Free Order - District Court of Connecticut - Connecticut

Case 2:89-cv-00859-AHN

Document 502-9

Filed 11/07/2005

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LINK Extraction Tool for the 2005 Outcome Measure Case Review (Outcome Measures 20-21) Final Version Dated July 28, 2005

Administrative
A.1 Reviewer Name: (check the appropriate box below) 1. Collins, Debra 2. Roderick, Joni Beth Date of LINK Extraction: ________ / ________ / 2005 (MM/DD/YYYY)

A.2

Demographics
D.1 Treatment Case Assignment Type 1. CPS In-home family (IHF) case CPS Child-in-Placement (CIP) case 2. Associated family case to Child-in-Placement (ACIP or VSACIP) case 3. 4. Voluntary Services In-home family (VSIHF) case Voluntary Services Child-in-Placement (VSCIP) case 5. LINK Case Number: _________________ LINK Family Case or Child's Name: _______________________________ (LAST NAME, FIRST NAME) LINK Person ID Number (Case name or child-in-placement): _____________ Child's Date of Birth: ______/_______/_________ (MM/DD/YYYY) (enter 11/11/9999 if IHF, ACIP, VSACIP, VSIHF) Race (Child's or Family Case Name): 1. American Indian or Alaskan Native Asian 2. 3. Black/African American 4. Native Hawaiian White 5. Unknown 6. 7. Blank (no race selected in LINK) UTD 8. Multiracial 9. Ethnicity (Child's or Family Case Name): 1. Hispanic 2. Non-Hispanic Unknown 3. 4. Blank (no ethnicity selected in LINK) Date the case was most recently opened/reopened: ____/_____/_______(MM/DD/YYYY)

D.2 D.3

D.4 D.5

D.6

D.7

D.8

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D.9

Current residence of child on the date of this review: 1. Detention 2. DHMAS Group Home Home of biological parent, adoptive parent or legal guardian 3. In-state hospital setting 4. 5. In-state residential setting Out-of state residential setting 6. 7. Out-of-state foster care setting 8. Out-of-state hospital setting Shelter 9. Independence Achieved - Apartment/Home 10. 11. Unknown Social Worker's Office: 1. Bridgeport Danbury 2. 3. Greater New Haven Hartford 4. Manchester 5. 6. Meriden Middletown 7. New Britain 8. 9. New Haven Metro Norwalk 10. Norwich 11. 12. Stamford Torrington 13. Waterbury 14. 15. Willimantic

D.10.

D.11 What is the child in placement's legal status on May 15, 2005? 1. 96 hour hold Committed 2. 3. Dually Committed Not Committed 4. OTC 5. TPR 6. 7. N/A ­ In-Home Family Case (Voluntary, AFCIP, or CPS) D.12 On May 15, 2005 were any children in this in-home case under protective supervision? 1. Yes No 2. 3. N/A ­ Not an In-Home Case D.13 On May 15, 2005 what is the status of this case? 1. Open/Reopen 2. Closed

Case 2:89-cv-00859-AHN

Document 502-9

Filed 11/07/2005

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Case Management Issues
CM.1 What is the assigned Social Worker's name as of the date of the case review (today)? ____________________________________(LAST NAME, FIRST NAME)

CM.2 What is the name of the Social Work Supervisor as of the date of the case review (today)? ______________________________(LAST NAME, FIRST NAME) CM.3 Date of most recent removal from home: _______/________/__________(MM/DD/YYYY) (enter 11/11/9999 if IHF, VSIHF)

CM.4 Has/was this child in out of home care for at least 6 months as of May 15, 2005 (or date of case closure during the quarter ending May 15, 2005)? 1. Yes 2. No 3. N/A ­ In-Home Case (IHF or VSIHF) CM.5 Do supervisory conference notes indicate that the SWS and SW discussed risk factors in the case during the period of February 15, 2005 ­ May 15, 2005? 1. Yes No 2. 3. UTD ­ No SWS narratives in LINK during this period CM.5a How many supervisory conferences are documented during this period? ___________ CM.6 In reference to the supervisory conferences in CM.5 above, did the SWS offer clear directives on how to proceed with the case to minimize the risks identified? 1. Yes No 2. 3. N/A ­ no risks identified UTD ­ no SWS narratives during this period 4. CM.6a In the reviewers opinion were there clear risk factors present within the documentation for the case that were not addressed in SWS conferences? 1. Yes No 2. 3. UTD ­ No SWS narratives in LINK during this period CM.7 Reading all narratives related to the case events during this period does the reviewer feel that the supervision provided was: 1. Negligible Poor 2. Good 3. 4. Exellent Please document your rationale for the rating on the reverse of this page. CM.8 Were the SWS' directives followed by the SW in the prescribed manner and timeframe from the date of supervisory conference documentation? 1. All directives were followed 2. Partial compliance with SWS directives noted 3. No directives were followed N/A ­ no directives issued 4. 5. UTD - No narratives during this period

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CM.9 What was the child's stated goal on the most recent approved treatment plan in place during the period November 15, 2004 ­ May 15, 2005? 1. Reunification Adoption 2. 3. Transfer of Guardianship Other Permanent Living Arrangement: Long Term Foster Care 4. 5. Other Permanent Living Arrangement: Independent Living 6. In-Home Goals ­ Safety/Well Being Issues Other 7. UTD ­ Plan incomplete, unapproved or missing for this period 8. CM9a. If "Other is indicated in CM9, specify here: ________________________ CM.10 What is the concurrent plan? ______________________ / _______________________ 1st State Goal / 2nd Stated Goal CM.11 Did the social worker actively manage the case so that both goals were concurrently being pursued? 1. Yes No 2. 3. N/A ­ There is not a concurrent plan 4. N/A ­ In-Home case UTD ­ there is no approved treatment plan in place for the period of November 15, 2004 ­ 5. May 15, 2005 CM.12 Was the goal as identified on the most recent approved treatment plan (November 15, 2004 May 15, 2005) changed from the stated goal in the prior approved treatment plan? 1. Yes No 2. N/A ­ there was no prior approved treatment plan with which to compare goals. 3. 4. UTD ­ there is no approved treatment plan in place for the period of November 15, 2004 ­ May 15, 2005 UTD ­ case closed prior documentation locked down 5. CM.13 Did this stated DCF treatment plan goal coincide with the court approved permanency goal? 1. Yes No 2. No court approved plan required 3. 4. UTD ­ No Legal Narratives in the twelve month period ending May 15, 2005 UTD ­ child placed via OTC pending court date ­ no court approved goal of CIP 5. CM.14 What is the target date for goal achievement on the most current DCF 553 (completed November 15, 2004 ­May 15, 2005)? ________/_________ (MM/YYYY) CM14.a. Was the goal achieved? 1. 2. Yes No

CM.15 Has TPR been filed for the child in question? 1. Yes No 2. 3. N/A ­ child's goal did not require termination of parental rights 4. N/A ­ In-home case (CPS or Voluntary Services) CM.16 Enter the date of filing here: ________/_________/__________ (11/11/9999 if not applicable)

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CM.17 Has TPR been granted? 1. Yes No 2. N/A ­ DCF did not file TPR 3. 4. N/A ­ In-home case (CPS or Voluntary Services) CM.18 Enter date that TPR was granted: _________/_________/__________ (11/11/9999 if not applicable) CM.19 What court granted TPR? ______________________________ (enter SKIP if not applicable) CM.20 Is there LINK documentation that the parent(s) appealed the TPR? 1. Yes No 2. N/A ­ TPR not applicable to this case 3. 4. TBD ­ TPR is currently pending UTD ­ Appeal window not yet expired 5. CM.21 For children in placement on May 15, 2005 with a singular or concurrent goal of adoption or transfer of guardianship, has a permanent resource been identified? 1. Yes 2. No N/A ­ child is not in placement on May 15, 2005 3. N/A ­ child does not have the goal of adoption or TOG on May 15, 2005 4. 5. N/A ­ child achieved goal of adoption during the quarter CM.22 For children in placement on May 15, 2005 with a singular or concurrent goal of adoption or transfer of guardianship, has the child been placed with the identified resource? 1. Yes No 2. 3. N/A ­ child is not in placement on May 15, 2005 N/A ­ child does not have the goal of adoption or TOG on May 15, 2005 4. 5. N/A ­ child achieved goal of adoption during the quarter

CM.23 For children in out of home placement at any point during the period of February 15, 2005 ­ May 15, 2005 with TPR status, does the record indicate that a Life Book has been initiated to identify all familial ties, placement history, and information suitable for the child's level of understanding? 1. Yes No 2. 3. N/A ­ child's legal status is not TPR

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Outcome Measures 20 & 21 ­ Discharge Measures
Answer the series of question related to Outcome Measure 20 and 21 for all cases in which a child of 18 or older was discharged from care during the quarter ending May 15, 2005. If not applicable check here and go on to OM22. OM20.1 Was there an Adolescent Discharge Plan (DCF-2092 Form) in LINK? 1. Yes 2. No OM20.2 Was there an Independent Living Plan (DCF-2091 Form) in LINK? 1. Yes 2. No OM20.3 Was the youth provided with Independent Living Services? 1. Yes 2. No 3. UTD OM20.4 Did the youth participate in the CHAPS program? 1. Yes 2. No 3. UTD OM20.5 Did the youth successfully complete the CHAPS program? 1. Yes 2. No 3. UTD The following definitions should be utilized when answering the remaining questions on the tool: (1) YES = Documentation in LINK exists to positively answer this question. (2) NO = There is documentation in LINK that exists to answer this question negatively (3) NA = Attending or graduated high school (4) UTD = There is conflicting information found in the data sources listed that does not allow for a clear answer to this question. (5) NO INFO = No documentation found in LINK regarding this question.

Case 2:89-cv-00859-AHN

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OM20.6 ­ OM 20.18a What is the reason for youth's discharge from DCF care? Check all that apply. Yes OM20.6 Youth reached age of majority OM20.7 Services refused OM20.8 Services to be provided by other agency OM20.9 Case goal achieved OM20.10 Youth non-compliant with policy requirements OM20.10a. Education OM20.10b Employment OM20.10c. Other (Please identify) _______________________(OM20.10d) OM20.11 Youth incarcerated/detention OM20.12 Youth died OM20.13 Youth ran away/missing OM20.14 Youth adopted- Subsidized adoption OM20.15 Youth adopted- Non-subsidized adoption OM20.16 Youth unwilling to remain in placement OM20.17 Youth enlisted full-time member of the military OM20.18 Other __________________________(OM20.18a) No

OM20.19a-OM20.19h What efforts were made by the SW to engage youth in the recommended services? Yes OM20.19a Increased contacts with youth OM20.19b Contracting OM20.19c Family Intervention OM20.19d Increased contact with providers OM20.19e Legal Interventions OM20.19f Transportation assistance OM20.19g Other _____________________(OM20.19h) No

OM20.20 Did the youth achieve one or more of the discharge measures prior to discharge during the "period under review"? 1. Yes 2. No 3. UTD No Info 4.

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OM20.21a-OM20.21n What were the barriers documented to achieving one or more of the six discharge measures prior to discharge from DCF? Check all that apply. Yes OM20.21a Approval Process OM20.21B Child Hospitalized OM20.21c Client Refused Service OM20.21d Delay in Referral by Worker OM20.21e Financing Unavailable OM20.21g Service Not Available in Primary Language OM20.21h Youth incarcerated/detention OM20.21i Youth did not have or utilize a support network OM20.21jYouth had no employment experience (s) prior to discharge OM20.21k Transportation Unavailable OM20.21l Placed on Waiting List OM20.21m Other __________________________(OM20.21n) OM20.21n No barriers documented OM20.22 1. 2. 3. 4. 5. OM20.23 1. 2. 3. 4. 5. At the time of discharge, was the youth Attending High School Graduated High School Dropped Out UTD No Info At the time of discharge, was the youth Working toward GED Earned GED UTD NA- attending or graduated high school No Info No

OM20.24 At the time of discharge was the youth enrolled in college or other post secondary training program. 1. Yes/Full Time (12 credits or more) Yes/ Part Time (less than 12 credits) 2. No 3. NA- youth is attending HS or working towards GED 4. 5. UTD No Info 6. OM20.25 1. 2. 3. 4. 5. OM20.26 1. 2. 3. At the time of discharge, was the youth employed Yes/ Full time (>35 hours/week) Yes/Part time (<35 hours/week) No UTD No Info At the time of discharge, was the youth enlisted as a full-time member of the military? Yes No UTD

OM20.27 Has substance abuse been identified as a need at the point of discharge? 1. Yes

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2. 3. 4. OM20.28 1. 2. 3. 4. OM20.29 1. 2. 3. 4. OM20.30 1. 2. 3. 4. OM21.1 1. 2. 3. 4.

No UTD No Info Have mental health issues been identified as a need at the point of discharge? Yes No UTD No Info Was the youth eligible for special education services? Yes No UTD No Info Has the youth been identified with complex medical needs? Yes No UTD No Info Has the youth been clinically diagnosed with Mental Retardation? Yes No UTD No Info

OM21.2 Does the youth have a Full Scale I.Q. score under 70? 1. Yes No 2. 3. UTD No Info 4. OM21.3 Has the youth been clinically diagnosed with a psychiatric disorder? 1. Yes No 2. 3. UTD No Info 4. OM21.4 Has the youth been hospitalized for psychiatric reasons during the last 12 months? 1. Yes 2. No 3. UTD No Info 4. OM21.5 Is the youth currently on psychiatric medication? 1. Yes No 2. 3. UTD No Info 4. OM21.6 Does child require adult services upon discharge from DCF? 1. Yes 2. No

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Filed 11/07/2005

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OM21.7 Does the LINK record indicate that DCF submitted a written discharge plan to either DMHAS and/or DMR for this youth for adult services? 1. Yes No 2. Youth does not require adult services 3. 4. UTD Child requires adult service for which of the following reasons: (select all that apply) Yes OM21.8 Child meets DMR criteria OM21.9 Child is in residential care due to mental health issues OM21.10 Child is in need of continuing clinical services due to severe or persistent major mental illness, or other developmental disorders OM21.11 Child does not require adult services OM 21.12 1. 2. 3. 4. Was child referred to DMR? Yes No N/A ­ does not qualify UTD No

OM21.13 At what age does the LINK record indicate a referral was made to DMR? 1. Age 0-5 2. Age 6-10 Age 11-15 3. Age 16-20 4. OM21.14 Was the referral accepted? 1. Yes ­ DMR Caseworker Assignment recorded 2. Yes ­ but no record of DMR Caseworker assignment No 3. TBD ­ too soon to determine 4. 5. UTD ­ Conflicting information related to referral in LINK OM21.15 Was child referred to DMHAS 1. Yes No 2. N/A ­ Does not Qualify 3. UTD 4. OM21.16 How soon prior to discharge was DMHAS Referral sent? 1. < 1 month 2-3 months 2. 3. 4-6 months >6 months 4. N/A ­ no record of referral in discharge plan or LINK 5. OM21.17 Was youth picked up by the referred adult system at the point of discharge so that there was no lapse in services to the youth? 1. Yes No 2. 3. UTD 4. N/A ­ Youth did not qualify