Home Based Family Centered Therapy Services
I. Service Description
Provision of structured, goal-oriented, time-limited therapy in the natural environment of families who need assistance recovering from physical, sexual, emotional abuse, and neglect. Other issues, including substance abuse, mental illness, personality/behavior disorder, developmental disability, dysfunctional family of origin, and current family dysfunction, may be addressed in the course of treating the abuse/neglect.
Professional staff will provide family and/or individual therapy including one or more of the following areas:
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• Family of origin/intergenerational issues
• Family organization (internal boundaries, relationships, roles)
• Stress management
• Self-esteem
• Communication skills
• Conflict resolution
• Behavior modification
• Parenting Skills/Training
• Substance Abuse
• Crisis intervention
• Strengths based perspective
• Adoption issues
• Child and Family team meetings
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• Goal setting
• Family structure (external boundaries, relationships, socio-cultural history)
• Problem solving
• Support systems
• Interpersonal relationships
• Supervised visitation
• Family processes (adaptation, power authority, communications, META rules)
• Cognitive behavioral strategies
• Brief therapy
• Family reunification
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II. Service Delivery
1. Services will be provided face-to-face for the amount of time needed by each individual or family.
2. Services will be provided at times convenient for or necessary to meet the family’s needs, not according to a specified work week schedule.
3. Services will be provided in the families’ home or in the community environment when assisting with a particular learning task.
4. Services will be based on objectives derived from the family’s established DCS case plan, Informal Adjustment, taking into consideration the recommendations of the Child and Family Team meeting.
5. Services will be time-limited. Providers must respect confidentiality. Failure to maintain confidentiality may result in immediate termination of the service agreement.
6. Services include providing any requested testimony and/or court appearances (to include hearing or appeals).
7. The family (families are self-defined) or individual will be the focus of service. Services will focus on the strengths of families and individuals and build upon those strengths
8. One (1) full time Home-Based Direct Therapy Worker may have a caseload of no more than 12 families at any one time. Services will be provided within the context of the DCS practice model with involvement in Child and Family team meetings if invited. A treatment plan will be developed and based on the agreements reached in the Child and Family Team Meeting.
9. Each family receives comprehensive services through a single Direct Worker acting within a team, with team back up and agency availability 24 hours a day 7 days a week.
III. Target Population
Services must be restricted to the following eligibility categories:
1. Children and families who have substantiated cases of abuse and/or neglect with moderate to high levels of risk and need, as well as moderate to high levels of service needs according to the DCS assessment matrix, and
2. Children who meet the requirements for CHINS, and or JD/JS, and their families or
3. Children and families who are currently in substitute care and who are in need of reunification/permanent placement services; and or,
4. Any child who has been adopted, and adoptive families
IV. Goals, Objectives and Outcome Measures
Goals #1
Maintain timely intervention with family and regular and timely communication with referring worker
Objectives
1. DCS Referrals are made to the provider within 24-hours of determining that the family is in need of Home Based Family Centered Therapy Services (HBFCT).
2. DCS worker may assist provider in contacting the family and beginning the engagement process.
3. Provider assures that all additional referral information is received from DCS.
4. Therapist is available for consultation to the family 24-7.
Outcome Measures:
1. 95% of all families that are referred will have face-to-face contact with the client within 5 days of the referral or inform the referring worker if the client does not respond to requests to meet.
2. 95% of families will have a written treatment plan prepared and sent to the referring worker within 30 days of the receipt of the referral.
3. 97% of all families will have monthly written summary reports prepared and sent to the referring worker.
4. Participation in Child and Family Team meetings when invited.
Goal #2
Development of positive means of managing crisis.
Objectives
1. Service delivery is grounded in best practice strategies, using such approaches as cognitive behavioral strategies, motivational interviewing, change processes, and building skills based on a strength perspective to increase family functioning.
Outcome Measures:
1. 90% of the individuals/families served will not be the subjects of a new investigation resulting in the assignment of a status of “substantiated” or “indicated” abuse or neglect throughout the service provision period.
2. 90% of the individuals/families that were intact prior to the initiation of service will remain intact throughout the service provision period.
Goal #3
DCS and client satisfaction with service provided.
Objective:
1. At the least a random sample of families will complete the Service Satisfaction Survey at the conclusion of services.
Outcome Measures:
1. DCS satisfaction will be rated 4 and above on the Service Satisfaction Report.
2. Clients will rate the services “satisfactory” or above
V. Qualifications
Direct Worker:
Master's degree in social work, psychology, marriage and family therapy, or related human service field and 3 years related clinical experience or a masters degree with a clinical license issued by the Indiana Social Worker, Marriage and Family Therapist or Mental Health Counselor Board, as one of the following. 1) Clinical Social Worker 2) Marriage and Family Therapist 3) Mental Health Counselor.
Supervisor:
Master's degree in social work, psychology, or marriage and family or related human service field with a current license issued by the Indiana Social Worker, Marriage and Family Direct Worker or Mental Health Counselor Board as one of the following: 1) Clinical Social Worker, 2) Marriage and Family Direct Worker, 3) Mental Health Counselor
In addition to:
- Knowledge of family of origin/intergenerational issues
- Knowledge of child abuse/neglect
- Knowledge of child and adult development
- Knowledge of community resources
- Ability to work as a team member
- Belief in helping clients change, to increase the level of functioning, and knowledge of strength-based initiatives to bring about change
- Belief in the family preservation philosophy
- Knowledge of motivational interviewing
- Skillful in the use of Cognitive Behavioral Therapy
- Skillful in the use of evidence-based strategies
Supervision/consultation is to include not less than one (1) hour of face to face supervision/consultation per 20 hours of direct client services provided, nor occur less than every two (2) weeks.
Services will be conducted with behavior and language that demonstrates respect for socio-cultural values, personal goals, life-style choices, as well as complex family interactions; services will be delivered in a neutral valued culturally competent manner.
VI. Billable Units
Face to face time with the client: (Note: Members of the client family are to be defined in consultation with the family and approved by the DCS. This may include persons not legally defined as part of the family)
- Includes client specific face-to-face contact with the identified client/family during which services as defined in the applicable Service Standard are performed.
- Includes crisis intervention and other goal directed interventions via telephone with the identified client family.
- Includes Child and Family Team Meetings or case conferences initiated or approved by the DCS for the purposes of goal directed communication regarding the services to be provided to the client/family.
Reminder: Not included is routine report writing and scheduling of appointments, collateral contacts, court time, travel time and no shows. These activities are built into the cost of the face to face rate and shall not be billed separately.
For hourly rates, partial units may be billed in quarter hour increments only. Partial units to be billed are to be rounded to the nearest quarter hour using the following guidelines: 8 to 22 minutes = .25 billable hours, 23 to 37 minutes = .50 billable hours, 38 to 52 minutes = .75 billable hours, 53 to 60 minutes = 1.00 billable hours. All billed time must be associated with a family/client.
Translation or sign language Services include translation for families who are non-English language speakers or hearing impaired and must be provided by a non-family member of the client. Dollar for dollar amount.
VII. Rates
Face to Face Maximum Rate: $76.00 (Minus 10% January 01, 2010)
Translation or Sign Language Rate: Actual Cost
VIII. Case Record Documentation
Necessary case record documentation for service eligibility must include:
1. A completed, dated, signed DCS referral form authorizing service;
2. Documentation of regular contact with the referred families/children and referring agency;
3. Monthly written reports, or more frequently if requested, regarding the progress of the family/children provided to the referring agency.
IX. Service Access
Services must be accessed through a DCS referral. Referrals are valid for a maximum of twelve (12) months unless otherwise specified by the DCS. Providers must initiate a reauthorization for services to continue beyond the approved period.
NOTE: All services must be pre-approved through a referral form from the referring DCS.
