Assessing Safety in Out-of-Home Care: Overview and Ground Rules

1. 204: Assessing Safety in Out-of-Home Care Overview

2. Ground Rules • Be on time • Training schedule: 9 – 4 • Document your presence - sign-in sheet • Provide constructive/motivational feedback • Be respectful • Take risks • Practice makes permanent • Ask questions • Focus on learning - no cell phones/text messaging

3. Name Tents

4. Characteristics of Safety and a Safe Environment • An absence of or control of threats of severe harm. • Presence of caregiver Protective Capacities. • A safe home is experienced as a refuge. • Perceived and felt security. • Confidence in consistency.

5. Information Explored to Identify Characteristics of Safety and a Safe Environment • How the children are behaving in the home. • How caregivers are performing. • How the family is operating. • The caregiver(s)’ capacity to sustain continued safety. • How community connections sustain continued safety.

6. Goal and Purpose of the Training • To review the Out-of-Home Care Safety Assessment and Management Process. • To provide updates/changes to the Out-of-Home Care Safety Assessment and Management Process.

7. Learning Objectives: • Participants will be able to: • Define “caregiver(s) of origin” and “informal care”. • Recall what ends must be reached in each step of the Pennsylvania Out-of-Home Care Safety Assessment and Management Process and how those ends are met. • Recall how the Characteristics of Safety and a Safe Environment connect to the information gathering process and help to inform analysis and decision-making regarding safety of children in out-of-home care. • Describe the updates/changes to Pennsylvania’s Out-of-Home Care Safety Assessment and Management Process.

8. Agenda: • Welcome and Introductions • What Happens before the Child is Placed? • Present Danger • Intervals and Worksheet Updates • Safety Indicators • Safety Analysis and Decisions • Communicating Safety Concerns • Workshop Closure and Evaluations

9. Definitions

10. Caregiver of Origin • The adult(s) who holds the primary responsibility for the child’s care and safety. • A person who operates in the capacity of a child’s birth parents. • Resides with the child. • Does NOT include people who care for a child temporarily.

11. Informal Care • Child is not in the custody of Children and Youth Agency. • Child goes to live with an alternate caregiver temporarily. • Arrangement made by the parents or agreed upon by the parents and Children and Youth Agency.

12. Informal Care Considerations • Are there dependency issues that necessitate the filing of a dependency petition? • Does the informal living arrangement caregiver(s) wish to be approved as a resource family? • Considering the definition of “informal care”, is the intent that the informal living arrangement becomes a permanent arrangement? If so, is the caregiver(s) now considered the “caregiver(s) of origin”?

13. Informal Care Considerations, cont’d • Are there sufficient supports for the informal living arrangement caregiver to maintain the placement on a longer basis (e.g. childcare, financial support, etc.)? • Does the informal living arrangement caregiver(s) have the legal authority to make medical and educational decisions regarding the child?

14. OVERVIEW OF THE OUT-OF-HOME CARE SAFETY ASSESSMENT PROCESS

15. Global Look at… The Out-of-Home Care Safety Assessment Process

16. Knowing the Child to be Placed Identifying the placement setting

17. The Six (6) Assessment Domains • Type of Maltreatment • Nature of Maltreatment • Child Functioning • Adult Functioning • General Parenting • Parenting Discipline

18. Action Planning • Take a moment to identify: • Something new I learned… • Something I need to know more about… • Something I will apply to my job…

19. Defining Present Danger in out-of-home care

20. Present Danger Defined • An immediate, significant, and clearly observable family condition (severe harm or threat of severe harm) occurring to a child/youth in the present tense, endangering or threatening to endanger a child and therefore requiring prompt response.

21. Safety Responsibility Standard • In no instance should a child be placed in or remain in an informal or formal placement setting if Present Danger is apparent and cannot be immediately addressed.

22. Present Danger: Definitions and Examples

23. Documenting Present danger Out-of-Home Care

24. Documenting Present Danger Assessments • Key transition points for children in out-of-home care: • At the time of the initial placement and • At the time of any subsequent placement changes.

25. County Policies Surrounding Present Danger Assessments • State provided Present Danger Assessment Worksheet (or comparable tool) OR structured case note • The county worker, a qualified worker, or the private provider worker is required to conduct and document a Present Danger Assessment at the key points. • Counties should establish policy surrounding completion of the Present Danger Assessments.

26. Action Planning: • Take a moment to identify: • Something new I learned… • Something I need to know more about… • Something I will apply to my job…

27. Interval updates Out-of-Home Care

28. Out-of-Home Care Safety Assessment Intervals • The Out-of-Home Care Safety Assessment Worksheet must be completed at the following intervals: • Within 60 days, or 2 months, from the date of placement in the current setting. • Within 180 days, or 6 months, from the previously completed worksheet. • Within 72 hours upon the identification of evidence, circumstances, or information that suggests a negative change in the safety indicators yet the child remains in the home.

29. Old Interval #3: • Within 72 hours upon the identification of evidence, circumstance, or new information that suggests a change in the child’s safety. This includes: •  New adult household members who are in the home longer than 30 days within the calendar year. Note: young adults who are already family members but are returning home from college would not be included in this interval. • Whenever there is a significant loss/change in the household that may impact child safety e.g. separation, divorce, serious illness, death, etc.

30. Old Interval #3, cont’d • Information is received from another county that may impact a child’s safety. • In conjunction with a Regional Office investigation: • If the child remains in the home throughout the time of the investigation. • If the child is returned to the home following an investigation.

31. Out-of-home care safety assessment worksheet Out-of-Home Care

32. Out-of-Home Care Safety Assessment Worksheet – Updates • Section I. Identifying Information, “Date Completed” was added. • Section V. Safety Analysis, item number five was removed • Under Section VI. Safety Decision • Unsafe • Second bullet was changed

33. Action Planning: • Take a moment to identify: • Something new I learned… • Something I need to know more about… • Something I will apply to my job…

34. Indicators of safety in out-of-home care Out-of-Home Care

35. Positive Concerning Safety Indicators Negative

36. Positive Characteristics • Describe for us those traits that we attribute to caregivers who are effective, caring, and protective caregivers. • Similar to the Protective Capacities but within the context of out-of-home care.

37. Characteristics of Concern • Family conditions or circumstances that tell us that functioning is • compromised, • marginal, or • deteriorating from a previously higher level.

38. Negative Characteristics • Those traits, attributes, or conditions that indicate that a placement setting may be unsafe.

39. Exploring the safety indicators and characteristics Out-of-Home Care

40. Small Group Activity • For each of the two (2) assigned Safety Indicators, answer the following: • Describe what is being assessed in the Safety Indicator. • Identify which of the Six Assessment Domains helps to inform the Safety Indicator? • What information gathered in those domains helps to inform the Safety Indicator? • What general themes run throughout the Safety Indicator? Record answers on a flip chart.

41. Rating the Indicators

42. Action Planning: • Take a moment to identify: • Something new I learned… • Something I need to know more about… • Something I will apply to my job…

43. Safety analysis Out-of-Home Care

44. Safety Analysis Questions 1. Have any changes (positive or negative) occurred within the out-of-home family since your last assessment? Describe the changes and explain what prompted the change. Include in the explanation whether or not the change in the family resulted in a change in response to the 10 Safety Indicators.

45. Safety Analysis Questions, cont’d 2. Considering all of the 10 Safety Indicators, are there sufficient positive Safety Indicators present and in operation that give you confidence that the child will remain safe in the setting? Provide your rationale for this judgment.

46. Safety Analysis Questions, cont’d 3. Describe in behavioral terms, any Negative Characteristic and/or Safety Indicators that are present. Include intensity, frequency, and duration of the Characteristic and/or Safety Indicator and the impact on this child. If there are negative Safety Indicators and the decision is to leave the child in this home, describe the rationale and justification for this decision. Supervisory signature below indicates agreement with this rationale.

47. Safety Analysis Questions, cont’d 4. A) Consider and describe any Safety Indicators that are rated as “concerning”. B) Are there supports (e.g. respite care, child care, training on the child’s specific needs, etc.) that will enhance the resource family’s ability to provide a safe environment for the child? Provide your rationale for this judgment. For supports already in place, describe the effectiveness/impact/continued need for that support.

48. The Safety Decision • Safe • Unsafe

49. Safe: • Sufficient Safety Indicators exist that cause the undersigned persons to confirm that the setting remains safe for this child.

50. Unsafe • Sufficient Safety Indicators exist that cause the undersigned persons to conclude that the setting does not remain safe for this child. Child must be removed from the setting. When this decision is made, the following additional steps must occur within the designated timeframe: • Review the child’s current Safety Plan to determine modifications needed and document any and all necessary changes. • If children from another county are placed in the home, concerns, as they relate to those children, should be communicated to the appropriate entities according to your County Children and Youth Agency’s policy.