Family Support Services Program

The Family Support Services Program is an intensive psychotherapeutic, home based treatment protocol designed as a DIVERSIONARY alternative to out of home placement for juvenile offenders, other at-risk populations, and their families. We embrace the treatment concept of implementing the least restrictive environment as the intervention domain of choice, and building upon existing child and family strengths to overcome non productive areas in their lives. A core component of all treatment programming is the instillation of hope and dignity, and being a voice to advocate for the family. More importantly, a core principle we hold is a commitment to teaching and coaching our client families to advocate directly for themselves.

We believe that kids belong with their families, and as such provide a treatment protocol that allows the child and family to receive intensive clinical services right in their own home, natural community, school, and neighborhood environment. While the child is the entry point for case referral from the Juvenile Court, the entire family unit is the targeted audience. Many of our client families have received a variety of mandated services prior to being referred to our treatment program. As a result, we pride ourselves on implementing creative and unusual approaches to treatment interventions.

The Family Support Services Program is an evidence based multi systems family therapy program, similar in scope to the national best practices model of such. We focus not only on the referred child, but on the parental adults and siblings. The age of the population we serve ranges from ten to eighteen. The average length of the program is six months, but is driven by the highly individualized assessment and treatment planning process. Each family has its own unique gift of transformation, and goals are thus achieved at their own pace. We place an emphasis on client respect, and allow them the freedom to learn and grow in a way best for them. We also match this approach with doses of reality, firmness, and an emphasis on choice making and learning responsibility. We expect mistakes, and they are responded to in a manner to enhance cooperation instead of denial and blame. We teach problem solving and solution focused skills that encourage ownership for their behavior, and a willingness to enhance their abilities for future life choice points.

The Family Counselor maintains a small case load in order to meet with the family several times per week to clarify, coach, and support them in their growth and change process. This also allows the Family Counselor to engage in case management type issues that are presenting problematic barriers to the targeted therapy process. A wraparound approach is emphasized, and resources and collaborative others are asked to partner with us in eradicating or solving these situations.

In addition to our diversionary efforts to maintain children in the home, at times a more restrictive treatment placement is indeed clinically warranted to maximize success. With this in mind, we also provide a full cadre of REENTRYprogramming, focusing on the family at home while the child is removed and maintaining close collaborative contact with the placement agency. Our goal is to actively work toward reducing the time the child spends away from home and ensure that family change has taken place in their absence. We assist in then successfully transitioning the child back home, and supporting the integration of family and child change into practical day to day living and coping once they are reunited as a family.

Referrals for the Family Support Services Program come directly from the Juvenile Court, as recommended by either the Juvenile Probation Office or the Department of Child Services. We have served families in fifteen counties, varying in nature from very rural to very urban. Currently, we are serving children and families in Elkhart, Lake, Marion, Madison, Allen, Tippecanoe, Boone, and Randolph County.

In 2008, 400 children and families recieved services through the Family Support Services Program!

LISTING OF STATE APPROVED SERVICE CONTRACTS

DEPARTMENT OF CHILD SERVICES

Region One: Lake Home Based Family Centered Therapy

Transition from Restrictive Placement

Interpreter

Random Drug Screen

Region Two: LaPorte Home Based Family Centered Therapy

Porter Interpreter

Starke

Pulaski

Jasper

Newton

Region Three: Elkhart Home Based Family Centered Therapy

Kosciusko Substance Abuse Assessment, Treatment & Monitoring

St. Joseph Transition From Restrictive Placement

Marshall Interpreter

Random Drug Screen

Region Four: Allen Home Based Family Centered Therapy

Wells Transition from Restrictive Placement

Huntington Interpreter

Stueben Random Drug Screen

Whitley

LaGrange

Adams

Dekalb

Noble

Region Five: Tippecanoe Home Based Family Centered Therapy

Fountain Transition from Restrictive Placements

Clinton Interpreter

Carroll Random Drug Screen

White

Benton

Warren

Region Six: Fulton Transition from Restrictive Placements

Wabash Interpreter

Miami Random Drug Screen

Cass

Howard

Region Seven: Randolph Home Based Family Centered Therapy

Grant Transition Form Restrictive Placement

Delaware Interpreter

Jay Random Drug Tests

Blackford

Region Eight: Parke Home Based Family Centered Therapy

Vigo Transition from Restrictive Placement

Vermillion Interpreter

Clay Random Drug Screen

Sullivan

Region Nine: Morgan Home Based Family Centered Therapy

Boone Interpreter

Hendricks

Putnam

Montgomery

Region Ten: Marion Substance Abuse Assessment, Treatment & Monitoring

Transition from Restrictive Placements

Interpreter

Random Drug Screen

Region Eleven: Madison Home Based Family Centered Therapy

Hamilton Transition From Restrictive Placement

Tipton Substance Abuse Assessment, Treatment & Monitoring

Hancock Interpreter

Random Drug Screen

Region Fourteen: Johnson Home Based Family Centered Therapy

Jennings Transition from Restrictive Placement

Shelby Interpreter

Jackson Random Drug Screen

Bartholomew

Region Fifteen: Dearborn Transition from Restrictive Placements

Decatur Interpreter

Jefferson

Switzerland

Ripley

Ohio

Region Seventeen Davies Home Based Family Centered Therapy

Martin Interpreter

Dubois

Crawford

Orange

Spencer

Perry

Region Eighteen: Scott Transition from Restrictive Placements

Clark Interpreter

Floyd Random Drug Screen

Harrison

Washington

SERVICE STANDARD DESCRIPTION

INDIANA DEPARTMENT OF CHILD SERVICES

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:

• 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

• 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

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.

INDIANA DEPARTMENT OF CHILD SERVICES

TRANSITION FROM RESTRICTIVE PLACEMENTS

I. Service Description

TRP is a provision of services to assist in transition from most the restrictive to a less/least restrictive placement. A Transition from Restrictive Placement (TRP) is a court-ordered program for youth adjudicated a CHINS or JD/JS. The purpose of the program is to prevent a return of the youth to a more restrictive setting/placement. TRP must include the following kinds of services to the youth and family:

Therapeutic/clinical interventions to address the service needs of the youth and family. Therapeutic interventions must be based on an evidence-based model such as Functional Family Therapy (FFT), Multisystemic Therapy (MST), Parenting with Love and Limits (PLL), etc.

Home-based services including but not limited to the following:

Home-based family therapy
Case management services
Home assessment
Coordination of services, with special emphasis on education and employment services
Educational transition services
Vocational services
Drug/alcohol screening & monitoring
Conflict management
Emergency/crisis services
Child development education
Domestic violence education
Parenting education/training
Family communication
Assistance with transportation
Family reunification
Family assessment
Community referrals and follow-up
Behavior modification
Budgeting/money management
Other services as deemed appropriate based on the needs of the youth and family
Services must include 24-hour access to crisis intervention seven days a week and must be provided in the family’s home, at a community site, or in the office.
Services must include ongoing risk assessment and monitoring family/parental progress.
Services must include development of goals with measurable outcomes.
Provider must complete an intake interview with the family within five calendar days after receipt of the referral.
Provider must provide home-based therapy services to the family during the time the youth is incarcerated to identify and address any issues that may hinder the youth’s success upon his/her return home.
Provider must maintain monthly contact with the youth’s placement agency during the time the youth is in the more restrictive placement to ensure that the transition plan remains consistent between both agencies.
Provider must participate in an initial meeting with the youth’s FCM or probation officer, youth, and family within 48 hours of release.
Provider must complete the Child and Adolescent Needs and Strengths (CANS) assessment within 30 days of release from the correctional facility, if not completed at the time of discharge from the more restrictive placement, and every six months thereafter. If no CANS was completed prior to the youth being admitted to the more restrictive placement, the service provider is responsible for completing the assessment within 2 weeks of the placement in a less restrictive placement. .
Provider must conduct a minimum of two (2) face to face visits per week with the youth during the first thirty (30) days of release from a more restrictive placement. The level of supervision after that period of time will be determined by the team but will never be less than 1 face to face visit per week.
When appropriate the provider may require the youth to submit to at least one random drug screen within fourteen (14) days of changing from a more restrictive placement. This may be done through probation or another approved vendor.
Provider must maintain frequent contact with the FCM/probation officer and notify the FCM/probation officer in writing of non-compliance issues. The provider must also develop a recommendation for the FCM/probation officer as to a suitable therapeutic intervention.
The family will be the focus of service and services will focus on the strengths of the family and build upon these strengths.
Services must be family focused and child centered.
Services must include intensive in-home skill building and after-care linkage.
Services include providing monthly progress reports in a format approved by the Court, participation in team meetings, and providing requested testimony and/or presence at court hearings.
Staff must respect confidentiality. Failure to maintain confidentiality may result in immediate termination of the service agreement.
The caseload of the therapist/case manager will include no more than ten (10) workload units per therapist. Youth being supervised in the community are weighted at 1 workload unit.

II. Target Population

Services must be restricted to the following eligibility categories:

1. Children with a status of CHINS and/or JD/JS who have been placed in a restrictive setting.

III. Goals and Outcome Measures

Goal #1: To improve the transition for youth back to their home by providing therapeutic services to the youth and family

Outcome Measures

1. Based on the CANS Assessment, 100% of participants will have an individualized service plan developed. (For Probation only)

2. 95% of families will participate in home-based counseling during the youth’s period of placement.

3. 90% of the youth will have a minimum of 2 face to face visits each week from their case manager/therapist during the first 30 days following their placement from a more restrictive to a less restrictive placement.

Goal #2: To reduce routine barriers by providing direct assistance with transition issues

Outcome Measures

1. 90% of all participants will have a state-issued ID or driver's license by the completion of the program.

2. 90% of all participants will actively participate in an education program.

3. 100% of participants not involved in an educational program will be employed and/or participating in a formal employment assistance program.

Goal #3: To develop a system of community supports for each youth that will continue after completion of the program.

Outcome Measures

1. 100% of the youth in the program will establish at least one community-based support that will continue to provide assistance and/or direction following completion of the program.

IV. Qualifications

Case Manager:

Bachelor’s degree in social work, psychology, sociology, or a directly related human service field required.

Therapist:

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

Therapist or Mental Health Counselor Board, as one of the following: 1) Clinical Social Worker 2) Marriage and Family Therapist 3) Mental Health Counselor.

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.

The staff person must possess:

Knowledge of community resources and ability to work as a team member
Understanding regarding issues that are specific and unique to youth transitioning back into the community following a period of incarceration

Services will be conducted with behavior and language that demonstrates respect for socio-cultural values, personal goals, life style choices, and complex family interactions and be delivered in a neutral valued culturally competent manner.

V. Billable Units

Face to face time with the youth and/or family

(Note: Members of the client family are to be defined in consultation with the family and approved by the Juvenile Court. 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 probation meetings or case conferences initiated and approved by Probation for the purposes of goal directed communication regarding the services to be provided to the client/family.

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.

VI. Rates:

Face to Face Rate: $101.00 (Minus 10% January 01, 2010)

Translation or Sign Language Rate: Actual Cost

VII. Case Record Documentation

Necessary case record documentation for service eligibility must include:

A completed, signed, and dated referral form authorizing services
A court order ordering the TRP program
Documentation of regular contact with the referred families/children
Written reports no less than monthly or more frequently as prescribed referral by the source.

VIII. Service Access

Services must be accessed through a DCS Family Case Manager or DCS Service Consultant referral form. Referrals are valid for a maximum of twelve (12) months unless otherwise specified by DCS. Providers must initiate a reauthorization for services to continue beyond the approved time period.

Note: All services must be pre-approved through a DCS Family Case Manager or DCS Service Consultant referral form.

INDIANA DEPARTMENT OF CHILD SERVICES

SUBSTANCE ABUSE ASSESSMENT, TREATMENT & MONITORING

I. Service Description

Drug addiction is a complex illness. It is characterized by compulsive, at times uncontrollable drug craving, seeking, and use that persist even in the face of extremely negative consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence. Matching treatment settings, interventions, and services to each individual's particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. Treatment does not need to be voluntary to be effective. Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, employment setting, or criminal justice system can increase significantly both treatment entry and retention rates and the success of drug treatment interventions.

Substance abuse negatively affects a parent’s social, emotional and physical functioning. Their ability to provide for their children will be impaired and poses a risk to child development, safety and/or well being. Recognizing the "cloak of secrecy" that often surrounds these families, efforts must be made to open lines of communication and be sensitive to a variety of sources in verifying substance abuse and corroborating the effects on children.

Assessment

Effective treatment attends to multiple needs of the individual, not just his or her drug use. To be effective, treatment must address the individual's drug use and any associated medical, social, psychological, vocational, and legal problems. A face-to-face clinical interview must take place with each referred individual. In-person sessions provide the ability to provide immediate attention to individuals who may be a danger to themselves or others. Tremors, needle marks, dilated pupils, exaggerated movements, yellow eyes, glazed or bloodshot eyes, lack of eye contact, a physical slowdown or hyperactivity, appearance, posture, carriage, and ability to communicate in person are vital components to the clinical interview.

The substance abuse assessment must include:

1. Any associated medical, psychological and social history of the client,

2. An in-depth drug and alcohol use history with information regarding onset, duration, frequency, and amount of use; substance(s) of use and primary drug of choice; associated health, work, family, person, and interpersonal problems; driving record related to drinking or drug use; past participation in treatment programs,

3. Standardized assessment tool for drug/alcohol abuse such as Substance Abuse Subtle Screening Inventory (SASSI), Addiction Severity Index (ASI) Teen Addiction Severity Index (T-ASI), ASI Lite, or the Addiction Society of Medicine Placement Patient Criteria Revised Version II(ASAM PPII), Drug Abuse Screening Test (DAST), Substance Abuse Relapse Assessment (SARA), etc.,

4. Results of urine screen with the requested drug panel.

Reports on non-emergency referrals must be delivered within 30 days of the completion of the assessment. For emergency assessments, it is expected that a verbal report will be provided to the referring office within 72 hours and a written report provided within 14 days after the completion of the assessment with the client. It is expected that a client with a history of homelessness, frequently changing employment and/or instability

in caring for their children will be addressed realistically regardless of an admission of substance abuse. Recommendations regarding the client’s needs must be provided on each assessment. This information should be used to develop an individualized treatment plan with specific strategies for coping with high-risk situations, slips, and relapses.

Treatment & Monitoring

There are many addictive drugs. Treatments for specific drugs can differ and varies depending on the characteristics of the patient. Problems associated with an individual's drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health, or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.

A variety of scientifically based approaches to drug addiction treatment exists. Treatment prescribed for all clients must be evidenced based. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination. Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse, and help them deal with relapse if it occurs. When a person's drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, behavioral therapies can help to reduce the risk of disease transmission. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many patients.

Change does not happen all at once. Much of the early change process takes place internally as a person weighs whether change is worth the time and effort required. Treatment must help the client to identify the events that typically precede their substance use, as well as the consequences that may reinforce that use. Individual and/or group treatment to assist the client toward change may include any or all of the following:

Consciousness raising
Self-revelations
Weighing pros and cons
Environmental reassessment
Problem solving
Stimulus control-triggers
Stress
Assertiveness
Refusal skills
Thought management
Cravings and urges
Alternatives to using
Social Support
Identifying needs and resources
Goal Setting
Relapse Prevention Planning
Role play
Role clarification

Following the assessment of each client, the service provider must inform the referring worker of the expected number of treatment sessions to be provided to each client. The service provider must contact the referring worker by phone or email to relay important information regarding the client such as active drug use that affects parenting abilities as situations develop. Copies of treatment plans, progress reports with recommendations for each court hearing and discharge summaries with prognosis and recommendations must be provided to the referring worker in a timely manner. If self-help groups (such as AA/NA) are part of the support of treatment process, the service provider must provide a means to document and verify attendance at such programs. Aftercare plans must be identified for all clients completing outpatient services.

Services must be available to clients who have limited daytime availability. The service provider must identify a plan to engage the client in the process, a plan to work with non-cooperative clients including those who believe they have no problems to address as well as working with special needs clients such as those who are mentally ill or developmentally delayed.

No-show alert forms will be provided by the contracted agency to inform the referring worker of the client’s failure to attend sessions based on five no-shows and ten no-shows. After ten no-shows, the client will be administratively discharged. Any client who is administratively discharged must request a new referral from the referring worker to begin receiving services again.

II. 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 service needs according to the assessment matrix

2. Children with a status of CHINS, and/or JD/JS

3. All adopted children and adoptive families

III. Goals and Outcome Measures

Goal #1

Timely receipt of report to prepare for services/court.

Outcome Measures:

1. For non-emergency assessments: 100% of the written reports will be received by referring worker 14 days after the completion of the assessment with the family.

2. For emergency assessments: 100% of Verbal reports will be received by the referring worker within 72 hours; written report received by the referring worker 14 calendar days after the assessment with the family.

Goal #2

Recommendations relevant and based on documentation in the body of the report.

Outcome Measures:

1. 100% of recommendations prepared as a result of the assessment are appropriate based on interviews, observations, review of other records, and completion of test instruments.

2. Abstinence or decrease use of alcohol or drugs.

3. Improvement of work or improvement of educational status

4. Stable living situation.

5. Decrease involvement with the criminal justice system

Goal #3

Drug screens will be provided to the referring worker in a timely fashion.

Outcome Measures:

1. 100% of positive reports will be reported verbally by phone, voice mail or email within 24 hours of receiving the results of the urine screen. Written reports of the urine screen will be mailed/faxed to the referring worker within 24 hours of receipt of laboratory results.

Decreasing evidence of illicit drugs in drug screens.

Goal #4

No-show alert forms based on five no-shows and ten no-shows will be provided to the referring worker.

Outcome Measures:

1. 100% of no-show alerts will be provided to referring worker immediately following the select number of no-shows. After 10 no-shows, the client will be discharged from services.

2. Retention – Improvement in length of stay in treatment.

Goal #5

Referring worker will be provided treatment plan and sessions needed for progress to occur for each client referred.

Outcome Measures:

1. 100% of referred clients will have a treatment plan developed following the assessment with the treatment plan provided to the referring worker within 10 days of completion.

Goal #6

DCS and client satisfaction with services

Outcome Measures:

1. DCS satisfaction will be rated 4 and above on the Service Satisfaction Report.

2 .80% of the clients who have completed substance abuse assessment and treatment services will rate the services “satisfactory” or above.

IV. Qualifications

Minimum Qualifications:

1. Master’s degree in social work, counseling or psychology with at least three years experience providing substance abuse services and a current license issued by the Indiana Social Worker, Marriage and Family Therapist and Mental Health Counselor Board, as one of the following: 1) Clinical Social Worker, 2) Marriage and Family Therapist, or 3) Mental Health Counselor or whose program is certified by the Division of Mental Health Administration to provide addiction services, or

2. An alcohol and drug abuse counselor certified by the Indiana Counselors Association on Alcohol or by the Drug Abuse (ICAADA), or by the Indiana Association for Addiction Professionals (IAAP), or by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission (NAADAC), or by the International Certification Reciprocity Consortium/Alcohol and Other Drug Abuse (ICRC), or by the National Board of Certified Counselors, Inc and Affiliates/Master Addictions Counselor (NBCC).

3. Sample collection does not require the services of a certified drug abuse counselor. The person providing this service must be highly training in sample collection and the chain of custody procedures to document the integrity and security of the specimen from time of collection until receipt by the laboratory.

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.

V. 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.

Per person per group hour

When DCS clients are referred to groups where most of the clients are non-DCS referrals. This is available when the nature of the group or the geographic location does not support a group composed of primarily DCS clients

Drug Screens

Actual cost of the screens. The provider is to present a list of the drug screens available with the total cost of each drug screen or set of drug screens. The DCS will specify which drug screen or screens they are authorizing for each client on the authorizing referral form.

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.

VI. Rates

Face to Face Rate: $118.00 (Minus 10% January 01, 2010)

VII. Case Record Documentation

Necessary case record documentation for service eligibility must include:

A completed, dated, signed DCS referral form authorizing service
Documentation of regular contact with the referred families/children
Written reports no less than quarterly or more frequently as prescribed by DCS.

VIII. Service Access

NOTE: All services must be pre-approved through a referral form from the referring DCS FCM or DCS Service Consultant.

INDIANA DEPARTMENT OF CHILD SERVICES

RANDOM DRUG TESTING

I. Service Description

Random screens are designed for individuals who may or may not meet the criteria for substance abuse and may or may not actively participate in drug treatment services. Each random screen referral shall consist of no more then twenty-four (24) screens to be completed over a period not to exceed six (6) months, with a maximum of three (3) screens per week as indicated by the referral form. It is expected that the referring worker and provider agency will work together to develop a plan to determine the appropriate duration (up to 6 months) of each referral. A second referral will be required if an excess of twenty-four (24) screens per referral are necessary.

The service provider must identify a plan to engage the client in the process, a plan to work with non-cooperative clients including those who believe they have no problems to address as well as working with special needs clients such as those who are mentally ill or developmentally delayed.

The types of drug screens included, but are not limited to, saliva drug screen/oral fluid based drug screen, hair follicle, and urine.

Services include providing any requested testimony and/or court appearances (to include hearing or appeals).

All sample collections drug screens will be observed. Minimum of substances tested should include Alcohol, Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabis, Opiates, Phencyclidine, Methadone, Creatinine (urine only), Propoxyphene, Oxycodone, and Methamphetamines. The agency will be expected to provide reports that state the minimum level necessary to detect the presence of each substance, the level of substance detected, and the chain of custody documentation.

Initial Testing

All sample collections drug screens will be observed sample collections screens. Minimum of substances tested should include Alcohol, Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabis, Opiates, Methadone, Oxycodone, Propoxyphene, and Methamphetamine. The agency will be expected to provide reports that state the minimum level necessary to detect the presence of each substance, the level of substance detected, and the chain of custody documentation.

For urine screens, testing for creatinine levels shall be conducted on all samples. The vendor shall also insure testing for total Cannabinoids per mg of creatinine using spectrophotometer technology. The Vendor shall insure testing for specific gravity on all samples with a creatinine level below 20 mg per deciliter. The Vendor shall also insure the administration of a nitrite test on any specimen that contains no creatinine and has a specific gravity test of 1.000.

Initial screening shall be conducted utilizing an enzyme immunoassay method. Testing should occur for the following substances utilizing the cut-off levels listed below:

DRUG		URINE		ORAL FLUID		HAIR LEVELS*
Amphetamines	1000NG/ML		20NG/ML		500PG/MG
Cannabinoids	50NG/ML		1NG/ML		1PG/MG
Benzodiazepines	300NG/ML		10NG/ML		200PG/MG
Methamphetamine (including ECSTACY(MDMA), ADAM(MDA)	1000NG/ML		20NG/ML		500PG/MG
Opiates	2000NG/ML		10NG/ML		200PG/MG
Cocaine	300NG/ML		5NG/ML		500PG/MG

*Hair uses = PG/MG = weight

* For all other substances tested use recommended laboratory cutoff levels

Confirmation Testing

Confirmation Testing shall be conducted utilizing GC/MS Technology on all samples initially testing POSITIVE. The following cut-off levels shall be utilized:

DRUG	URINE	ORAL FLUID	HAIR LEVELS*
Amphetamines	500NG/ML	10NG/ML	300PG/MG
Cannabinoids	15NG/ML	.5NG/ML	.05PG/MG
Benzodiazepines	100NG/ML	1NG/ML	50PG/MG
Methamphetamine (including ECSTACY(MDMA), ADAM(MDA)	500MG/ML	10NG/ML	300PG/MG
Opiates	150NG/ML	5NG/ML	200PG/MG
Cocaine	150NG/ML	1NG/ML	50PG/MG

*Hair uses = PG/MG = weight

* For all other substances tested use recommended laboratory cutoff levels

In situations where the source of the Amphetamine present in any specimen may come into question, the vendor must insure the performance of a d-1-isomer differentiation. This service is to be offered at no additional cost to the Department of Child Services and performed when requested by DCS.

The Vendor shall ensure proper legal chain-of-custody procedures are maintained and comply with departmental procedure, state and federal law. The vendor shall also ensure complete integrity of each specimen tested and the respective test results. Receiving, transfer and handling of all specimens by personnel shall be fully documented using the proper chain-of-custody.

The vendor shall insure that all laboratories used for drug testing purposes must comply with all applicable Federal Department of Health and Human Service, and, under these federal requirements, are subsumed Substance Abuse and Mental Health Services Administration (SAMSHA) or The College of American Pathology (CAP), or Clinical Laboratory Improvement Act (CLIA) requirements.

A letter to all referred clients will be required within three (3) calendar days of referral with instructions for contacting the agency immediately to begin screens. It is expected that the first screen will be collected within seven (7) calendar days of referral and each subsequent screen will be random. One or more toll free phone lines for clients to call daily to determine the day their screen is to be required. Agency must have a plan in place to modify the phone messages every day by 5 a.m., instructing clients whether to report that day for a screen or call again the next day

Note: It is expected that the referring worker and provider agency will work together to develop a plan to administer random testing for clients who do not have access to public transportation or telephone.

The agency shall update the referring worker, by phone or email, within ten (10) calendar days of the date the referral was sent regarding the status of the referral. Agencies should inform the referring worker of the date the client completed their first screen or, if the client has not contacted the agency to complete their first screen, a consultation with the referring worker should be held to determine the next steps of services.

It is expected that the referring worker and provider agency will work together to develop a plan to determine the appropriate duration (up to 6 months) of each referral. All random screen referrals shall include no more than twenty-four (24) screens and are to be completed over a period of no more than six (6) months. A second referral will be required if an excess of twenty-four (24) screens per client are necessary.

Results Notification:

The vendor shall notify the local Department of Child Services Office/ Probation Officer of testing results via email on vendor letterhead. The results will also be sent by U.S. mail to the referring county as well. The vendor shall gain approval from DCS for any changes in the results notification system.

The referring worker and DCS (if not the referral source) will be notified of positive test results within 24 hours of receiving test results from the testing laboratory. Negative test results will be provided within 72 hours of receiving test results from the testing laboratory.

No-show alert forms will be provided by the contracted agency to the referring worker within 24 hours of the client’s failure to show. Failure to show may result in an administrative discharge. Any client who is administratively discharged must request a new referral from the referring worker to begin receiving services again.

The referring location shall be notified in writing if the specimen has been rejected due to an invalid chain-of-custody or any other integrity problem.

For those employing urine tests diluted results must be reported on the result form.

Testing shall not be conducted on any specimen that does not have a legal chain-of-custody. All specimens found to be “Adulterated” shall be treated as an Invalid Specimen. Any specimen without a valid chain-of-custody is to be destroyed. The referring location shall be notified in writing when a specimen has been rejected due to an invalid chain-of-custody or any other integrity problem. Monthly reports shall document how many random samples were attempted and completed minus how many "Adulterate" specimens there were for the month.

II. Target population

Services must be restricted to the following eligibility categories:

1. Parent(s) for whom a CPS assessment has been initiated

2. Children and parent(s) who have substantiated cases of abuse and/or neglect

3. Children with a status of CHINS, and/or JD/JS

4. Minor children suspected of drug use prior to adjudication

III. Goals and Outcome Measures

Goal #1

Drug screen results will be provided to the referring worker in a timely fashion.

Outcome Measures

1) 100% of positive reports will be reported verbally by phone, voice mail or email within 24 hours of receiving results of the drug screen from the lab.

2) 100 % of written sample reports will be mailed or faxed to the referring worker within 24 hours of receipt of laboratory results.

Goal #2

100% of “No Shows” alerts will be provided to referring worker within 24 hours of failed attempts.

IV. Qualifications

Sample collection does not require the services of a certified drug abuse counselor. The person providing this service must be trained in sample collection and the chain of custody procedures to document the integrity and security of the specimen from time of collection until receipt by the laboratory.

V. Billable Units

Rejected or Unfit Specimens

The provider cannot claim for the handling of rejected specimens or those otherwise unfit for testing.

Drug Screens

Grantees will bill monthly based on these payment points:

Initial Test

Services include the collection of sample collections specimens and ensuring that the chain of custody procedure is followed to maintain the integrity and security of the specimen from time of collection until receipt by the laboratory. This will be billed for all tests that are negative.

Confirmation Testing (lab processing)

Services include the collection of the specimen. This confirmation testing charge shall include confirmation of positive results for one or more substances in the same sample. Ensuring the testing of specimens and that the chain of custody procedure delivery to the testing laboratory to the results notification.

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

VI. Rates

Grantees will bill monthly based on these payment points:

Initial Test: Actual Cost

Confirmation Testing: Actual Cost

Translation or sign language: Actual Cost

VII. Case Record Documentation

Necessary case record documentation for service eligibility must include:

1. A completed, dated, signed DCS/Probation referral form authorizing service

2. Documentation of regular contact with the referred families/children

3. Written reports as stated in this service standard.

VIII. Service Access

Services must be accessed through a DCS Family Case Manager or DCS Service Consultant 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 FCM or DCS Service Consultant.