?
    • How many hours of foster parent training were documented during the period?
    • Was the need for training in a language other than English a barrier to the completion of training?
    • Was childcare a barrier to the completion of training?
    • Was location of the training a barrier to the completion of training?
    • Was training schedule a barrier to the completion of training?
    • Was the foster parent relicensed during the period of January 1, 2005 – January 1, 2006 without having completed the required DCF post-licensure training requirement?

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK Reporting will be used to capture compliance with the percentage of children placed in foster homes operating within their licensed capacity. The logic established by the DCF to be used by the LINK system to capture this measurement is provided below :

Licensed Capacity (formerly Overcrowding)

Data Source: LINK DCF will query the LINK database to retrieve Provider data for all Juan F. children in foster care placement.

Subtract the Provider’s licensed bed capacity from the number of actual placements open with that provider.

Exempt any overcapacity placements involving sibling groups placed together where the placement caused the overcapacity to be exceeded.

Divide the number of children placed in overcapacity homes by the number of Juan F. children in foster care placement. 

LINK will not be used to produce reporting on this measure.  The measurement of Outcome Measure 15 requires a case review.   The QID quarterly case reviews will include the following research questions in its data collection instruments: 

  1. To what extent have the medical, dental, mental health, and other service needs been provided to the child and family as specified in the most recently approved, clinically appropriate treatment plan ? (a-f below)
    • Were there clearly indicated needs identified for the case participants in the most recently approved clinically appropriate treatment plan?
    • Are medical issues as identified in the plan presently being addressed?
    • Are mental health issues as identified in the plan presently being addressed?
    • Are dental issues as identified in the plan presently being addressed?
    • Are educational/development (0-3) issues as identified in the plan presently being addressed?
    • Are other service needs as identified in the plan presently being addressed?

Methodological Notes:

The Department’s Quality Improvement Division will conduct quarterly LINK case reviews, so that a representative sample, including all area offices, will be reviewed annually. 

    • The universe includes all in-home and out-of-home cases except probate, interstate, and subsidy only cases, having an Administrative Case Review scheduled during each quarter beginning January 2004.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004.

DCF and the Court Monitor’s Office will jointly conduct a quarterly review, utilizing the protocol of the Quality Improvement Division for outcome measure 15.  A minimum of 40 cases (representing all area offices) will be randomly selected each quarter.  Additionally, this team will attend the treatment planning conferences, to collect data for analysis on this outcome measure and to report on the quality of the treatment planning process itself.

Additionally, a qualitative review shall be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).  This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

Case Review is required to verify compliance status with the quantitative requirement for this measure until such time that LINK enhancements are completed.  The logic established by the DCF will be established based upon enhancements to the LINK system as indicated below :

    • Current Narrative Categories will be condensed and those that are to be counted for reporting purposes will be clearly delineated.  
    • A new narrative category will be added for Service Provider Contact with Child (counted toward the requirement for out of state placements.
    • The logic that will be applied when enhancements are realized in LINK will result in two reports averaging each quarter’s performance as follows:
  1. What percentage of children placed are seen on a monthly basis by the DCF/ICPC or private provider social worker?
  2. What percentage of children in placement, regardless of where that placement is geographically, has been seen in the last quarter by his/her DCF worker?
    • This calculation is based upon:
      1. The denominator is all Juan F. children in an open placement for at least 30 days during the period, excluding Probate, Voluntary and ICO cases.
      2. The numerator is all children from the denominator who have been visited at least once in the calendar month or calendar quarter.

The Quality Improvement Division will include the following questions in its quarterly review data collection instruments.  

  1. Does the case record contain documentation that a face-to-face visit with the child in placement occurred in each calendar month of the quarter under review? 
  2. Did the DCF Social Worker meet with this child in person at least once during the quarter of this review?

Methodological Notes:

The Department’s QID will conduct a quarterly LINK case review until such time that the LINK system can report out on the full universe of children in out of home placement.  

    • The universe includes all children in out of home placement during each quarter of review beginning January 1, 2004 forward. Probate cases will be excluded.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004. The size of the quarterly samples will not be statistically valid but rather, are intended to provide a snapshot/indicator until such time that the LINK enhancements will be available to measure quantitative compliance on the full population.  

Additionally, a qualitative review shall be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).  This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

  1. What is the quantity and quality of the visitation between worker and child in out of home placement? (Elements below)
    • In how many of the last six months did the DCF worker meet with the child in person?
    • If child is out of state, did ICPC/private provider social worker document in-person visits with the child during each month in the six-month period ending with this review?
    • Did the DCF worker see this child within the quarter preceding this review?
    • Did the social worker meet with the child alone?
    • During conversation, did the worker assess the placement’s ability to meet the needs and well being of the child?
    • Did the social worker discuss progress or regression in meeting the treatment plan goal?
    • Did the social worker document any needs for FASU support to maintain the placement?
    • Was the caretaker spoken to during the visit?

Case Review is required to verify compliance status with the quantitative requirement for this measure until such time that LINK enhancements are completed.  Logic applied by the DCF will be established based upon enhancements to the LINK system as indicated below :

Current Narrative Categories will be condensed and those that are to be counted for reporting purposes will be clearly delineated.  The following calculations will be applied in the LINK reporting
  1. The denominator of in-home children will be determined by querying the LINK database to determine all cases with a CPS In-Home assignment.
  2. From these cases, determine all active case participants under age 19 who are NOT in an out-of home placement.
  3. Determine all In-Home children visited during the period as the numerator by identifying in-home children visited at least twice during a calendar month or quarter.

Until such time that LINK system capabilities are available to report on the full universe of children in the in home caseload, the Department’s Quality Improvement Division will collect data via case reviews.  The QID case review will include the following questions in its data collection instrument:

  1. What is the frequency of DCF’s visits?
  2. Did DCF visit with the children active in the case on average two times per month during the quarter of this review?

Methodological Notes: The Department’s QID will conduct a quarterly LINK case review until such time that the LINK system can report out on visitation between child and worker for the full universe in-home cases.  

    • The universe includes all children in-home during each quarter of review beginning January 1, 2004 forward. Probate and Interstate and Adoption Subsidy cases will be excluded.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004. The size of the quarterly samples will not be statistically valid but rather, are intended to provide a snapshot/indicator until such time that the LINK enhancements will be available to measure quantitative compliance on the full population.  

Additionally, a qualitative review shall be conducted by the Monitor’s Office on a sample of all open cases identified, except probate, interstate, and subsidy only cases for the first two quarters of practice during 2005 (report produced September 2005) and 2006 (report produced September 2006).  This case review process will also be initiated at the point of DCF assertion of compliance with the 22 outcomes.  

  1. What is the quantity and quality of the visitation between worker and child in DCF’s in-home caseloads? (elements below)
    • During each of the six months preceding this review, did the worker physically meet with the child in accordance to the mandate?
    • How many times during the past six month period did the work did the DCF worker meet with the child in person?
    • Did the social worker meet with the child alone?
    • During conversation, did the worker assess the parent’s ability to meet the needs and well being of the child?
    • Did the social worker discuss progress or regression in meeting the treatment plan goal?
    • Did the social worker document any needs for additional supports to maintain the child in the home?
    • Was the primary caregiver (parent) spoken to during the visit?

Case Review is not required to verify compliance status with the quantitative requirement for this measure.  LINK will be used to capture compliance with the percentage of workers at or below established caseload utilization via the average of the daily reports during each quarter from January 1, 2004 forward.  LINK logic for the reporting is provided below:

Caseload Standards

Report Source: LINK

Each night a batch program will run that will recognize any assignment changes and calculate caseload accordingly based on the point designations in figure 1.1. These point totals will be displayed next to each Worker’s name on a Supervisor's Workers tab of the LINK desktop as well as in Worker Search.  

Compliance can be measured through a utility that displays the number of workers over 100% on any given day and, of those, the number of workers that have been over 100% for 30 of the most recent 30 calendar days.

(Figure 1.1) Assignment Category Table
Assignment Type  Assignment Responsibility  Assignment Role  Case Points
Placement Points  Maximum Points   
Adolescent Services  N/A  Primary  1  0  20  
Adolescent Services  N/A  Lead Wkr  1  0  20  
CPS In-Home N/A  Primary  1  0  15  
CPS OOH  N/A  Primary  1  1  20  
CPS OOH  N/A  Lead Wkr  1  0  20  
ICO  N/A  Primary  1  0  49   
ICO  N/A  Lead Wkr  1  0  49   
Investigation Region Primary  1  0  17  
Investigation Region N/A  1  0  17   
Permanency Services N/A  Primary  0  1  20  
Permanency Services N/A  Lead  1  0  20  
Probate  N/A  Primary  1  0  35  
Probate  N/A  Lead  1  0  35   
Voluntary  N/A  Primary  1  0  49  

Last amended August, 2002
Percentage Utilization Calculation: For each of the 9 categories, the program computes % Utilizations follows:

Determine the % Util. for each assignment category for a worker by dividing the number of caseload points for that Worker by the Maximum number of points for that category. Then add all of the percentages to arrive at an overall percentage utilization figure.

Adolescent (#points in category /20) + CPS In-Home (#points in category /15) + CPS (#points in category /20) + CPS OOH (#points in category /20) + ICO (#points in category /49) + Investigation (#points in category /17) + Permanency (#points in category /20) + Probate (#points in category /35) + Voluntary (#points in category /49) = % Utilization

A.

  1. Case review will not be required to measure compliance with this mandate.  The Department is responsible for implementing the child specific review process and quarterly reporting on all children in in-state and out-of-state residential facilities in addition to the number of new admissions and discharges from residential facilities on a quarterly basis.
    • The universe for Outcome Measure 19 will be all children  in in-state and out-of-state residential facilities.  
    • DCF should identify the following groups of children in residential care to generate a more accurate portrayal of children who are eligible for less restrictive settings:
    • Children for whom mental retardation levels require facility care until child may pass into the adult DMR system, 
    • Children in facilities via voluntary placement per the request of parent,  iii. Children for whom mental health levels require facility care until child may pass into the adult DMHAS system, and
    • Children with medically complex status requiring intensive facility settings through transition to adult facility care The Monitor may take this additional information into account when determining compliance with Outcome Measure 19.
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004.
  2. DCF will report on its aggregate assessments of the needs of all children placed residentially sorted by in state and out-of-state.  The Department has begun contracting for the services of Care Coordinators to assist in this regard.  The focus will initially be on those children at the highest need level or awaiting discharge with no identified options to allow planful step down.
    • The universe for Outcome Measure 19 will be all children in in-state and out-of-state residential facilities.  
    • DCF should identify the following groups of children in residential care to generate a more accurate portrayal of children who are eligible for less restrictive settings:
    • Children for whom mental retardation levels require facility care until child may pass into the adult DMR system, 
    • Children in facilities via voluntary placement per the request of parent, 
    • Children for whom mental health levels require facility care until child may pass into the adult DMHAS system, and
    • Children with medically complex status requiring intensive facility settings through transition to adult facility care
    • Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected August 15, 2004.
    • Reporting on the number of children in in-state and out-of-state residential facilities quarterly.  LINK reporting logic includes the following calculation:
    • The denominator is all Juan F. children in care on the last day of the reporting period.
    • The numerator is all children in care on the last day of the reporting period placed in one of the designated residential service types identified below:

Service Code Service Type

306 Residential School - CPS

307 Residential Tx - CPS

319 Residential Tx - JJ*

325 Residential School - Mental Health

328 Residential Tx - Mental Health

334 Residential Tx - Substance Abuse

514 Residential Tx - Mental Health/Sex Offender

515 Residential Tx - Mental Health Intensive

* Includes only Dually Committed Children

    • Reporting quarterly on the barriers to meeting this measure.
    • Reporting on its aggregate assessments of the needs of all children placed residentially sorted by in state and out-of-state.
A review of these documents will be conducted as well as the LINK placement data analysis as a means to determine compliance.  

Initial reports will be provided via sample case review conducted by the Quality Improvement Division  Subsequently, upon LINK enhancement, the Monitor shall determine if these outcomes have been achieved through quarterly reports.  LINK reporting on the universe population will be implemented by December 2004.  DCF is required to report quarterly on the barriers to meeting this measure. 

The Quality Improvement Division has developed a tool to capture the above information and report out following case review on Outcome Measures 20 and 21, until such time that LINK enhancements are tested and verified.
  1. The universe is all youth discharged from care each quarter beginning on January 1, 2004 forward (excluding probate, interstate and voluntary cases). 
  2. Subcategory populations indicated in bullets #2 and #3 of the Exit Plan shall be documented and reported separately from the remaining discharge population when determining final performance percentage for Outcome Measure 20.
  3. The Department should report on those children who had not achieved any of the required measures at discharge, but who were in the active process of doing so.  Specifically: youth attending high school or GED classes and/or holding part time employment at point of discharge. 
  4. Quarterly reporting is due to the Monitor’s Office no later than 45 days from the close of each calendar quarter.  Initial reporting is expected May 15, 2004.
The QID Research Questions that have been approved by the Monitor are:
  1. What is the total percentage of youth who have achieved one or more of the following prior to discharge from DCF custody?
    • Graduation from High School 
    • Acquisition of a GED
    • Enrollment in or completion of college or other post secondary training program full-time.
    • Enrollment in college or other post secondary training program part-time with part-time employment.
    • Full-time Employment
    • Enlistment full-time member of the military
  2. What is the total number of youth with signed refusal of services form in file at age 18?
  3. What were the identifiable barriers to meeting these measures? 
  4. What is the extent to which LINK documentation indicates that a written discharge plan has been submitted to DMHAS and/or DMR for all children who are mentally ill or mentally retarded and require adult services?  
Elements that need to be captured to respond to this measure include the following:
  1. What is the reason for the youth’s discharge form DCF care?
  2. Was there an Adolescent Discharge Plan (DCF2092) in LINK
  3. Was there an Independent Living Plan (DCF 2091) in LINK?
  4. Was there a written discharge plan submitted to either DMHAS or DMR for this youth to go on to adult services
  5. Was the youth provided with Independent Living Services?
  6. Did the youth participate in CHAPs programs?
  7. At time of discharge was the youth working toward or earned GED?
  8. At time of discharge was the youth attending High School, Graduated from High School, or dropped out from High School?
  9. Was the youth eligible for special education services?
  10. Did the youth have medically complex status?
  11. Was substance abuse identified as an issue for this child?
  12. Does child have a clinically diagnosed psychiatric disorder?
  13. Had child been hospitalized for psychiatric reasons during the last 12 months preceding discharge?
  14. Is the youth on psychiatric medication?
  15. Did the youth achieve one or more of the discharge measures prior to discharge during the period under review?
  16. Was youth in residential placement during the 12-month period preceding discharge?
  17. Is youth clinically diagnosed with mental retardation?
  18. Is youth’s Full Scale IQ score under 70?
  19. At the time of discharge was the youth enrolled in college or other post secondary training program?
  20. At the time of discharge was the youth employed
  21. At the time of discharge was the youth enlisted full time in the military?
  22. What are the documented barriers to achieving one or more of the discharge measures prior to discharge from DCF?

The LINK system can currently generate a report indicating the percentage of children entering out of home placement for the first time who have had an MDE conducted within 30 days. LINK logic for the reporting is as follows :

Multidisciplinary Examinations

Report Source: LINK

Query the LINK database to retrieve all children entering care (removal date) for the first time.

Retrieve the MDE date for each child.

Filter out children with a valid Exception Code  Subtract the removal date from the MDE date to determine number of days to examination.

Divide the number of children with and MDE completed within 30 days by the number of children entering care for the first time.

Currently the filter for exception codes requires a manual process – LINK Enhancements will improve process by automating exception code identification.  Until such time that the enhancement is tested and verified, LINK reporting will be based on current system capabilities.