Deliverables: Contractual Requirements for FPS Providers

1. Deliverables:Contractual Requirementsfor FPS Providers

2. A training module for FPS therapists created byCheri Johnson, MSWCentral Washington Universityfor Children’s AdministrationOlympia, Washington

3. Introduction • Every part of the FPS Client Service Contract is IMPORTANT! • Signing a contract signifies your intent to comply with all requirements, no matter how seemingly small or obscure.

4. Before beginning this training…. • It will be especially helpful for you to have read the FPS Client Service Contract thoroughly. • Some level of familiarity with the contract will ensure that the topics addressed in the training make more sense!

5. Please have the following items handy: • Your copy of the FPS Client Service Contract • Copies of handouts (some are referred to as “cheat sheets”) • Highlighter • Note-taking implements (pen and paper, sticky notes)

6. Whenever you see this symbol, we will be turning to the handout indicated on the slide—this is your cue to pull out the appropriate handout to follow along.

7. Suggestion: • Highlight every item in the contract that details a contractual requirement. • Take notes regarding any questions that arise as you go through the contract or the training module. • Direct questions to your supervisor, your regional CA program consultant, the FPS Program Manager in Olympia, or a CA-designated trainer.

8. A special note to providers using subcontractors… • Provide a copy of the Client Service Contract to each subcontractor, and require they read it thoroughly. • Provide subcontractors with administrative as well as clinical supervision. • Know that you are responsible for errors or oversights made by subcontractors who don’t know the contract!

9. This training module will focus primarily on Exhibit A, Statement of Work but you still need to be aware of all aspects—business, legal, and clinical—of the FPS Client Service Contract.

10. Are you ready? We’ll now begin a step-by-step exploration of deliverables outlined in the FPS Client Service Contract.

11. Exhibit A: Statement of Work

12. FPS Purpose and Goals • Family Preservation Services are committed to reinforcing the strengths of the family to prevent the out-of-home placement of a child or to expedite the earlier return of children from out-of-home care… • …i.e, to preserve the family unit.

13. Services focus on empowering families to: • Solve problems, • Become self-sufficient, and • Strengthen relationships with community resources.

14. Helping to improve family functioning is critical in order to enhance the health, safety, and welfare of children… • …allowing them to remain at home, and the family to remain intact.

15. FPS Values and Beliefs • Children need their families and should be raised by their own families whenever possible. • Interventions should focus on family strengths, and must be responsive to the family’s needs and to their cultural values.

16. Child safety is our first priority. • Participation should be voluntary. • All families have the ability to learn, grow, and change. • FPS works in partnership with families, respecting their expertise and inviting their collaboration.

17. Service Outcomes • RCW 74.14C.030 lists 5 expected outcomes of FPS: • Connection to community resources; • No new referrals to CPS or FRS within one year of FPS case closure; • Consumer satisfaction; • For reunification cases, reduction in length of stay in out-of-home placement; and • Reduction in level of risk factors identified at time of referral.

18. …as translated into a contractual requirement… • Providers must demonstrate at the conclusion of services: • Improved child safety/harm reduction, • Improved family functioning, • Connection to community resources, and • Client satisfaction.

19. So how do we demonstrate that we’ve helped our clients achieve the required outcomes?

20. The NCFAS • Administer the NCFAS (North Carolina Family Assessment Scales) to assess family functioning at both intake and exit from services. • Compare intake and exit scores in each domain. • Progress is indicated by improvement in scores from intake to exit.

21. Consumer Satisfaction Survey • Provide each family with a Consumer Satisfaction Survey at the conclusion of services. • Surveys are confidential, and are mailed directly to DSHS in Olympia. • Results are not linked to specific families; data is compiled to provide insight into overall consumer satisfaction with FPS as a service.

22. Connections to Community Resources • Document in client file all referrals made to community resources—also include this information in weekly updates to social worker and in Monthly Status Report. • Summarize community referrals under the appropriate goal(s) in the narrative portion of the Exit Summary.

23. Document, document, DOCUMENT! • Provide information related to required outcomes in Exit Summaries and Quarterly Reports.

24. The FPS Program Manager compiles data from Exit Summaries, Quarterly Reports, and Consumer Satisfaction Surveys into a report which is submitted to the Washington State Legislature. • This data helps determine whether FPS will continue to be funded—thus, your cooperation in supplying the information is critical!

25. Furthermore….provider success in achieving desired outcomes is one way Children’s Administration evaluates provider performance…. • …and may help determine whether you continue to receive a Client Service Contract.

26. Availability of Services • FPS clients must have access to their therapist or designated backup 24 hours a day, 7 days a week, including holidays. • From the contract: “the therapist and paraprofessional [if utilized], or designated back-up, assigned to the family shall be accessible…for all emergent situations.”

27. From contract: “The Contractor shall ensure consistency of services for the family by assigning a single designated therapist to provide services for the family. The Contractor shall identify a back-up therapist to assist each family as needed.”

28. What this means is… • Each newly-referred FPS familyis assigned a specific FPS therapist, as well as a back-up therapist. • The FPS therapist, as well as the parapro (if one is being used) and/or back-up therapist, must be available to the family in case of emergencies.

29. Family crises do not always occur during business hours… • …so make sure your agency is able to comply with this crucial requirement!

30. FPS meetings take place at theclient’s convenience, not at the therapist’s or referring social worker’s convenience. • The FPS therapist must be available during those hours when problems can be seen and addressed—as long as the family agrees to meet at those times.

31. Please note: The contract DOES NOT support the use of unannounced, surprise visits by the therapist! While this may be necessary in cases where the client has no phone, drop-in visits should be avoided whenever possible (leave these up to the social worker, if they feel the need for such methods).

32. Of course, if you’ve asked the client for permission to make unannounced visits and they agree, dropping in without an appointment is completely acceptable.

33. Meetings with families take place in their own homes, unless the family requests an alternate location. • Potential exceptions to this expectation: safety, need to access equipment located elsewhere, etc.

34. Caseload • Average caseload must not exceed 10 cases per full-time FPS therapist. • Caseload size may be adjusted when parapros are used or therapist is hired to provide FPS less than 40 hours/week. • Any adjustments in caseload size must be addressed in the contractor’s Operating Procedures.

35. Caseload size must also be adjusted to take into consideration a therapist’s other responsibilities (e.g., carrying cases under other service contracts, such as FRS Phase II or BRS; providing clinical supervision to other staff, etc.).

36. An FPS therapist may always carry fewer than 10 cases (as long as their agency agrees! ), but the contract prohibits going above an average of 10 unless this is approved by CA and incorporated into the contractor’s Operating Procedures.

37. Duration of Services • Each FPS referral is limited to a maximum of 6 months, or until the funds allotted for that case have been exhausted (whichever comes first).

38. Occasionally, families may be re-referred, if substantial risk of placement continues to exist and the regional program consultant approves the re-referral. • Written approval from the referring social worker and regional program consultant must be retained in the client file for any extension of services.

39. Please note... • When a case has been referred for reunification, the child MUST be returned to the home within 30 days of the referral, or the FPS therapist is required to terminate services. • The FPS Client Service Contract does not provide for exceptions to this requirement.

40. Authorization of Services and Referrals • All referrals must be initiated in writing by a CA social worker. • All referrals must be made using the referral form designated by CA for FPS (if referring social worker is not sure how to access this, the CA Regional Program Consultant will advise them).

41. The referring social worker must indicate on the referral form whether the child(ren) is/are at risk of placement or in need of reunification.

42. Important! • “The Contractor shall not accept a case… without a complete written referral on the [CA-designated] referral form.” • “Complete” means: • Uses the designated referral form (as opposed to an obsolete form); • Is signed by the supervisor; and • Includes all required documentation.

43. Please keep in mind… • CA Social Workers have large caseloads and many service contracts with which to work—they can’t be expected to remember the ins and outs of the FPS referral process! • YOU need to be the expert in this area… so we have a “cheat sheet” to help.

44. Referral/Intake Process

45. Step-by-Step Referral Process • Social worker meets with family, gathers info, suggests FPS, family agrees. • Social worker completes referral form, obtains supervisor’s approval and signature, attaches Safety Plan, etc. • Social worker/supervisor select provider and contact them by phone to determine provider’s ability to take case. • Referral packet faxed to provider.

46. When you receive the referral… • Make sure it’s on the correct form. • Check for supervisor’s signature. • Check whether referring social worker has indicated “At risk of placement” or “In need of reunification” for each child. • Check whether social worker has checked “yes” or “no” to indicate completion of CA Documents (Safety Plan, etc.), and that they have attached the appropriate forms.

47. If any one of these items is missing or incomplete, the FPS therapist must contact the referring social worker immediately to explain he/she may not begin working with the family until the referral is complete.

48. Delivery of Services Every FPS intervention will differ, depending on the individual family’s strengths, challenges, situations, needs, and goals.

49. The effective therapist utilizes his/her experience, clinical skills, and unique individual strengths and abilities to determine the best way to proceed with each individual and each family. • Children’s Administration also provides specialized trainings to ensure the consistency and effectiveness of Family Preservation Services.

50. For example… • All FPS therapists and paraprofessionals receive training in Motivational Interviewing (MI): a client-centered, directive intervention that focuses on enhancing intrinsic motivation by exploring and resolving client ambivalence.