CODES/REFERENCES

O.C.G.A § Section 15-11-190 Social Study

O.C.G.A § Section 15-11-191 Contents of Social Study 45 CFR §1355.25

REQUIREMENTS

The Division of Family and Children Services (DFCS) shall:

1. Complete an individualized, culturally competent Comprehensive Child and Family Assessment (CCFA) in partnership with the family for each child entering foster care (see Practice Guidance: Child and Family Assessments). The CCFA shall:
   
    
   1. Identify the behaviors and conditions of the child, parents/caregivers and family that contributed to the safety threats; and
   2. Make recommendations for what changes must be made to mitigate or eliminate those safety threats; and
   3. Provide recommendations for the child’s placement, permanency and well-being.
2. Utilize DFCS staff or approved/contracted providers to complete the CCFA.
3. Refer to a state approved/contracted provider to complete a CCFA within one business day of the Preliminary Protective Hearing (PPH), if the CCFA is not being completed by DFCS staff.
4. Complete a Service Authorization in Georgia SHINES and obtain approval to initiate the CCFA in accordance with the Georgia SHINES Job Aide: Comprehensive Job Aid for Service Authorization in Forms and Tools. Document the provider’s acceptance of the referral in Georgia SHINES. NOTE: Emailed referrals must be encrypted. To encrypt the email, type DHSEncrypt in the Subject line.
5. Require the contracted CCFA provider to provide acceptance or non-acceptance of the CCFA referral decision to the Social Services Case Manager (SSCM) within 48 hours of receipt.
6. Within 24 hours of the CCFA provider accepting the referral, notify the parent/guardian/legal custodian and placement resource that a CCFA will be completed. Explain the family assessment process and provide the name and contact information of the selected provider. NOTE: The initial notification can be made via telephone and followed up in writing.
7. Ensure all family/household members are engaged in the development of the CCFA, which includes the following components:
   
    
   1. Family Assessment: Provides a picture of the child and other family members (see Practice Guidance: Child and Family Assessment).
      1. Household Composition (marital, education, and citizenship status of each household member)
      2. Living Arrangements
      3. General Financial Status
      4. Health of household members
      5. Genogram
      6. Birth Family Background Information for Child
      7. Provides an idea of their relationships, strengths, stressors, history and behaviors
      8. Prior DFCS Involvement
      9. Description of the parent-child relationship
      10. Family functioning (see policy 19.13 Case Management: Family Functioning Assessment). NOTE: This includes reviewing any existing Family Functioning Assessment.
   2. Social Study: Provides a social history of the child and family.
      1. Description of the plan, if any, for the return of the child to his/her parents and for achieving legal permanency for the child if reunification efforts fail;
      2. Indicate whether the best interests of the child will be served by granting reasonable visitation rights to his/her other relatives in order to maintain and strengthen the child’s family relationships;
      3. Indicate whether the child has siblings under the court’s jurisdiction, and if so:
         1. The nature of the relationship between such child and his/her siblings;
         2. Whether the siblings were raised together in the same home, have shared significant common experiences or have an existing strong bond;
         3. Whether the child expresses a desire to visit or live with his/her siblings and whether ongoing contact is in such child’s best interest;
         4. The appropriateness of developing or maintaining sibling relationships;
         5. If siblings are not placed together in the same home, indicate why the siblings are not placed together and what efforts are being made to place siblings together or why those efforts are not appropriate; and
         6. If siblings are placed or reside in another state.
      4. The appropriateness of any placement with a relative of the child;
      5. Whether a caregiver is willing and able to provide a legally permanent home for the child if reunification is unsuccessful.
   3. Trauma Assessment: Determines if the child or family has been exposed to trauma or has experienced any significant stressful impacts;
      1. Collaborate with the Amerigroup Care Coordination Team (CCT) to ensure each child five years of age and older receives a trauma assessment and incorporate the results into the CCFA (see policy 10.12 Foster Care: Psychological and Behavioral Health Needs).
   4. Medical Assessment: Determines the child’s current health status.
      1. Collaborate with the Amerigroup Care Coordination Team (CCT) to ensure that each child entering foster care receives a Health Check within 10 calendar days of entering foster care and incorporate the results into the CCFA (see policy 10.11 Foster Care: Medical, Dental, and Developmental Needs).
      2. This is required even if the child has been recently seen by a doctor.
   5. Kinship Assessment: Assesses the capacity of relatives or fictive kin to serve as placement, visitation or permanency resources for a child; Completed if an identified kin resource is available and willing to serve as a resource; Supervisory approval is required prior to requesting the CCFA provider to complete a Kinship Assessment (see Practice Guidance: Kinship Assessment).
   6. Reassessment: May be necessary if the current CCFA Assessment is more than 12 months old.
   7. Additional Assessments: May be necessary based on the individual needs of the child and family.
8. Ensure the CCFA includes a summary of findings/conclusions and recommendations for services, placement, case planning and permanency planning.
9. Require providers to submit the completed CCFA to DFCS no later than 25 calendar days of the referral.
10. Utilize the multi-disciplinary team (MDT) meeting that occurs within 25 calendar days of a child entering foster care to discuss the summary, conclusions and recommendations from the CCFA.
11. Incorporate applicable recommendations from the CCFA into the case plan.
12. Terminate the CCFA if a child exits foster care before the CCFA is completed.
13. Upload the following into Georgia SHINES External Documentation within 72 hours of receipt.
    
     
    1. The Service Authorization/Referral Form with the Provider Only section completed indicating the provider’s acceptance or non-acceptance of the referral.
    2. The completed CCFA or completed portions if CCFA was terminated.
14. Initiate the Supplemental Security Income (SSI) application process on behalf of any child whose CCFA indicates the presence of mental or physical disabilities within five business days of receiving the CCFA.
15. Ensure providers and staff respect families’ rights to confidentiality and protected health information through adherence to the Health Information Portability and Accountability Act (HIPAA) and other confidentiality laws in accordance with policy 2.5 Information Management: Health Insurance Portability and Accountability Act (HIPAA) and 2.6 Information Management: Confidentiality/Safeguarding Information.

PROCEDURES

The Social Services Case Manager (SSCM) will:

1. Consult with the Social Services Supervisor to determine which CCFA components need to be completed and whether the CCFA will be completed by the SSCM or an approved provider.
   
    
   1. Gather and analyze past records and reports.
   2. Review any formal assessments of the family completed within the previous 12 months (e.g. medical, social, educational, family, psychological, etc.).
   3. If the CCFA will be completed by a provider select a provider from the approved provider directory.
      
       
      1. Ensure the CCFA provider can communicate effectively with the child and family. Consider any potential language barriers or whether any reasonable accommodations are needed.
      2. Record the name of the provider on the Needs and Outcomes page in Georgia SHINES.
      3. Complete the Service Authorization Detail page in Georgia SHINES and obtain approval (see Forms and Tools: Georgia SHINES Job Aid: Completing a Service Authorization).
2. Submit the referral to the selected CCFA provider within one business day of the Preliminary Protective Hearing.
   
    
   1. Provide the CCFA provider with the contact information for the Amerigroup CCT at the time of the referral.
   2. Provide the Amerigroup CCT with the contact information for the CCFA provider as soon as the referral is accepted by the provider (see policy 9.2 Foster Care: Applying for Medical Services at Initial Entry and Exit for the Amerigroup referral process).
      
       
      1. The Amerigroup CCT will contact the SSCM or CCFA provider regarding scheduling of medical/dental appointments and trauma assessment (if applicable).
      2. The Amerigroup CCT will provide the results of the medical and trauma assessments to the CCFA provider for inclusion in the CCFA.
   3. Within 24 hours of the CCFA provider accepting the referral, notify the parent/guardian/legal custodian and placement provider of the agency’s intent to complete the CCFA. Explain the family assessment process and identify the selected provider. If the notification is done by telephone, also follow up with written notification. When possible, conduct a face-to-face introduction (see Practice Guidance: Family Engagement).
   4. Within two business days of the provider accepting the referral, make available for review any background information on the child and parents, including the FFA.
      
       
      1. Obtain the appropriate written release of information prior to disclosure of protected health information (i.e., HIPAA).
      2. Allow the provider to review the record except for the names of any reporters.
      3. Only DFCS staff may copy documents from a case record.
3. Participate in a multi-disciplinary team (MDT) meeting within 25 calendar days of a child entering foster care (see policy 19.5 Case Management: Case Consultation).
   
    
   1. Ensure the child’s placement setting, permanency plan, and service needs (including those of the family and/or caregiver) are adequately addressed.
   2. Ensure recommendations are reasonable and address the specific behaviors or conditions that must be corrected for the child to be safely reunited with family.
4. Within five business days of receiving the final CCFA report from a CCFA provider, carefully review the CCFA information for quality and accuracy.
   
    
   1. Ensure the recommendations concerning each child’s placement setting, permanency plan, and service needs (including those of the family and/or caregiver) are clearly documented.
   2. If the CCFA is incomplete or of poor quality, immediately return it to the provider with specific information about what must be improved or changed.
5. Make appropriate service referrals in accordance with policy 19.17 Case Management: Service Provision.
6. Incorporate applicable recommendations from the CCFA into the case plan in accordance with policy 10.23 Foster Care: Case Planning.
7. Submit a copy of the CCFA to the Juvenile Court upon completion.
8. If the CCFA is cancelled:
   
    
   1. Notify the provider (if applicable) and the Amerigroup CCT as soon as the decision is made to cancel the CCFA. The initial notification may be made via telephone and followed by written notification.
   2. Notify the Amerigroup CCT that the CCFA has been cancelled via the Amerigroup GA families 360º DFCS Form (see policy 9.2 Foster Care: Applying for Medical Services at Initial Entry and Exit).
   3. Include the date of cancellation in the written notifications (e.g., date of the Adjudicatory Hearing returning the child).
   4. Document the verbal and written notifications of cancellation in the Contact Detail in Georgia SHINES. Indicate the full name of the person(s) notified.

Completing the CCFA:

1. Gather information about the family to complete the CCFA (see Practice Guidance: Gathering Information), including:
   
    
   1. Information from the DFCS case record, including the FFA;
   2. Formal evaluations and treatment summaries (e.g., medical, psychological, drug and alcohol assessments, etc.);
   3. Whether interpretation services are needed for non-English speaking or auxiliary aids for sensory impaired individuals; and
   4. Contact information for the Amerigroup CCT.
2. Contact the family and placement resource to initiate the comprehensive assessment process:
   
    
   1. Engage all pertinent family members of the child in foster care, including those outside of the removal household.
   2. Partner with parents to identify their family’s developmental stage(s), needed behavioral change, and actions needed to develop relapse prevention skills.
   3. Observe family interactions, living conditions, behaviors, etc.
   4. Explore all areas of family functioning in accordance with policy 19.13 Case Management: Family Functioning Assessment.
   5. Develop a genogram (see policy 19.19 Case Management: Genogram).
   6. Complete the Birth Family Background Information for Child form.
3. Collaborate with the Amerigroup CCT to obtain completed medical, dental, and trauma assessments. Review the assessment results provided by the Amerigroup CCT for inclusion in the CCFA report.
4. Explore all available sources of possible information about the family, including making collateral contacts with individuals/agencies that know or have worked with the family.
5. Facilitate a MDT meeting within 25 calendar days of a child entering care.
   
    
   1. Coordinate the date and time for the MDT.
   2. Include representatives from at least three professional disciplines (e.g., public health, mental health, and education).
   3. Provide participants written notice of the MDT meeting at least five business days in advance of the scheduled meeting date(s).
   4. Present the completed CCFA Report and discuss what was learned about the family.
   5. Identify high risk or difficult situations the family faces in everyday life (see policy 19.2 Case Management: Family Developmental Stages and Tasks).
   6. Review recommendations for services, placement and permanency planning, and the expected outcomes from such recommendations.
   7. Discuss any edits and revisions that need to be made to the CCFA report.
   8. Establish a deadline for submission of the edited version of CCFA, if applicable.
6. Complete all required forms in accordance with DFCS guidelines.
7. Submit the completed CCFA within 25 calendar days of the referral date (if a CCFA provider).
8. Submit the completed sections of the CCFA within 10 calendar days of being notified of the termination or cancellation of the CCFA (if a CCFA provider).

The Social Services Supervisor will:

1. Determine whether the CCFA will be completed by the SSCM or a provider.
2. Ensure the timeliness of referrals to CCFA providers and the Amerigroup CCT.
3. Ensure families and placement providers are informed about the CCFA process and are made aware of who will be completing the CCFA.
4. Ensure the results of the medical and trauma assessments are received timely and incorporated into the completed CCFA.
5. Ensure kinship assessments are initiated immediately following the identification of potential kinship placement resources.

PRACTICE GUIDANCE

Child and Family Assessment

The comprehensive child and family assessment expands upon the assessment conducted during the investigation and identifies behaviors and conditions about the child, parent, and family that contributed to safety threats and the risk of child maltreatment. The assessment provides the SSCM and the family with a greater understanding of how a family's strengths, needs, and resources affect the child's safety, permanency and well-being. It is strengths- based, family-centered, culturally competent, individualized, and developed in partnership with the family. The strengths identified provide the foundation upon which the family can make changes. The assessment also involves the extended family, formal and informal support. The information gathered guides the family and SSCM in:

1. Identifying what must change to mitigate or eliminate the safety threats.
2. Addressing the effects of maltreatment.
3. Addressing the effects of the child’s removal.
4. Eliminating or reducing the risk of maltreatment reoccurring.
5. Providing the foundation for providing appropriate services.
6. Developing the case plan.

When a child enters foster care, it is extremely important to obtain as much information about the child and family as soon as possible. The SSCM must engage parents/caregivers at the time of removal and each subsequent contact to obtain a complete picture of each child’s needs. The SSCM must be knowledgeable and resourceful in utilizing and developing resources to enable children to achieve the highest level of functioning possible. This will involve working in partnership with birth families, placement providers, service providers, medical professionals and other community partners.

Gathering Information

Explore all sources of possible information about the family that will assist in conducting a family assessment, especially any existing FFA. It may require obtaining a signed Authorization for Release of Information form. Some ways of obtaining information include:

1. Consulting with the previous Case Managers, Supervisor or other DFCS staff familiar with the family.
2. Reviewing past CPS and Foster Care history.

3.   Making collateral contacts with individuals/agencies that know or have worked with the family.

• Interviewing the family and observing family interactions, living conditions, behaviors, etc.
• Accessing reports and records generated from other agencies and/or other professionals.
• Reviewing formal evaluations and treatment summaries (e.g., medical, psychological, drug and alcohol assessments, etc.).
• Accessing any other source of information pertinent to the assessment process.

Family Engagement

Children as well as their immediate and extended family should be engaged in the assessment process to develop a complete picture of the family. Family-centered approaches are effective ways to involve the family in assessment, planning and decision-making around the needs of the child (see policy 19.3 Case Management: Solution-Focused Family Team Meetings). One early and important step is to make sure the parent/guardian/legal custodian and the placement provider know who will be completing the CCFA. If the CCFA is being completed by a provider, DFCS should make every effort to introduce the provider to the parties involved as soon as possible. Face-to-face introductions are preferred and help providers establish working relationships and support timely completion of the CCFA.

Engage families with the understanding that situations resulting in a child entering foster care are associated with the challenges of everyday life events that all caregivers face (see policy 19.2 Case Management: Family Developmental Stages and Tasks). The assessment information also assists judges, CASAs, citizen panels, and other providers working with the child and family to gain a better understanding of the:

 

1. Situations in everyday life that are difficult for the family and the exceptions;
2. Parental capacities and child vulnerabilities;
3. Degree of parent-child attachment and the child’s sense of belonging;
4. Child’s extended family as a potential resource for support and/or placement;
5. Family’s history and/or patterns of behavior (e.g., prior CPS involvement or foster care placements, past experience with handling crisis, problems with addiction, criminal behavior, etc.);
6. Strengths and resources which the family can engage;
7. Core needs of the family which, at a minimum, must be changed or corrected for the child to be safely returned within a reasonable period of time;
8. Challenges impacting the success of a reunification permanency plan; and
9. Medical, emotional, social, educational and placement-related needs of the child.

Kinship Assessment

The CCFA should identify kin to be explored as possible placement, visitation and/or permanency resources. With supervisory approval, a case manager may request a CCFA provider to complete the Kinship Assessment. The Kinship Assessment must be requested as part of the CCFA in order to utilize the CCFA funding source. Refer to the Field Fiscal Services COSTAR Manual Section 3006 Support Services for information regarding funding.

FORMS AND TOOLS

Birth Family Background Information for Child 

CCFA WRAP Approved Providers List 

CCFA/WA Provider Qualifications

Comprehensive Job Aid for Service Authorization - Georgia SHINES Job Aid 

COSTAR Manual Section 3001 Family Foster Care Programs

COSTAR Manual Section 3006 Support Services