3.1 Providing Services- Home Visit Requirements
Minimum Contact Standard for FCS Cases
Supervisor discretion will be used to determine the number of Home Visits and Safety Network Contacts are needed for FCS cases. The number should be based on the needs of the family. This may be one HV per week or just weekly contact with the family through (in person, phone, collateral, etc.). At a minimum, one face to face home visit per month must be completed on all FCS cases. It is important to meet with all family members to adequately assess risk and safety, being especially important to see all the children. Consult with a supervisor if any of the children are unavailable at the time of the home visits. A plan should be made to assure the children are safe.
Staff may provide services based on the family needs. Examples of direct services that the worker may need to provide are:
- Teaching the family behavioral techniques for changing undesirable behaviors. An example of this would be introducing the parents to behavior modification methods such as positive reinforcement and “time-out,” rather than physical punishment;
- Teaching the family appropriate methods to channel frustrations and manage anger;
- Modeling effective family communication and structuring family activities to enhance communication and family functioning;
- Engaging the family in the treatment process;
- Teaching life skills, such as how to improve self-esteem and how to look for employment;
- Teaching and role modeling household management skills, such as house cleaning, budgeting, and cooking;
- Providing “hard services” to meet basic needs of the family, such as securing food, shelter, and transportation;
- Developing resources and making these resources available to the family for their ongoing support.
- Encouraging and working with parents to be cooperative and engaging of the non-custodial or non-resident parent as appropriate in preserving the best interest and safety of the child/ren;and
- Referring the family to any available culturally-relevant community resources that help them meet basic needs and stabilize their family, including:
- Housing referral and assistance;
- Public benefits and income support, including any assistance needed to obtain food, clothing, and utility services;
- Child care;
- Home care and support services, including household management and home health aide services;
- Medical and dental care;
- Respite care;
- Transportation services; and
- Vocational and educational assistance.
Providing Services for Children Receiving In-Home Services
Children who are at home with their families should receive individualized services that promote positive development and address any effects of maltreatment. Children should be connected to services that address any identified needs they may have for:
- Medical and dental care;
- Mental health care;
- Substance use treatment;
- Educational services;
- Services to increase well-being; and
- Specialized services and supports for children with special needs.
Providing Services through Referrals
Staff should utilize all available community resources to help the family. This may require the use of purchased services. See Section 8 Chapter 7 for additional information on contracted services.
Intensive In Home Services (IIS)
An IIS referral is required in all cases when staff plan to recommend removal of a child(ren). Intensive In-Home Services (IIS) is a short-term, intensive, home-based, crisis intervention program that combines skill-based interventions with maximum flexibility so that services will be available to families according to their individual needs. The goal of IIS is to offer families in crisis the alternative of remaining together safely, averting out-of-home placement of children whenever possible. IIS are, however, offered solely to families that have a child or children at imminent risk of removal from the home due to neglect, abuse, family violence, mental illness, delinquency, or other circumstances. Services provided assist with crisis management and restoration of the family to an acceptable level of functioning.
Referrals for IIS originate from many sources. While the majority of referrals come from Children’s Division (CD), others may come from Department of Mental Health, Division of Youth Services, juvenile office, and other community resources such as practitioners, hospitals, and schools. Self-referrals are also received from families experiencing a crisis. Staff are responsible for assessing the appropriateness of referrals for IIS if recommendation has been made for out-of-home placement of children. When it has been determined that IIS is the most appropriate service for a family (in those circumstances) the family is referred for services.
All families referred for IIS are received on first-come, first-serve basis. Families are not accepted for IIS services when families do not meet the referral criteria or in instances where specialists have no available openings. Waiting lists are not maintained for IIS referrals based on the rationale that responding to an immediate crisis cannot be postponed to a later date. When a family is not accepted into IIS, out-of-home placement may occur.
Local Collaboration Plans with Head Start Agencies
The Children’s Division is committed to working with local Head Starts in providing services to Protective Services children. The Children’s Division Circuit Manager will develop a local collaboration plan with their local Head Start Director, which includes Head Start and Early Head Start programs. The Local Collaboration Plan, CD-199, is designed to provide a framework for local Children’s Division and Head Start agencies to improve the coordination of services for the children and families served by both agencies. The Circuit Manager is to complete the CD-199, with the local Head Start Director no less than every two years, or as needed and as agreed upon by both agencies. A copy of the completed CD-199 is to be shared with the local Head Start and submitted to the Children’s Division, Early Childhood and Prevention Services Section via email at CD.AskECPS@dss.mo.gov.
Referral to Head Start and Early Head Start Programs
The Children’s Division case manager is encouraged to refer children and families, who may be eligible, to their local Head Start agency by completing the Head Start/Early Head Start Referral Form (CD-200). While children in foster care are categorically eligible for HS/EHS programs, a referral does not guarantee placement. A referral to HS/EHS does not preclude families from choosing a child care provider of their choice.
Home Visiting is an in-home service designed to assist with the prevention of child abuse and neglect by offering additional in-home support for at-risk families.
The Home Visiting Program is a voluntary program providing assistance to eligible parents whose family income does not exceed 185% of the federal poverty level, and are currently pregnant or have a child under the age of 3 years. The program provides parents various opportunities to gain skills in the areas of child abuse and neglect prevention, early childhood development and education, parenting skill development, and school readiness. The Home Visiting program also provides parents with hands-on training and educational support groups, developmentally appropriate books and toys for the children, as well as various incentives for the parents to keep them engaged in the program. As the child(ren) age out of the Home Visiting program, they are referred to a Head Start or another early learning program to maintain continuity of educational services for the family.
70% of the families enrolled in Home Visiting must be referred by Children’s Division. This can include families that come to the attention of CD by means of a newborn crisis assessment, investigation or family assessment, in addition to ongoing FCS cases and AC cases with an active plan for reunification.
The Home Visiting providers are required to develop, or participate in, a multi-disciplinarian team in their assigned region as a means of providing wrap-around services for the families served and to create networks of referral sources for our families.
Each program is developed to include incentives for the families. Some of these incentives include, but are not limited to, diapers/wipes, formula, educational toys and books, gift cards or “cash” for needed items such as clothes and formula with mechanisms to ensure that only eligible items are purchased, gas cards, and or cribs and car seats.
Each HV provider offers different incentives and supports which is why it is so important to build these relationships early and to collaborate with the providers in your area. Some additional supports provided by Home Visitors for CD staff include: attending FST meetings, attending court hearings, attending TDM meetings, aiding in safe reunification of children with their families, and continuing in-home supports for families well after CD cases close.
The home visiting program follows evidence based models, or one promising approach, that are designed to prevent child abuse and neglect. The models choses are Healthy Families America and Nurturing Parenting Model, the promising approach is Capable Kids and Families.
Related Practice Points and Memos: