Placement Information for Managing Conservator Dear Parent/Managing Conservator, Thank you for placing with Pathways. This handbook contains several polices related to our agency that are important for you to know. List of Included Polices: Program Description, 749.337 Child Rights Policy on Educational Programming, 749.1113. Policy on Visitation including Family and Overnight Visits, 749.1113. Policy on Gifts, 749.1113. Policy on Mail and Telephone Calls, 749.1113. Policy on Personal Possessions, 749.1113. Policy Concerning Trips, 749.1113. Policy on Religion, 749.1113. Program Rules & Expectations, 749.1113. Policy on Discipline, 749.337, 749.1113. Policy on Emergency Behavior Intervention, 749.337, 749.1113. Child Grievance Procedures, 749.1113. Policy on Service Planning & Notifications to Parents/MC, 749.1113. Policy Regarding Use of Volunteers, 749.1113. Policy on Fundraising/ Publicity Notice of Privacy Practices, (HIPAA) Thank you for entrusting us to care for your child. Please do not hesitate to contact the assigned Pathways staff if you have any questions. Sincerely, The Pathways Staff Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 1 Placement Information for Managing Conservator Program Description Pathways utilizes an integrated treatment team approach that combines milieu therapy and family/ individual/group therapy concurrent with special education services where applicable. Treatment and counseling is directed by a team of child-care professionals consisting of a Licensed Therapist, Masters level Treatment Staff, Case Manager, Psychiatrist, Psychologist, school liaison staff, and foster parents. Therapeutic Program Description: Forms of direct therapeutic intervention may include: Milieu/Home; The Foster Family first provides the safe and stable environment and atmosphere for the child. The foster family also provides numerous experiential opportunities for the child to heal, grow, and mature. These opportunities include learning how to develop and maintain appropriate personal relationships, learning to identify their own personal strengths and limitations, and learning how to take responsibility for their own emotions and actions on a day-to-day basis. These are evidenced by providing the child opportunities to exhibit appropriate boundaries, self- control, and personal responsibility. The Foster Families utilize the structure of their home, their relationships, and skilled supervision, to create an active and dynamic environment that uses the child’s successes and failures as teaching opportunities. Individual, group, and/or family therapy or any combination thereof. Therapeutic approaches utilized by may include but are not limited to cognitive-behavioral, play therapy, solution-focused, supportive, relational, trauma-based and attachment-oriented. Each provider works from their own area of expertise to help the child and their foster family manage issues from their past and present while working towards a healthy and successful future Psychiatric and psychological consultation, and psychotropic medication are also available to the children/youth in PYH care. Therapeutic modality and other interventions may vary and will be based on clinical assessment and determination by therapist and treatment team. The therapeutic program utilizes these types of therapeutic modalities to address; sexual abuse, physical and emotional abuse, family separation issues, sibling relationships, social skills, anger management, appropriately identifying and expressing emotions, identifying and changing maladaptive behavior, substance abuse, coping skills, and taking responsibility for behavior, actions and emotions. It is the responsibility of the Pathways Treatment Team to assist foster families in understanding the importance of providing a structured living environment that aims to build self-esteem, establish coping skills, and learn and exhibit socially acceptable behavior. The foster parents, therapists, and the entire treatment team utilize positive reinforcement, logical and/or natural consequences, loss of privileges, and supportive nurturing relationships to intervene at a therapeutic level with the children and youth placed with Pathways. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 2 Placement Information for Managing Conservator Ultimately, the goal of Pathways programming is to develop healthy foster families who then; Actively participate in the educational enrichment, moral development, and community participation of the children in their care, and Teach their children how to cope and take responsibility for their emotions, learn more socially acceptable behavior, and be able to realize their full potential at home, school and in the community. Assist children, according to their developmental level, in developing daily living skills such as personal hygiene, grooming, communication, self-help skills and maintaining personal safety. Expose children to culturally appropriate activities and education based on their specific values, interests, ethnic background, race, customs and heritage. Prepare children for life experiences after discharge by encouraging and seeking out vocational training, developing application and interviewing skills, allowing older children to work and earn money, as appropriate, and develop coping skills. Educational Services: Children and Youth placed with Pathways attend the TEA accredited schools. Pathways Foster Parents work closely with the teachers to ensure that each child is assessed appropriately and placed in a program curriculum designed the meet the individual child’s needs. Pathways Case Managers and the Foster Parents act as the school liaison and ensure that the appropriate information is provided to place the child in the right classroom setting. Foster Parents as well as Pathways staff are available to offer assistance to the schools. Close attention is given to the detection of possible learning disabilities or other factors, which might influence the child’s educational process. In addition to academics, Pathways emphasizes functional living skills to include vocational awareness, independent living skills, and budgeting. Pathways attempts to provide our students with well-rounded, practical educational experiences. Pathways will ensure that appropriate educational services are available for hearing impaired clients by ensuring that the child will have access to a deaf education certified teacher at the deaf or hard of hearing student’s Admission, Review and Dismissal (ARD) Committee Meetings through a public or private school system. The ARD committee will consider the student’s language and communication needs including opportunities for direct communication with peers and professionals and for direct instruction in the student’s language and communication mode, as well as academic level and full range of needs in determining appropriate educational services and placement. Behavioral Program Description: Pathways uses a social model based primarily on reality therapy principles with its various foster homes. The children are provided structure and guidance within a nurturing environment. Foster Parents are trained in the use of natural and logical consequences, and other techniques in order to provide the children a consistent, structured, therapeutic approach in all of their activities. Within this framework, foster parents spend time developing supportive and therapeutic relationships with the children. The foster home provides opportunities for learning relationship-building skills, as well as skills in maintaining important relationships. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 3 Placement Information for Managing Conservator Foster Parents emphasize and reinforce the positive aspects of each child’s behavior. The use of positive reinforcement and positive responses to children greatly reduces their negative responses and acting out. Restrictions, restitution, loss of privileges, are sample activities that may be used as consequences for misbehavior. Disciplinary measures used by foster parents are: To be consistent with Pathways policies, Not physically or emotionally damaging to the child. Individualized to meet each child’s needs. Age/Developmentally appropriate. Recreation/Leisure Program Description: Pathways places a strong emphasis on recreation with children. Recreation and leisure are essential components designed for children to experience fun in non-dangerous, lawful, and appropriate ways. Recreation allows a person to develop skills, achieve goals, and gain a positive self-identity. Involvement in competitive and noncompetitive recreation/leisure activities can give a child a great deal of recognition through individual achievements and positive participation. The therapeutic components of our Recreational activities are designed to enhance the treatment program by exposing children to a variety of opportunities for personal growth in areas of social skills, physical fitness, teamwork, life skills, progress toward treatment and educational goals and independence. The therapeutic value of recreation is multifaceted and includes, but is not limited to: Improved fitness and coordination Development of pro-social communication skills Increased frustration tolerance Decreased aggression Improved group and team interaction skills Development of leadership skills Aptitude and skill development An outlet for academic, spiritual and cultural pursuits Development of independent living skills Children and Adolescents placed with Pathways may be involved in numerous extracurricular activities such as football, track, FFA, Stock shows, and UIL. Foster Parents assist the children and adolescents in a variety of activities such as 4H, finding employment, weekly family activities, boy and girl scouts, dance, gymnastics, swimming, and yearly vacations. These types of activities allow children to interact within the community. Pathways encourages structured activities that are designed for group participation, including arts and crafts, group games, and entertainment and cultural activities such as trips to museums, parks, movies, shopping centers and community affairs. These activities are designed to provide the children with the opportunity to work on cooperation and teamwork, to explore their own creativity, to gain knowledge of culture and to develop a sense of responsibility in society. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 4 Placement Information for Managing Conservator Recreation is the work of children and youth. It is a strategically planned component of the Pathways program. Recreation allows for discovery and development of the self. Children begin to encounter what their abilities are and what their limitations are through structured and strategic recreational planning. They gain in areas of personal strength, self-accomplishment and ego development through involvement in the recreational programs. In addition to building self-esteem, they develop a sense of competency and camaraderie with others. Peer relationships are a crucial aspect within all recreational planning. Often children who come into care have a history of poor peer relationships. They often do not have the skills to cooperate, negotiate, and compete with others in healthy ways. Recreation also allows for renewed understanding of relationships with persons in authority including adults, officials, PE teachers, and/or others who are directly involved in and responsible for recreational activities. Authority figures can take on a new identity and children can begin to build relationships with them through mutual, playful activity. Through leisure time, children can relax, reflect, develop independence and have the opportunity to explore their own interests in a way they might choose. Leisure time is provide for children on a daily basis and may include time spent indoors and outdoors. Board games, toys, sports equipment, playscapes, and spontaneous group and individual activities such as walks, bike rides are all part of daily leisure time activities. Reading, television, listening to music, and other arts and crafts are encouraged as well for leisure time. Pathways will individually assess each resident’s recreational preference and needs. Children will be exposed to culturally appropriate activities and recreation based on their specific abilities, values, interests, ethnic background, race, customs and heritage. Participation in a given recreational activity is contingent upon the child’s behavior and need for supervision. Foster parents and treatment team members are responsible for planning therapeutic recreation activities which allow children to work toward their treatment goals. Foster parents will arrange for supervision of these activities as appropriate to meet the specific needs of individual children. Information about duration, supervision and frequency of therapeutic recreation activities will be documented in the child’s case record. Foster parents are responsible for providing recreational activities such as indoor, outdoor, school, community and church activities for children that are age-appropriate, varied, and are of interest to the child. Recreational activities must, at a minimum, be supervised in accordance with Pathways Policies, Minimum Standards and Service Level requirements. In addition, the foster parents and staff shall intervene, as necessary, to reduce the risk of and occurrence of any and all injuries. Foster parents and child-placing staff shall ensure that the youth have input into the type of recreational activities they wish to participate in. Religious Program Description: Although Pathways claims no religious affiliation, church attendance is an integral part of our program and serves as a positive outlet for both social and recreational activities. Children and youth often have spiritual questions and thoughts, and every family has it’s own thoughts about spirituality, and a history of dealing with many of those same questions. Children and youth are encouraged to ask those questions and discover answers to those questions. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 5 Placement Information for Managing Conservator Foster Parents participate in the denomination or faith of their choice. Pathways will inform the parents or managing conservator of the foster home religious preference at the time of the child’s admission for foster care services. Pathways is aware that religion is a personal matter and is sensitive to each child’s spiritual needs, and avoids anything that might be viewed as coercion to accept a particular set of beliefs. Pathways does not believe that church attendance is the same as coercing a belief system. Therapeutic Programs for Special Populations: Services for Dually Diagnosed Clients (Behavioral and Developmental) When providing services to children with a dual diagnosis of a behavior in conjunction with mental retardation or autism, Pathways will: a. Meet the therapeutic and behavioral needs of children with a diagnosis of mental retardation and/or autism. b. Meet the therapeutic and behavioral needs of children at the Moderate and Specialized service levels with multiple DSM diagnoses. c. Provide services and teach skills to maximize the child’s level of functioning (e.g. self help, independent living). Child’s Rights Pathways is responsible for protecting your rights in the following ways: Your rights must be protected while you are in foster care or in an adoptive placement prior to the consummation of adoption Pathways must ensure that the caregiver or adoptive parent, prior to consummation of the adoption, does not restrict or deny your rights. Pathways is responsible for removing you if abuse, neglect, or exploitation exists. You and your parent/managing conservator will get a copy of these rights and will sign that you both received them and understand them. A copy will be placed in your chart. Your rights are as follows: The right to be care for and receive services that meet your needs The right to be treated equally and not be treated differently because you are a boy or girl, the color of your skin, where you go to church or what/who you believe in, where you were born, or your sexual orientation The right to have your physical, emotional, developmental, educational, social and religious needs met The right to be safe and not be hurt physically, emotionally or sexually The right to be taken care of and have food, clothing, a safe place to live and to be supervised/watched by a responsible adult The right to be free from physical harm, cruel, unusual, or unnecessary remarks that hurt or embarrass you. This includes but is not limited to: 1. No hitting, spanking, shaking Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 6 Placement Information for Managing Conservator 2. No threatening to hit, spank, shake 3. Not making you do work without a purpose like moving rocks 4. No denying you food, sleep, bathroom use, mail, or family visits as punishment 5. Not saying things that hurt you or your family 6. No threatening you with loss of placement/loss of home as punishment The right to be given consequences that are appropriate to your age and developmental stage The right to be told why you have been given a consequence The right to be protected from harm and have appropriate privacy or time by yourself The right to go to school and learn The right to learn and be taught how to take care of your body, including bathing, brushing your teeth, getting dressed, and washing your hair The right to be able to participate in activities in the community and at school The right to have personal clothing suitable to your age and your size and including the right to have protective clothing against the sun, snow, wind, rain, insects, cold The right to have your own things at your home and to be able to get more of your own things within reasonable limits The right to maintain regular contact with your family unless it is not in your best interest according to appropriate professionals or the court places restrictions on this The right to send and receive mail that does not have to be looked over by anyone, to have telephone conversations, keep a personal journal and to have visitors, unless appropriate professionals or the court place restrictions on this The right to hire your own mental health professionals, medical professionals, and attorneys at your own expense The right to be paid or compensated for any work done for the agency or home as part of your service plan or vocational training with the exception of routine chores that relate to your living environment. For example: making your bed, cleaning up the restroom, taking out your trash etc. The right to have the money you earn from work or allowances, your own things, and gifts with you as your property The right to be able to communicate/talk in a language or any other means that is understandable to you at admission or within a reasonable time after you are admitted if applicable. The right to care and treatment that is confidential or not talked about with anyone else without permission from you The right to not participate in any fund raising activity for the agency without written consent first. No one can use your picture without consent first. The right not to be required to make public statements about your gratitude/thankfulness to the foster home or agency The right to be free of unnecessary or excessive medication The right to have a comprehensive Service Plan that addresses your needs, and one that plans for when you are discharged or leave placement The right to participate in the development and review of your service plan within the limits of your comprehension and ability to manage the information The right to receive emotional, mental health, or chemical dependency treatment separately from adults Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 7 Placement Information for Managing Conservator The right to receive appropriate treatment for physical problems that affect your treatment or safety The right to be free from pressure to get an abortion, relinquish your child for adoption, or to parent your child, if applicable The right to report abuse, neglect, exploitation, or violation of personal rights without fear of punishment, interference, force, threats or retaliation Child’s Rights Regarding Education Pathways will ensure you have appropriate education through participation in an educational/vocational program in the most appropriate, least restrictive educational settings. Pathways will ensure foster parents and caregivers must, as applicable, attend and participate in school staffings, conferences, and educational planning meetings for you. Foster parents will make reasonable efforts to allow you to participate in extracurricular activities. Foster parents will make reasonable efforts to allow you to participate in school extracurricular activities to the extent of your interests and abilities and in accordance with your Service Plan. (See Educational Policy for additional info.) Child’s Rights Regarding Contact with a Parent Pathways must allow contact between you and your parent whose rights have not been terminated according to Pathways Policies and the provisions of a court order or any visitation agreement. Pathways staff will document in your record any plans for contact between you and your parent and any decision to limit contact with your parent. Before any temporary restrictions are placed on ongoing contacts and communication between the you and your parent, Pathways team must explain the reasons for the restrictions to the you and your parent and document this in the your record. Restrictions that continue for more than 30 days must be re-evaluated monthly by Pathways team. The team must explain the reasons for continued restrictions to you and your parents and document this in your record. If communication/visits are limited due to practical reasons, such as, geographical distance or expense, Pathways staff must discuss the limits with you and your parents. This must be documented and placed in your record. Child’s Rights Regarding Contact with Siblings Pathways must provide reasonable opportunity for you to have sibling visits and contact with them. The plans for sibling visits and contacts must be addressed in your record. When contact is restricted or not allowed, Pathways staff must include justification in the your record. If the restriction lasts more than 90 days, justification for continued restrictions must be documented in your record at least every 90 days. If barriers to visits exist, such as unavoidable geographic distance and expense issues, the Pathway’s team must make provisions for sibling contact through letters, telephone calls, or some other means. Child’s Right to Privacy Regarding Contact with Others Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 8 Placement Information for Managing Conservator Except when determined by Pathway’s team and/or parent/managing conservator, Pathways team may not open or read your incoming or outgoing mail, including electronic mail, unless necessary to assist you with reading or writing or listen to or screen telephone calls unless you need assistance with the phone. Pathway’s team must document in your record any reason for restricting your mail or telephone calls and a listing of the mail or telephone calls that are restricted. Pathway’s team must inform you and your parent/managing conservator about the restrictions that are in place. Restrictions that continue for more than 30 days must be re-evaluated monthly by Pathway’s team who must explain the reasons for the continued restrictions to you and document the reasons in your record. Educational Program Policy It is the policy of Pathways that you will have appropriate education through participation in an educational/vocational program in the most appropriate and least restrictive educational settings, for example: attending regular classes conducted in an accredited elementary, middle, or secondary school within the community. Responsibilities of Caregiver include: Notify the school district no later than the third day after the child is placed if the child is 3 years of age or older, or if the child is younger than 3 notify a local early intervention program. Must ensure that you attend an educational facility or program that is approved or accredited by the Texas Education Agency, the Southern Association of Colleges and Schools, the Texas Private School Accreditation Commission unless approved by your service planning team with documented justification; Advocating that a school-age child receives the educational and related services to which he is entitled under provisions of federal and state law and regulations. Attend and participate in school staffings, conferences, and education planning meetings. This includes requesting ARD, IEP, and ITP meetings if concerned with your educational program or if you do not appear to be making progress. Review report cards and other information received from teachers or school authorities with you and provide necessary information to agency staff; Make reasonable efforts to allow you to participate in extracurricular activities; and to the extent of your interests and abilities and in accordance with your service plan. Ensuring a school-age child has the training and education in the least restrictive setting necessary to meet the child’s needs and abilities; For a child attending an accredited educational facility or program, ensuring the facility or program that implements a special education student’s individual education plan (IEP); Counsel and assist you regarding adequate classroom performance; Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 9 Placement Information for Managing Conservator Provide a quiet, well-lighted space for you to study and allow regular times for homework and study. If the foster parents would like the child to attend a private school, the foster parents are responsible for the tuition. Children may not attend a private school unless it is certified by the Texas Private School Accreditation Commission and until the managing conservator and the treatment team have approved the decision. This approval must be documented in the child’s record. Foster children may not be home schooled. Pathways shall maintain and update an Education Portfolio, including but not limited to; report cards, transcripts, the Admissions, Review, and Dismissal (ARD) team meeting notes, the Individual Education Plan (IEP), the Full Individual Evaluation (FIE), Diagnostic testing, and the school withdrawal or discharge paperwork for each child in the Pathways care. Pathways will make the Education Portfolio readily available to the Department's caseworker on any visit with the child or otherwise, if requested. Additionally, Pathways will document that the report card and progress reports are discussed with you. Upon Discharge, Pathways will provide the your Education Portfolio to your caseworker at the time you are discharged from Pathway’s care. Pathways will minimize disruptions to your education by scheduling therapy and other appointments outside school hours, whenever possible. Relationship with the School and Conflict Resolution: Foster parents serve as the liaison between the school and the foster children placed in their care by Pathways. Pathways staff, usually the foster child’s case manager, provide support to the school, foster child, and foster family when needed or requested (i.e., conflict resolution, ARD’s, etc). Pathways Youth and Family Services, Inc. makes every effort to avoid conflict with schools. This is accomplished by using a variety of skills to include designating a school liaison and sharing appropriate information with key personnel who will be involved in the final decision making process. The protocol for conflict resolution begins with a conference with the teacher. If this does not sufficiently resolve the matter, a conference will take place with the teacher and the principal. If the issue is still unresolved, a conference will be held with the superintendent. The final step will be a conference with the school board. Pathways is committed to maintaining a strong working relationship with the school system. Policy on Contact with Family Members When appropriate, Pathways encourages contact to include visits, mail, and/or telephone calls for the child in placement with siblings, parents, and the managing conservator. Pathways will allow and coordinate contacts between the child and their Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 10 Placement Information for Managing Conservator parents as approved by the managing conservator or a court order unless parental rights have been terminated or relinquished or contacts are not in the child’s best interest. Child Placement Management staff may determine that contact with parents is not in the best interest of the child. The reasons for any restrictions on contact must be explained to the child and the child’s parent and the reasons must be documented in the child’s record. If restrictions continue longer than one month, Child Placement Management staff must re-evaluate the restrictions at least monthly. Reasons for the continued restriction must be explained to the child and the child’s parents and be documented in the child’s record. If communications or visits with parents are limited for practical reasons (such as expense or distance), the limits will be discussed with the child and his parents or managing conservator. The limits will be documented in the child’s record. Child Placement Management staff may determine that contact with siblings is not in the best interest of the child. The reasons for any restrictions must be documented in the child’s record. If restrictions continue longer than 90 days, Child Placement Management staff must document the justification for continuing the restriction in the child’s record at least every 90 days. If barriers to visits with siblings exist, such as unavoidable geographic distance and expense issues, Pathways will make provisions for sibling contact through letters, telephone calls, or some other means. The managing conservator, court orders, will determine the frequency and length of visits or the child’s treatment/service plan. All visits will be arranged in advance through the case manager or managing conservator. It is requested that the foster parents be notified one week prior to the visit in order to ensure that the visit will not conflict with the foster home schedule. Visits will take place in designated visiting areas unless prior arrangements have been made. Rules for telephone calls are determined by each foster home or group home, and all children in the home will follow the rules unless the managing conservator provides additional instructions. Rules for telephone use will be made available to the child upon admission into the home. A child may make long distance calls from the foster home, however these must be made “collect” to the parent they are calling unless the foster parent allows otherwise. “Collect” calls that are from parents to Pathways homes will not be accepted. Gift Giving As a child in care, you have the right to give and accept gifts, as deemed appropriate and safe by Pathway’s team/ and or Managing Conservator. You will be allowed to receive, open and keep gifts in your possession from other children, foster parents, Pathway’s staff, biological family etc. as long as the gifts are deemed safe and appropriate by Pathway’s team. These gifts are your personal property and must go with you whenever you leave the foster home or placement, as they belong to you. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 11 Placement Information for Managing Conservator You will also be allowed to purchase gifts, as deemed appropriate (doing so from your own desire with no force from others) for other foster children, foster parents, biological family or other persons with whom you have a relationship with using your allowance or money you earned from a job. You will be given opportunities to select and purchase these gifts. Mail, Email, Internet, and Phone Calls Except as determined by Child Placement Management Staff or the Managing Conservator or Child’s parent, Caregivers will not open or read your incoming or outgoing mail, including electronic mail, unless necessary to help you in reading or writing. The caregiver must also not listen to or screen your telephone calls unless you need help using the telephone. If restrictions are determined to be necessary by Child Placement Management staff, the reasons will be documented in your record, including a listing of the mail or telephone calls that are restricted. You and your Parent/Managing Conservator must be informed about the restrictions. Restrictions lasting for longer than 30 days must be re-evaluated monthly by the Child Placement Management staff who must also explain the reasons for the continued restrictions to you and must document the reasons in your record. Rules for telephone calls are determined by each foster home or group home, and all children in the home will follow the rules unless the managing conservator provides additional instructions. Rules for telephone use will be made available to you upon admission into the home. You may make long distance calls from the foster home, however these must be made “collect” to the parent they are calling unless the foster parent allows otherwise. “Collect” calls that are from parents to Pathways homes will not be accepted. Internet Instant Messaging, On-line chat rooms, blogging, MySpace, and Internet usage are treated differently than regular mail and telephone contacts, in that these venues are virtually open to the entire world. Any adult can pose as a youth and secretly communicate with other children as has been documented by several credible news organizations and police departments. Allowing a child unsupervised Internet access is akin to allowing the to invite the entire world to their door. Caregivers are expected to monitor your Internet usage to ensure your safety, including utilizing monitoring software. Caregivers will inform you when you are placed in their home as to the level and extent of Internet usage, privileges and level of monitoring. Personal Possessions Policy: You will be allowed to bring and acquire personal possessions and gifts while in Pathways’ care. Items given to or bought for you become your property. You and your parents or managing conservator must bear in mind that storage space is limited and Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 12 Placement Information for Managing Conservator that expensive personal possessions are brought to the home at the risk of the child and parents or managing conservator. Pathways will not be responsible for damage or theft. Pathways will maintain an inventory of your clothing and personal belongings that are of substantial value and/or sentimental value. 1. A complete inventory of clothing and personal items will be completed at admission. The Clothing and Personal Item Inventory will be signed and dated by you (when age and developmentally able), the Foster Parent, and the Pathways Case Manager. 2. The Foster Parent will track additional clothing by updating the Clothing Inventory. Pathways Staff will review the Clothing and Personal Possession Inventory during the Quarterly Review Process. 3. Your Clothing and Personal Item Inventory will be sent with your Managing Conservator at Discharge. 4. Pathways will allow you to label your clothes with your name or initials and, at the time of discharge, provide your Managing Conservator with all the clothing obtained for and given to you. You may receive allowance, earn money, or receive gift cards while placed in foster care. Your money and gift cards must be accounted for separately from the agency’s funds or the funds of the family with whom you are placed. This tracking must be accounted for in writing and managed by the caregiver, and must be available for review by the Pathways case manager or Managing Conservator at any time. You may be limited to the amount of money you may have in your possession. None of your personal earnings, allowances, or gifts may be used to pay for your room and board, unless such a use is a part of your service plan and your Managing Conservator approves it in writing. The Caregiver must give or send your money to you, mc/parent, or next placement within 30 days of your discharge. All children are prohibited from having the following items: Alcohol Drugs and drug paraphernalia Tobacco products Weapons Gang related attire There are no exceptions to these items. Other prohibited items may be added. If an item not on this list becomes a problem, the Case Manager will discuss it with you. Your possessions must be free of unreasonable searches and unreasonable removal of personal items. Pathways may search you, your possessions, or your room only when Pathways has reasonable suspicion: Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 13 Placement Information for Managing Conservator (1) (2) (3) Of the presence of a prohibited item or an item that endangers yours or others safety; That you have made suicidal threats or threatened to hurt yourself or others; or That you or other children were involved in theft. Only a caregiver may conduct searches that involve the removal of clothing, other than outer clothing, such as coats, jackets, hats, gloves, shoes, or socks. If a search of a child who is five years old or younger involves the removal of clothing (other than outer clothing), another adult must witness the search. If a search of a child who is over the age of five involves the removal of clothing (other than outer clothing), an adult of the same gender must witness the search. The caregiver must ensure that other children do not witness a search that involves the removal of clothing, other than outer clothing. With the exception of a child’s mouth, a caregiver may not conduct a body cavity search of a child in care. A caregiver must document the following in the child’s record when conducting a search if it results in the removal of personal items or clothing worn by the child: (1) (2) (3) (4) (5) (6) (7) (8) (9) The date of the search; The name of the child; Reason for the search; A description of what was searched; The articles of clothing removed, if applicable; The name of the person conducting the search; The name of the witness, if applicable; The results of the search; and The resolution of the issue with the child or children involved. Policy Concerning Trips: 749.771, 749.1111 Pathways Youth and Family Services, Inc. provides opportunities for you to plan and take trips into the community. The trips can be with a group of children and staff. Depending on a child’s need for supervision, he or she may be allowed to take trips in the community without direct care supervision. The child will always check out and check in with a foster parent. Out-of-town and overnight trips may be planned with a group of children and with foster parent supervision. Pathways staff must be notified when the foster child is away from the home more than 48 hours or longer. The Managing Conservator must provide written approval. Foster children may not travel outside of the contiguous United States without written permission from the Managing Conservator. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 14 Placement Information for Managing Conservator In some cases, travel may require approval by a court or judge. Foster Parents should notify Pathways staff of upcoming travel as soon as possible in order that written approvals can be received from the Managing conservator. Foster Parents are responsible to exercise appropriate judgment regarding the people they utilize as additional caregivers or respite providers. This includes making appropriate decisions regarding the various community activities or overnight visits with friends that children placed in their home may participate in. The foster parent is responsible for ensuring that appropriate levels of supervision are available for activities they allow you to participate in away from the home setting. Religion Policy Pathways Youth and Family Services, Inc. claims no religious affiliation to a particular denomination or faith and has no formal religious program. Foster parents may participate in the denomination or faith of their choice. Pathways will inform your parents or managing conservator of the foster home religious preference at the time of your admission. Foster Parents will be sensitive to your religious beliefs. You have the right to be free from discrimination on the basis of religion. Caregivers must be willing to provide you opportunity for religious and spiritual development, if you want and as appropriate to your supervision needs. Pathways is aware that religion is a personal matter and will be sensitive to your spiritual needs. Pathways does not allow or tolerate forcing a child to a religion or specific set of beliefs. Pathways does not believe that church attendance is the same as forcing a belief system. Program Rules & Expectations: 749.339(11), 749.1111 Listed below are Expectations and Rules for you while placed in a Pathway’s Foster Home. Each family may have their own version in the home, but these Expectations are for everyone. Basically, we expect you to; 1) Respect Others, 2) Respect Yourself, 3) Respect the Home you live in, and 4) Try your best in school. I. Respect Others: Everyone in the house shows respect to everyone else. Treat others like you want to be treated. Ask permission before you borrow or use something that belongs to someone else. Don’t threaten or intimidate others through your words, actions, appearance, or facial expressions. Be ready on time. Don’t make others late or wait on you. II. Respect Yourself: Be honest about your feelings. Admit it when you make a mistake, and make a plan to do better. Don’t blame others for what you do Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 15 Placement Information for Managing Conservator Ask for help when you need it. III. Respect the Home: Keep your room, belongings, and bathroom in reasonable order. Complete any assigned Chores. All families work together to keep a home running. Running, roughhousing, wrestling, fighting, yelling and tearing up the house are not allowed. Don’t curse. Be nice to pets, they are part of the family too. IV. School: Be respectful towards Teachers, whether you agree with them or not. Satisfactory report cards are necessary for permission to attend social events. What you can expect from your Foster Parents: You will get their attention. They do foster care because they want to help you. You will always have enough food, clothing, and a safe living envirnment. They will give you time to play and relax. They will provide a structured schedule and explain the rules to you. They will provide all the moral and emotional support you let them give you. They will help you with homework as needed to the best of their ability. They will help you be successful in school, work, sports, whatever you want to be better at. Discipline & Behavior Management Policy Foster parents must provide opportunities to emphasize and reinforce the positive aspects of your behavior. Restrictions, restitution, or other activities may be used as consequences for misbehavior. The use of positive reinforcement and positive responses to children will greatly reduce the negative responses and acting out of children. Foster parents must also look for opportunities to reward and acknowledge good or improved behavior. Responses/interventions to appropriate behavior may include: 1. 2. 3. 4. Additional privileges Additional activities Participating in activities with less supervision Increased opportunities to participate in community events Responses/interventions to address inappropriate behavior may include: 1. Reminding you of behavior expectations daily by using clear, positive statements Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 16 Placement Information for Managing Conservator 2. Giving you acceptable choices or alternatives 3. Loss of privileges 4. Using praise, positive reinforcement, and encouragement of good behavior instead of focusing only on unacceptable behavior 5. Providing prior notice of possible consequences for inappropriate behaviors 6. Increased supervision 7. Redirecting your attention or behavior using positive statements 8. Processing of event or talking with you about the situation 9. Role Play appropriate behavior 10. Giving logical consequences that are appropriate to the situation and severity of the behavior 11. Arranging the environment to allow safe testing of limits 12. Focusing on the rule to learn and the reason for the rule 13. Focusing on solutions that are respectful, reasonable, and related to the problem behavior, rather than blaming or focusing on consequences 14. 1-on-1 observation 15. Using brief supervised separation or time away from the group or situation, when appropriate for you understanding, age, and development. 16. Notification to other Treatment team members Disciplinary measures used by foster parents must: 1. 2. 3. 4. Be consistent with Pathways policies Not be physically or emotionally damaging to the child Be individualized to meet each child’s needs Be appropriate to the child’s level of understanding, age, and developmental level, and 5. Be appropriate to the incident and severity of the behavior demonstrated. The goal of each disciplinary measure must be to teach the child acceptable behavior and self-control. The caregiver must explain the reason for the disciplinary measure when the caregiver imposes the measure. Only a caregiver known to and knowledgeable of a child may discipline the child. Types of Punishment not allowed: Corporal Punishment: Caregivers may not use or threaten to use corporal punishment with any child in care. Corporal punishment is the infliction of physical pain on any part of a child’s body as means of controlling or managing the child’s behavior. It includes: 1. Hitting or spanking a child with a hand or instrument; or 2. Forcing or requiring the child to do any of the following as a method of managing or controlling behavior: Perform any form of physical exercise, such as running laps or doing sit ups or push ups; Hold a physical position, such as kneeling or squatting; or Do any form of “unproductive work.” Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 17 Placement Information for Managing Conservator “Unproductive work” is work that serves no purpose except to demean the child. Examples include moving rocks or logs from one pile to another or digging a hole and then filling it in. Unproductive work is never an appropriate behavior management tool. “Unproductive work” does not include work that corrects damage that the child’s behavior caused. For example, you may require a child who defaces a fence or wall to repaint it. This example includes a logical consequence and an acceptable behavior management tool. In addition to corporal punishment, prohibited discipline techniques include, but are not limited to: 1. Any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline or punishment; 2. Denial of mail or visits with their families as discipline or punishment; 3. Threatening with the loss of placement as discipline or punishment; 4. Using sarcastic or cruel humor and verbal abuse; 5. Maintaining an uncomfortable physical position, such as kneeling, or holding his arms out; 6. Pinching, pulling hair, biting, or shaking a child; 7. Putting anything in or on a child’s mouth, such as soap or tape; 8. Humiliating, shaming, ridiculing, rejecting, or yelling at a child; 9. Subjecting a child to abusive or profane language; 10. Placing a child in a dark room, bathroom, or closet; 11. Requiring a child to remain silent or inactive for inappropriately long periods of time for the child’s age; 12. Confining a child to a highchair, box, or other similar furniture or equipment as discipline or punishment; 13. Denying basic child rights as a form of discipline or punishment; 14. Withholding food that meets the child’s nutritional requirements; and 15. Using or threatening to use emergency behavior intervention as discipline or punishment. Within limits, a foster parent may restrict a child’s activities as a behavior management tool. 1. Restrictions of activities, other than school or chores, which will be imposed on a child for more than 30 days, must be reviewed with and approved by the child placement management staff or treatment director prior to or within 24 hours of imposing the restriction. 2. Restrictions to a particular room or building that will be imposed on a child for more than 24 hours must have approval from the service planning team, a professional service provider, or treatment director prior to or within 24 hours of imposing the restriction. 3. You must inform the child and parent about any such restrictions you place on the child. 4. Documentation of all approvals, justification for the restriction, and informing the child and parents must be in the child’s record. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 18 Placement Information for Managing Conservator Emergency Behavior Intervention As a standard of practice, Pathways Child Placing Agency does not allow or utilize Emergency Behavior Interventions, including personal restraints, for Child-care or Treatment services. Caregivers may be considered, on a case-by-case basis for training and certification for personal restraints in order to meet the needs of a specific child or type of child placed in their home. These caregivers must participate and complete personal restraint training, and follow all applicable polices and procedures regarding type of holds, length of restraint, monitoring of restraint, de-escalation, releasing of restraint, reporting, documentation, and debriefing. At no time does Pathways allow mechanical restraints, emergency medication or the use of seclusion as Emergency Behavior Interventions. Emergency Behavior Interventions: Emergency behavior intervention may never be used as: 1. 2. 3. 4. 5. Punishment; Retribution or retaliation; A means to get a child to comply; A convenience for caregivers or other persons; or A substitute for effective treatment or habilitation. Short Personal Restraints: A short personal restraint is used in urgent situations, such as: 1. To protect the child from external danger that causes imminent significant risk to the child, such as preventing the child from running into the street or coming into contact with a hot stove. The restraint must end immediately after the danger is averted. 2. To intervene when a child under the age of five (chronological or developmental age) demonstrates disruptive behavior, if other efforts to de-escalate the child’s behavior have failed; or 3. When a child over five years old demonstrates behavior disruptive to the environment or milieu, such as disrobing in public, provoking others that creates a safety risk, or to intervene to prevent a child from physically fighting. When a caregiver implements a short personal restraint, the caregiver must: 1. Minimize the risk of physical discomfort, harm, or pain to the child; and 2. Use the minimal amount of reasonable and necessary physical force. A caregiver may not use any of the following techniques as a short personal restraint: 1. A prone or supine restraint; Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 19 Placement Information for Managing Conservator 2. Restraints that impair the child’s breathing by putting pressure on the child’s torso, including leaning a child forward during a seated restraint; 3. Restraints that obstruct the airways of the child or impair the breathing of the child, including procedures that place anything in, on, or over the child’s mouth, nose, or neck, or impede the child’s lungs from expanding; 4. Restraints that obstruct the caregiver’s view of the child’s face; 5. Restraints that interfere with the child’s ability to communicate or vocalize distress; or 6. Restraints that twist or place the child’s limb(s) behind the child’s back. Caregivers do not have to have completed Personal Restraint training in order to utilize Short Personal Restraints. Caregivers must report the use of a Short Personal Restraint to their Assigned Case Manager within 24 hours of the occurrence. Caregivers should complete the Short Personal Restraint Form, and the Form is to be reviewed by the assigned Case Manager. Preventive and De-Escalating Measures to Use to Avoid Personal Restraint: Foster parents/caregivers must first try to de-escalate the situation before restraining a child. These de-escalation techniques include, but are not limited to: Remove the agitated child from the setting Place yourself between the child and the stimulator to change focus and remove eye contact from others Remove other children from the area Provide a break/time out Quiet time Talking to the child to facilitate expression of thoughts/feelings Personal Restraints: Only a caregiver qualified in emergency behavior intervention may administer any form of emergency behavior intervention, except for the short personal restraint of a child. Before using a permitted type of emergency behavior intervention, the caregiver must: 1. Attempt less restrictive behavior interventions that prove to be ineffective at defusing the situation; and 2. Determine that the basis for the emergency behavior intervention is: a. An emergency situation; b. A need for a personal restraint to administer intra-muscular medication or other medical treatments prescribed by a licensed physician, such as administering insulin to a child with diabetes; or Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 20 Placement Information for Managing Conservator c. A need for a personal restraint in a foster home where a child is significantly damaging property, such as breaking car windows or putting holes into walls. If this is the basis of the personal restraint, only a short personal restraint may be used and only to prevent the damage. The use of emergency behavior intervention must be an appropriate response to the behavior demonstrated, and de-escalation must have failed. The caregiver must act to protect the child's safety and consider the: 1. Characteristics of the immediate physical environment; 2. Permitted types of emergency behavior intervention; and 3. Potential risk of harm in using emergency behavior intervention versus the risk of not using emergency behavior intervention. The caregiver must: 1. Initiate an emergency behavior intervention in a way that minimizes the risk of physical discomfort, harm, or pain to the child; and 2. Use the minimal amount of reasonable and necessary physical force to implement the intervention. The caregiver must make every effort to protect the child’s: 1. Privacy, including shielding the child from onlookers; and 2. Personal dignity and well being, including ensuring that the child's body is appropriately covered. As soon as possible after starting any type of emergency behavior intervention, the caregiver must: 1. Explain to the child the behaviors the child must exhibit to be released or have the intervention reduced, if applicable; such as remaining calm, refraining from hurting others and/or hurting self 2. Permit the child to suggest actions the caregivers can take to help the child deescalate. If the child does not appear to understand what he must do to be released from the emergency behavior intervention, the caregiver must attempt to re-explain it every 15 minutes until the child understands or is released from the intervention. A child must be released as follows: Type of Emergency Behavior Intervention The caregiver child: Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. must release the 21 Placement Information for Managing Conservator (1) Short personal restraint (2) Personal restraint (A) Immediately when an emergency health situation occurs during the restraint. The caregiver must obtain treatment immediately; or (B) Within one minute, or sooner if the danger is over or the disruptive behavior is de-escalated. (A) Immediately when an emergency health situation occurs during the restraint. The caregiver must obtain treatment immediately; (B) Within one minute of the implementation of a prone or supine hold; (C) As soon as the child’s behavior is no longer a danger to himself or others, the medication was administered, or the child is no longer damaging property; or (D) When the maximum time allowed for personal restraint is reached. The maximum length of time that certain emergency behavior interventions can be administered to a child is as follows: Types of Emergency Behavior Intervention (1) Short personal restraint The maximum length of time is: One minute. (2) Personal restraint (A) For a child under nine years old, 30 minutes. (B) For a child nine years old or older, one hour. (C) A prone or supine personal restraint hold may not exceed one minute. Follow up after a Personal Restraint: Caregivers must report the use of a Personal Restraint to their Assigned Case Manager within 24 hours of the occurrence. Caregivers should complete the Restraint Form, and the Form is to be reviewed by the assigned Case Manager. The caregivers must take appropriate actions to help the child return to routine activities. The follow-up actions of the caregivers must include: Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 22 Placement Information for Managing Conservator 1. Providing the child with an appropriate transition and offering the child an opportunity to return to regular activities; 2. Observing the child for at least 15 minutes; and 3. Providing the child with an opportunity to discuss the situation that led to the need for emergency behavior intervention and the caregiver’s reaction to that situation. The discussion must be held in private as soon as possible and no later than 48 hours after the child’s use of an emergency medication or release from any emergency behavior intervention. Caregivers involved in the emergency behavior intervention must conduct a postemergency behavior intervention discussion. The goal of the discussion is to allow the child and caregiver to discuss: 1. The child’s behavior and the circumstances that constituted the need for an emergency behavior intervention; 2. The strategies attempted before the use of the emergency behavior intervention and the child’s reaction to those strategies; 3. The emergency behavior intervention itself and the child’s reaction to the emergency behavior intervention; 4. How caregivers can assist the child in regaining self-control in the future to avoid the administration of an emergency behavior intervention; and 5. What the child can do to regain self-control in the future to avoid the administration of an emergency behavior intervention. Caregivers must document the following after discussing with the child the Restraint: 1. 2. 3. 4. The date and time the caregiver offered the discussion; The child’s reaction to the opportunity for discussion; The date and time the discussion took place, if applicable; and The content of the discussion, if applicable. Caregivers involved in the emergency behavior intervention must: 1. Debrief with child placing staff concerning the incident as soon as possible after the situation has stabilized; and 2. Make reasonable efforts to debrief with children in care who witness the incident. The child placing staff must review the use of the emergency behavior intervention within 72 hours of the intervention. The caregivers do not have to return the child to previous activities or place the child in current activities that the group is participating in if the caregivers deem the child’s participation is not in the best interests of the child or the other children in the group. However, caregivers must engage the child in an alternative routine activity. This section regarding Follow Up after a Personal Restraint does not apply to short personal restraints. During any personal restraint, a caregiver qualified in emergency behavior intervention must monitor the child's breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 23 Placement Information for Managing Conservator Appropriate action includes responding prudently to a potentially life-threatening situation, for example, releasing a child when a child is unresponsive or indicates he cannot breathe and immediately seeking medical assistance from a health-care professional. The caregiver must take into account that a child may thrash about more violently as he struggles to breathe. The following personal restraint techniques are prohibited: 1. Restraints that impair the child’s breathing by putting pressure on the child’s torso, including restraints that obstruct the child’s lungs from expanding such as leaning a child forward during a seated restraint; 2. Restraints that obstruct the child’s airway, including procedures that place anything in, on, or over the child’s mouth, nose, or neck; 3. Restraints that obstruct a caregiver’s ability to view the child’s face; 4. Restraints that interfere with the child’s ability to communicate or vocalize distress; or 5. Restraints that twist or place the child’s limb(s) behind the child’s back. 6. Prone and supine restraints are also prohibited as a short personal restraint. 7. Prone and supine restraints are also prohibited as a personal restraint except: a) As a transitional hold that lasts no longer than one minute; b) As a last resort when other less restrictive interventions have proven to be ineffective; and c) When an observer meeting the following qualifications ensures the child’s breathing is not impaired: Trained to identify risks associated with positional, compression, or restraint asphyxia; and Trained to identify risks associated with prone and supine holds. Personal Restraint Triggered Reviews: The following circumstances trigger a review for certain emergency behavior interventions: Types of Emergency Behavior Intervention (1) Short personal restraint Circumstances that trigger a review: Not applicable, because short personal restraints are not monitored. (2) Personal restraint (A) The same child is personally restrained four times within a seven-day period, Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 24 Placement Information for Managing Conservator A triggered review must occur as soon as possible, but no later than 30 days after the review is triggered. The regularly scheduled review of the child’s service plan can serve as the triggered review if it meets the requirements if it takes place no later than 30 days after the review is triggered. The service planning team must participate in the triggered review. The following must be included in a triggered review and documented in the child’s record: 1. A complete Service Plan Review 2. A review of the records and orders of the emergency behavior interventions; 3. A review and documentation of any potential medical or psychiatric reason for not using emergency behavior interventions on the child, including the prescribing professional’s consideration of any potential medical and/or psychiatric contraindications for the specific child, such as a history of physical or sexual abuse or victimization involving the type of intervention; 4. An examination of alternatives to manage the child's behavior and to assist the child in managing his own behavior; and 5. A written plan for reducing the need for emergency behavior intervention. If there are four triggered reviews within a 90-day period: 1. A licensed psychiatrist, psychologist, clinical social worker, professional counselor, or marriage and family therapist must examine the child; and 2. The licensed professional must make service plan recommendations regarding the use of emergency behavior interventions. You must document these recommendations in the child’s record. Child Grievance Procedures While in Pathway’s care, you should not be treated in a way that is unfair, demeaning, cruel, or embarrassing, or discriminated against because of your race, sex, color, national origin, age, political belief, religion, or disability. 1. You have the right to file a complaint at placement if you feel you have mistreated. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 25 Placement Information for Managing Conservator 2. You may write and submit complaints at any time that does not interfere with an organized or regularly scheduled activity or routine. 3. Upon request, caregivers and/or staff will help you file a complaint if needed. 4. Each complaint is turned into the Executive Director and is resolved within five work- days. 5. You will not be punished, discriminated against, threatened, or retaliated against for filing a complaint or helping someone else to file a complaint. 6. If you feel that you are not safe at Pathways, you may file a complaint in person or by telephone to the Executive Director or the local Director. Such reports are investigated immediately with actions taken to ensure your safety until the allegation is investigated. The Executive Director is informed of the complaint as soon as possible after receipt of the report. Grievances can be submitted through our website at www.pathway.org, or be submitted in writing or by phone to: Attn: CPA Executive Director Pathways Youth & Family Services 4243 E. Piedras San Antonio, TX 78228 Phone: 210 733-7117 Fax: 210 733-7118 Service Plan Policy, Notifications to Parents/Managing Conservator 1. Assignment of Treatment Team: After admission, each Child/Youth placed with Pathways is assigned a Treatment Team consisting of Caregivers and other professionals. This information is given to the Managing Conservator at the time of placement. The Treatment Team consists of the following: Foster Parents Parents/Managing Conservator Case Manager Therapist, if applicable Child Placement Management Staff For children receiving Treatment Services include the above in addition to at least two of the following: A Licensed Professional Counselor (LPC) Psychologist Psychiatrist* or physician A Licensed Registered Nurse A Licensed Maters Social Worker Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 26 Placement Information for Managing Conservator A Licensed or Registered Occupational Therapist; or Any other person in a related discipline or profession that is licensed or regulated in accordance with state law 2. Preliminary Service Plan: A preliminary treatment plan will be completed within 72 hours of admission for all children in care by the assigned team member. The Preliminary Service Plan addresses the immediate needs of the child, such as enrolling the child in school or obtaining needed medical care or clothing. The Preliminary Service Plan is to be completed within 72 hours of admission by the assigned Team Member and filed in the child’s record. Each Team Member must be informed of the Preliminary Service Plan. 3. Initial Service Plan: The Initial Service Plan will be completed within 30 days of admission and includes: Any needs identified in the Admission Assessment, Needs identified in the Preliminary Plan, DFPS Permanency Plan, Child’s Individual Education Plan, if applicable, Child’s Educational Transitional Plan, if applicable, Any other special needs. These are incorporated into the Service Plan domains of: Medical, Dental, Intellectual functioning, Developmental, Educational, Social/Recreational, Emotional/Psychological, Community, Cultural, Familial, Behavioral, and Permanency Planning. Supplemental Plans will be completed under the following circumstances; For youth 13 years and older, a Supplemental Plan for educating the youth in the following areas: Healthy Relationships, Healthy Boundaries, Pro-Social Communication Skills, Sexually Transmitted Diseases, and Human Reproduction is required. For youth 16 years and older, a Supplemental Plan for Preparation for Independent Living is required. For children and youth who receive Treatment Services (as defined by admission policy), a Supplemental Plan is required that includes: conditions that require treatment services, conditions the child must achieve and maintain to function in a less restrictive setting, and a list of needs that require professional expertise and plans to obtain the needed services. For children who are transitioning to a new living arrangement or new provider services, this will be addressed in the Service Plan, as well as the services to assist the child in the transition. The Treatment Team will be notified and invited to participate in the review by the Pathways Staff. Pathways staff will give at least 2 weeks advanced notification to Parents/Managing Conservator. Documentation of this notification, along with any response from Parents/Managing Conservator must be included in the child’s record. The following people will be invited to the Initial Service Plan. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 27 Placement Information for Managing Conservator The Child, as appropriate, At least one Caregiver Pathways Case Manager Managing Conservator/Legal Parent For Children receiving Treatment Services, at least two of the following professionals must be involved in developing an initial service plan. A Licensed Professional Counselor Psychologist Psychiatrist or physician A Licensed Registered Nurse A Licensed Masters Social Worker A Licensed or Registered Occupational Therapist; or Any other person in a related discipline or profession that is licensed or regulated in accordance with state law The Initial Service Plan must document the Professionals name and date of participation. If the provider disagrees with any portion of the plan, the provider must document the issues before signing it. The Initial Service Plan is considered approved after signatures are obtained and is reviewed, approved, and signed by the assigned Child Placement Management Staff. The Initial Service Plan must be implemented and followed no later than 10 days after the date of the Service-planning meeting. Upon approval, the parents/managing conservator, will be notified in writing that they plan is available for viewing and downloading via the Pathways on-line database. The date the Legal conservator was notified of the approved plan must be documented in the child’s record It is the responsibility of the case manager to share the plan with the child if the child was not present at the review. Documentation of this must be noted on a child’s signature page. 4. Service Plan Review: For children receiving Child-Care Services, Service Plans will be reviewed at least 180 days from the date of the child’s last Service Plan. For children receiving Treatment Services for Emotional Disorder, Pervasive Developmental Disorder, or Primary Medical needs, Service Plans will be reviewed at least 90 days from the date of the child’s last Service Plan. For children receiving Treatment Services for Mental retardation, Service Plans will be reviewed at least every 180 days (6 months) from the last Service Plan for the first year in care. Thereafter, the plan must be reviewed annually from the date of the last Service Plan. For children receiving Treatment Services for Mental retardation, each child’s Intellectual Functioning must be re-evaluated at least every 3 years by a psychologist qualified to provide psychological testing or a psychologist must determine the need and frequency for a specific child’s Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 28 Placement Information for Managing Conservator intellectual functioning to be re-evaluated. This determination, including justification for the time frame must be documented in the child’s record annually by the service planning team. If a child’s is moved into another Foster Home verified by Pathways, the child’s service planning team must approve the decision not to review and must document this decision in the child’s record. The Treatment Team will monitor the progress of the child in achieving the goals. A sixpoint scale measures the child's progress towards the achievement of each goal. Progress is rated at given intervals on the following six-point scale: +3 Goal achieved and maintained; +2 Substantial improvement in behavior identified in the goal; +1 Some improvement in behavior identified in the goal; 0 No decline or improvement in behavior identified in the goal; -1 Some worsening in behavior identified in the goal; and -2 Substantial worsening in behavior identified in the goal. The child's progress will be assessed on each identified goal within the identified domains listed in earlier in this section. If the child has shown improvement in 50% or more of the identified goal(s) as measured by a positive rating (+1, +2, or +3) during the monitoring period, the child will be considered to be progressing towards the goal(s). The Service Plan Review will assess progress on current goals and identify new needs, and plans for meeting those needs. This includes incorporation of the managing Conservators Permanency Plan, the child’s Individual Educational Plan if applicable, the child’s Educational Transitional Plan if applicable, and any other identified needs. These are incorporated into the Service Plan domains of: Medical, Dental, Intellectual functioning, Developmental, Educational, Social/Recreational, Emotional/Psychological, Community, Cultural, Familial, Behavioral, and Permanency Planning. The Treatment Team will be notified and invited to participate in the review by the Pathways Staff. Pathways staff will give at least 2 weeks advanced notification to Parents/Managing Conservator. Documentation of this notification, along with any response from Parents/Managing Conservator must be included in the child’s record. The following will be invited to the Service Plan Reviews. must have at least two weeks notice in writing. The Managing Conservator The Child, as appropriate, At least one Caregiver Pathways Case Manager Managing Conservator/Legal Parent For Children receiving Treatment Services, at least two of the following professionals must be involved in the Service Plan Review. The Service Plan Review must document the Professionals name and date of participation. If the provider disagrees with any portion of the plan, the provider must document the issues before signing it. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 29 Placement Information for Managing Conservator A Licensed Professional Counselor Psychologist Psychiatrist or physician A Licensed Registered Nurse A Licensed Masters Social Worker A Licensed or Registered Occupational Therapist; or Any other person in a related discipline or profession that is licensed or regulated in accordance with state law The Service Plan Review is considered approved after signatures are obtained and is reviewed, approved, and signed by the assigned Child Placement Management Staff. The Service Plan Review must be implemented and followed no later than 10 days after the date of the Service-planning meeting. Upon approval, the parents/managing conservator, will be notified in writing that they plan is available for viewing and downloading via the Pathways on-line database. The date the Legal conservator was notified of the approved plan must be documented in the child’s record.It is the responsibility of the Case Manager to share the plan with the child if the child was not present at the review. Documentation of this must be noted on a child’s signature page. 5. Service Plan Addendum: A Service Plan Addendum may be developed in response to any significant events that need to be quickly addressed. The purpose of the Service Plan Addendum is to identify updated treatment goals, objectives and needs of the child. The written Service Plan Addendum is incorporated as part of the child’s most recent Service Plan, and the additions to the Service Plan are to be implemented by the Treatment Team members. Service Plan Addendums are completed on an as needed basis and do not alter the schedule of Service Plan reviews. A staffing signature sheet will document those members of the treatment team who participate in the staffing process. Discharge Planning A child’s plan for discharge and after care begins at admission. Staff, the caregiver, and the child, review the child’s discharge plan at each Service Plan Review. A child will remain in care with Pathways as long as the agency is able to meet the child’s needs. Pathways will make all reasonable attempts to meet the needs of the child in our care in order to prevent placement disruption. A child will be discharged from Pathways when: The child has successfully completed the treatment goals The child’s needs are greater then what the agency can provide The child is adopted The child is reunified with a family member/relative The child is Emancipate The child ran away and cannot be located Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 30 Placement Information for Managing Conservator Pathways will not discharge a child to any person or agency other than the parent/managing conservator without written authorization from the parent/managing conservator or a person authorized by the court of law or by law to assume custody of the child. Discharge Planning- Non-Emergency (a) The following persons must be involved in planning the child’s non-emergency discharge: (1) At least one of the child’s current caregivers; and (2) At least one professional service provider involved in the child’s service planning. (b) The following persons must be invited to participate in planning the child’s nonemergency discharge or transfer, if appropriate: 1. The child; 2. The child’s parent(s); and 3. Any other person pertinent to the child’s care. (c) If staff are unable to plan the transfer or discharge with the persons required in subsections (a) and (b) of this section, this must be documented in the child’s record the reason why. (d) If a child is not receiving treatment services, staff will inform him of his nonemergency discharge or transfer at least four days prior to the date of the discharge or transfer, unless child placement management staff has clear justification for not giving him such notice. The child placement management staff who determines the justification for the child not having the advance notice of the discharge or transfer, must put the justification in writing and sign and date it. The justification must be in the child’s record. (e) If a child in care is receiving treatment services, staff will inform him of his nonemergency discharge or transfer at least four days prior to the date of the discharge or transfer, unless your treatment director, three members of the child’s service planning team, or the child’s psychiatrist or psychologist has a justification for not giving him such notice. Whoever determines the justification for the child not having the advance notice of the discharge or transfer must put the justification in writing and sign and date it. The justification must be in the child’s record. For Planned Discharges, designated staff will complete a Discharge summary. The Discharge Summary will include: 1. A discharge or transfer summary showing services provided to the child, accomplishments, assessment of remaining needs, and recommendations about the services to meet those needs; 2. The date and circumstances of the discharge or transfer; 3. Discharge or transfer medications and/or prescriptions for medications; 4. Support resources for the child, including telephone numbers and addresses; Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 31 Placement Information for Managing Conservator 5. Aftercare plans and recommendations, including medical, psychiatric, psychological, dental, educational, and social appointments; 6. Date and time the child was informed of his discharge or transfer; and 7. For discharges, the name, address, telephone number and relationship of the person to whom you discharge the child, unless the child legally consents to his discharge. If the child legally consents to his discharge and does not want to involve the child’s parent(s), you must document this in the child’s record. For children returning home, a copy of the Discharge Summary will be sent to the Child’s parent/MC within 30 days of the Discharge. Emergency/Unplanned Discharges An emergency discharge occurs when: 1. 2. 3. 4. The parent/MC withdraws a child unexpectedly from care; There is a medical emergency requiring inpatient care; The child is absent from the home and cannot be located; or There is an immediate danger to the child or others and Pathways cannot serve the child. For children that are an immediate danger to themselves or others, the child’s caregiver(s) or the child placement staff must accompany the child to the receiving operation, agency, or person unless the child’s parent or law enforcement transports the child. At the time of an emergency discharge or transfer, the following must be documented in the child’s record: 1. The circumstances necessitating the emergency discharge or transfer; 2. The explanation given to the child regarding the reason for the discharge or transfer; 3. The child’s reaction to the discharge or transfer; 4. The date of discharge or transfer; and 5. The name, address, and relationship of the person to whom you transfer or discharge the child, where applicable. Notification Timelines and Approvals for Unplanned Discharges. In the event a child poses a danger to self or others, or exhibits volatile or self-injurious behaviors that are inappropriate for Pathways, or Pathways determines it is not longer in the child’s best interest to remain in the program, the following Notification procedures are in place. In the case the child poses a danger to self or others, Pathways will provide the Managing Conservator with documentation from a physician that the child poses a danger to self or others, to facilitate admission to a hospital, the Managing Conservator shall remove the child within twenty-four (24) hours. Admission of the child to a hospital by the Pathways serves as documentation of the need for a more secure setting. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 32 Placement Information for Managing Conservator Pathways shall immediately inform the Managing Conservator of the admission and shall document whether Pathways is willing to accept placement of the child upon discharge from the hospital by email to the Managing Conservator. If Pathways provides the Managing Conservator with documentation from a psychiatrist, licensed psychologist, physician, LCSW-ACP, or LPC showing that the child consistently exhibits behavior that cannot be managed within our program services, the Managing Conservator shall remove the child within fourteen (14) calendar days. The Managing Conservator shall immediately communicate with the Pathways and staff the child’s circumstances to determine a plan for moving the child to ensure the child’s safety and that of others. Pathways shall notify the Managing Conservator within twenty-four (24) hours of the child’s placement in jail or juvenile detention and shall state whether Pathways is willing to accept placement of the child upon the child’s release from jail or juvenile detention. If Pathways is not willing to accept placement of the child upon the child’s release, the Managing Conservator shall, within twenty-four (24) hours of receipt of notification from Pathways, remove the child placed by the Managing Conservator. If Pathways provides other documentation to the Managing Conservator that it is no longer in the child’s best interest to remain at Pathways, or that Pathways cannot meet the needs of the child, the Managing Conservator shall remove the child within thirty (30) calendar days. The designated Child Care Management Staff shall sign this documentation. The Managing Conservator shall immediately communicate with Pathways and staff the child’s circumstances to determine a plan for moving the child to ensure the child’s safety and best interests and those of others. The Managing Conservator shall remove the child as quickly as is necessary. The Managing Conservator may immediately remove the child. Treatment and Discharge Information provided to receiving Operations. On or before the child’s discharge, Pathways will attempt to obtain legal consent from the Managing Conservator to release the discharge summary and the information in subsection (b) of this section. If consent is not obtained, Pathways attempt to obtain consent must be documented in the child’s record. If consent is obtained, the information must be provided to the receiving operation within 30 days of the date the child is discharged. 1. The child’s background information, including progress notes for the past 60 days if applicable; 2. Any unresolved incidents or investigations involving the child, if applicable; 3. Assessments and/or evaluations that you have performed for the child, including the child’s admission assessment, diagnostic assessment, educational assessment, neurological assessment, and psychiatric or psychological evaluation; 4. The child’s service plans while in your care for the past 12 months; 5. A list of medications the child is taking, the dosage, frequency, and reason the medication was prescribed; and 6. Any treatment for a physical condition that is in progress and requires continuing or follow-up medical care. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 33 Placement Information for Managing Conservator Policy Regarding Use of Volunteers/Sponsoring Families: 1. Volunteers are oriented to the type of programs provided by Pathways, as well as the type of children served by Pathways. Orientation also includes information regarding the reporting of abuse. 2. The Program Director supervises each volunteer; however, a specific individual is assigned responsibility for monitoring the volunteer’s activities and interactions. 3. Volunteers are selected based upon an interview process by supervisory personnel. 4. Volunteers are informed in writing of their responsibility to immediately report any incident of abuse or neglect of a child in care to the Executive Director or supervisory personnel. 5. Volunteers are not utilized as child- care staff or are in any supervisory role with clients. A person whose behavior or health impairs their ability to protect the child’s health, safety, and well being, is not allowed to serve as a volunteer. Policy on Fundraising/ Publicity and the Right to Refuse/Withdraw Consent for Publicity, Fundraising and Research Programs Pathways does not involve children in care to participate in any publicity, fundraising activities, or research programs. Updated 8-07. Related to RCCL Standards 749.337 and 749.1113. 34