016.15.13 Ark. Code R. 001

Current through Register Vol. 49, No. 10, October, 2024

Rule 016.15.13-001 - Changes to POLICY II-I: Early Intervention Referrals and Services

EXCERPT, DIVISION OF CHILDREN & FAMILY SERVICES POLICY & PROCEDURES MANUAL

POLICY ll-l: EARLY INTERVENTION REFERRALS AND SERVICES

04/2013

For children who have or are at risk of a developmental delay, appropriate early intervention services are essential. Early intervention services are designed to lessen the effects of any potential or existing developmental delay. Ultimately early intervention services help the child learn and reach his or her individual potential with the support and involvement of the child's family, as appropriate, it is important for such services to begin as early as possible and for biological parents to be involved in decisions related to early intervention services.

REFERRALS TO DIVISION OF DEVELOPMENTAL DISABILITIES FOR EARLY INTERVENTION SERVICES SCREENING

When a child maltreatment investigation involving any children in the home under the age of three is initiated, the Division will consider referring as appropriate all children in the home under the age of three to the Division of Developmental Disabilities Services' (DPS) Children's Services for an early intervention (i.e., First Connections; this program is not the same as the waiver program) screening in an effort to enhance the well-being of these children. Any children under the age of three involved in a substantiated case of child maltreatment (regardless of whether all of the children are named as alleged victims) must be referred to DPS Children's Services for an early intervention screening if not already referred while the investigation was pending. This will not only ensure DCFS compliance with the Child Abuse Prevention and Treatment Act (CAPTA) regarding substantiated cases of child abuse and neglect involving children under the age of three, but will further promote the well-being of this population.

DPS Children's Services will screen all of the children under the age of three who have been referred to First Connections to determine their need and eligibility for early intervention services. If the results of the screening determine that a child will benefit from DPS early intervention services, the person serving as the parent (e.g., biological parent in a protective services case; other Individual legally caring for the child involved in a protective services or foster care case including foster parents) must consent to allow his or her child to participate before services are initiated.

For children under the age of three, eligibility for PPS Children's Services will be determined by a screening assessment to determine the need for additional evaluations (if a child referred to DPS Children's Services is within 45 days or less of his or her third birthday, then PPS Children's services may forward the referral to the Arkansas Department of Education, Special Education (Part B)).

If warranted, a developmental evaluation for children under age three will be completed in the areas of cognition, communication, social/emotional, physical, and adaptive as available and appropriate. Based upon the developmental evaluation results, a speech, occupational, and/or physical therapy evaluation may be conducted as available and appropriate. All evaluation results as well as medical information, professional informed clinical opinion(s), and information gathered from biological parents and DCFS will be utilized to determine early intervention eligibility.

While a referral for early intervention services is encouraged for all children under three when an investigation is initiated and is required for children under the age of three in substantiated cases of child maltreatment, a referral for early intervention services on behalf of any child suspected of having a developmental delay or disability may be sent at any time.

DPS EARLY INTERVENTION INDIVIDUALIZED FAMILY SERVICE PLANNING

If a child is determined to be eligible for services and the person acting as a parent on behalf of the child (e.g., biological parent involved in a protective services case; other individual legally caring for the child in a protective services or foster care case including foster parents) consents to services, Individualized Family Service Plan (IFSP) meetings will be held to develop an appropriate service plan for the child. IFSP activities and services must be added to the child's case plan.

Adult participation in the IFSP meetings and related decision-making on the child's behalf is required. If the child is involved in a protective services case or if a child in foster care has a goal of reunification, the child's biological parent(s) should be invited and encouraged to attend the IFSP meetings to make decisions related to individualized Family Service Planning and early intervention services for his or her child.

However, another adult who is legally caring for the child on a daily basis may serve in place of the biological parent if:

A. The court orders that the child's parent/guardian shall have no involvement in the child's educational Planning; or,

B. The child's parents cannot be located; or,

C. The goal is not reunification for those children involved in foster care cases.

If for one of the reasons listed above or if for any other reason the biological parent(s) is unable or unwilling to attend IFSP meetings and make the decisions related to early intervention services for his or her child, one of the following may serve as the parent to make decisions regarding early intervention planning and services for the child (provided the court has not issued a no contact order for the person selected to act in place of the parent):

A. Foster parent;

B. Guardian, generally authorized to act as the child's parent (but not the state if the child is a ward of the state; i.e., FSW may act as the liaison between DPS and the parent or surrogate parent, but the FSW may not be the sole contact and/or decision-maker for a child);

C. An individual otherwise acting in place of a biological parent (e.g., grandparent, step-parent, or any other relative with whom the child lives);

D. An individual who is legally responsible for the child's welfare;

For any individual serving in place of the parent In the child's early Intervention process, support in the form of DPS Surrogate Parent Training is available but not required. The local DPS Service Coordinator or designee can assist in coordinating the PPS Surrogate Parent Training. After an individual has completed the PPS Surrogate Parent Training, they may serve as a surrogate parent for any child.

However, an appointed PPS certified surrogate may be assigned by the lead agency to represent the child during the IFSP if there is no adult (as listed in items A-P above) available to represent the interests of the child. An appointed PPS surrogate parent is generally the least preferred option since this person does not have daily interaction with the child- Furthermore, a DPS certified surrogate parent will usually only be appointed in the event that the child's parent, foster parent, etc. is unable or unwilling to participate in the child's early intervention process and IFSP meetings:

In any situation in which an individual other than the biological parent (e.g.; foster parent, relative, etc.) is acting on behalf of the child, that Individual will be discharged when the child's biological parent is ready and able to resume involvement.

REFERRALS FOR FETAL ALCOHOL SYNDROME DISORDERS (FASD) SCREENING

Fetal Alcohol Syndrome Disorders is an umbrella term used to describe the range of effects or disorders that can occur in an individual whose mother consumed alcohol during pregnancy. All caretakers involved in the delivery or care of infants must contact DHS regarding an infant born and affected with a Fetal Alcohol Spectrum Disorder (FASD). In addition, DCFS FSWs and Health Service Workers will refer children who have known prenatal alcohol exposure and exhibit FASD symptoms and/or behaviors to the DCFS FASD Unit for an FASD screening. The FASD screening will help determine if early intervention services specific to FASD are needed.

In order to conduct an effective FASD screening, the FSW and/or Health Service Worker will gather information regarding the child's in utero and birth history. Depending on the information collected and the results of the screens, a referral for an FASD diagnosis may be provided. If a child is diagnosed with FASD, the following services may be offered to the family:

* Referral to DPS (early intervention or DPS waiver), if applicable and available

* Referral to specialized day care, if applicable

* Referral to FASD family support group (available to biological, foster, and adoptive families), if available

* FASD parenting classes (available to biological, foster, and adoptive families)

A plan of safe care must also be developed for any infant born and affected with FASD who is referred to the Division by a healthcare provider via the Child Abuse Hotline. See Policy ll-D and Procedure II-D6 for more specific information regarding healthcare providers reporting infants born with or affected by FASD.

PROCEDURE II-I1: DDS Early Intervention Services Referrals

04/2013

When children under the age of three are involved in a substantiated case of child maltreatment, but a case is not opened, the investigator will:

A. Provide an overview of the benefits of early intervention services to the parent/guardian.

B. Make a referral to DDS for each child in the home (victims and non-victims) under age three.

1) Complete form DHS-3300 available in CHRIS.

a) The DHS-3300 can be accessed in the Information and Referral Screen.

b) When the button "DCO-3350/DHS-3300" is selected, a dialogue box will open so that staff can select the form to be completed.

c) Select the "OK" button to open the DHS-3300.

d) Select "Developmental Disabilities" as the Receiving Agency.

e) Select "Other" in the "Services Requested and Codes" section and enter "Early Intervention Screening Referral" in the specification box.

f) Note in the comments box that a case will not be opened, so DCFS will have no further involvement.

g) Complete the remainder DHS-3300 with as much information as possible.

i. At minimum, the child's name, child's date of birth OR Social Security number, and FSW contact information must be entered.

2) Print the completed DHS-3300 to either scan and email or fax to the local DDS Services Coordinator.

C. Inform the parent/guardian that their child(ren) will be referred to DDS Children's Services to assess the child(ren)'s need and eligibility for early intervention services that may help the child learn and reach his or her individual potential.

When children under the age of three are involved in a substantiated case of child maltreatment and a protective services or foster care case is subsequently opened, the FSW caseworker (either protective services or foster care, as applicable) will:

A. Provide an overview of the benefits of early intervention services to the parent/guardian.

B. Make a referral to DDS for each child in the home (victims and non-victims) under age three.

1) Complete form DHS-3300 available in CHRIS.

a) The DHS-3300 can be accessed in the Information and Referral Screen.

b) When the button "DCO-3350/DHS-3300" is selected, a dialogue box will open so that staff can select the form to be completed.

c) Select the "OK" button to open the DHS-3300.

d) Select "Developmental Disabilities" as the Receiving Agency.

e) Select "Other" in the "Services Requested and Codes" section and enter "Early Intervention Screening Referral" in the specification box.

f) Complete the remainder DHS-3300 with as much information as possible.

i. At minimum, the child's name, child's date of birth OR Social Security number, and FSW contact information must be entered.

C. Print the completed DHS-3300 to either scan and email or fax to the local DDS Services Coordinator.

D. Inform the parent/guardian that their child(ren) will be referred to DDS Children's Services to assess the child(ren)'s need and eligibility for early intervention services.

E. Prior to the early intervention services intake meeting, provide the local DDS Services Coordinator with:

1) Court-order, if applicable

2) Copy of Social Security Card or number

3) Copy of Medicaid Card or number, if applicable

4) Any other pertinent information related to the request for the early intervention screening

5) Copy of EPSDT, if available (parent must obtain)

6) Copy of all evaluations, if applicable

G. Coordinate remaining paperwork and services, as applicable, with the local DPS Service Coordinator. This includes but is not limited to:

1) Coordinating the completion of DMS-800: Authorization for Children's Medical Services if the early intervention intake meeting determines the child is eligible for DPS Children's Medical Services

2) Providing a copy of CFS-6009: Family Strengths, Needs, and Risk Assessment (FSNRA) and the case plan once they are completed;

3) Notifying, as applicable, PACE, Health Service Worker, and foster parent(s) that early intervention screening referral has already been made to DPS Children's Services per CAPTA requirements prior to PACE evaluation.

H. Invite DPS services coordinator and early intervention service providers to staffings if child is receiving early intervention services.

I. Keep the local DPS Service Coordinator informed of any changes to the case plan that may affect early intervention services and coordination.

J. Document contacts related to the DPS early intervention services referral in the contacts screen in CHRIS.

K. Update the child's case plan as appropriate.

L. Conference with supervisor as needed regarding the referral to DPS early intervention services.

The Investigative and FSW Supervisors will:

A. Conference with the investigator and/or FSW caseworker as needed regarding the child's DPS early intervention referral and/or any subsequent services.

B. Notify, as necessary, his or her supervisor of any issues related to the child's DPS early intervention referral and/or services.

Upon referral, the DPS Service Coordinator should:

A. Acknowledge receipt of the DHS-3300 via email or fax.

B. Arrange the early intervention intake meeting.

C. Assess and determine the need and eligibility of the child for services and notify in writing the DCFS Family Service Worker (FSW) and FSW Supervisor indicating the eligibility status and needs of the child, if applicable.

D. If it is determined that the child needs and is eligible for early intervention services:

1) Provide a more detailed explanation to the parent/guardian of early intervention services including types, benefits, requirements, etc.

2) Provide copies of the child's IFSP and any early intervention evaluations to the FSW.

3) Keep the child's FSW and person serving as the parent informed of the child's progress and any changes in services.

PROCEDURE II-I2: DPS EARLY INTERVENTION INDIVIDUALIZED FAMILY SERVICE PLANNING

04/2013

The FSW will:

A. Regardless of the type of case (i.e., protective or foster care), include early intervention services and Individualized Family Service Planning (IFSP) meetings in the case plan as appropriate and ensure the biological parent participates IFSP and related services as appropriate.

B. If the biological parent is unable or unwilling to participate in IFSP (e.g., court orders that the child's parent/guardian shall have no involvement in child's educational planning, parents cannot be located; goal is not reunification):

1) Ensure that an appropriate adult serving in place of the parent attends the IFSP meetings to act as a decision-maker regarding the child's early intervention services. The person serving in place of the parent is generally the person who is currently caring for the child (e.g., temporary guardian, foster parent, etc).

a) Ensure that a no contact order from the court pertaining to the person serving in the place of the parent does not exist and that the surrogate parent is otherwise appropriate.

b) If the person selected to serve in the place of the parent would like to attend a DPS Surrogate Parent Training, contact the DPS Service Coordinator to request the DPS Service Coordinator to arrange the training.

c) If the individual caring for the child/serving in place of the parent cannot attend or otherwise participate in the IFSP meetings, PPS will appoint a PPS certified surrogate parent.

C. Continue to update child's case plan accordingly with information from IFSP.

D. Conference with supervisor as needed regarding the child's IFSP.

The FSW Supervisor will:

A. Conference with the FSW as needed regarding the child's IFSP.

B. Notify, as necessary, his or her supervisor of any issues related to the child's IFSP.

PROCEDURE II-I3: FASD REFERRALS AND SERVICES

04/2013

Note: This procedure is applicable to those children already involved in an open DCFS case and who DCFS staff or providers suspect may be affected by FASD. This procedure is not applicable to infants born with and affected by FASD and reported to the Child Abuse Hotline by a healthcare provider. Please see Policy II-D and Procedure II-D6 for more information regarding infants born with and affected by FASD.

If child is symptomatic of FASP, the Family Service Worker or Health Service Worker will:

A. Gather information regarding the child's in utero and birth history to determine if the biological mother consumed alcohol (e.g., at what points during the pregnancy, amount consumed, frequency consumed, etc.) and/or any illegal substances while pregnant with child.

B. Complete and submit CFS-099: FASP Screening Referral to the FASP Director via fax (see CFS-099 for the current fax number).

C. Collaborate with the FASP Unit to ensure the child receives any necessary referrals and accesses any needed services as per the results and recommendations of the FASP screening and/or diagnosis.

D. Conference with supervisor as needed regarding FASD referrals and services.

The FSW Supervisor will:

A. Conference with the FSW as needed regarding FASP referrals and services.

B. Notify, as necessary, his or her supervisor of any issues related to the FASD referrals and services.

The FASP Director will:

A. Review the completed CFS-099: FASD Screening Referral.

B. Assign the FASD FSW (or self-assign if FASD FSW is unavailable) to conduct an FASD screening.

C. Collaborate with the FASD FSW and child's FSW to make necessary referrals or access services per the results and recommendations of the FASD screening and/or diagnosis.

The FASD FSW will:

A. Conduct FASD screenings as assigned.

B. Communicate results of FASD screening and/or diagnosis to the child's FSW and FASD Director.

C. For all children screened for and/or diagnosed with FASD, collaborate with FASD Director and child's FSW to make appropriate referrals or access services per the results and recommendations of the FASD screening and/or diagnosis.

016.15.13 Ark. Code R. 001

3/22/2013