WHO IS ACCREDITED?

Private Organization Accreditation

Germaine Lawrence is a residential treatment center for girls ages 12-18 with complex behavioral, psychological and learning challenges.   Girls live at our programs while receiving special education, individual, family and group therapy; psychiatric and primary medical care; and a wide variety of therapeutic activities and interventions.
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VOLUNTEER TESTIMONIAL

Harry Hunter, MSW, MBA, Ph.D.

Volunteer Roles: Peer Reviewer; Team Leader

Peer Reviewer for the month of January 2013, Dr. Hunter has been volunteering for COA since 2005, conducting five site reviews.
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Purpose

Children in Family Foster Care and Kinship Care live in safe, stable, nurturing, and often temporary family settings that best provide the continuity of care to preserve relationships, promote well-being, and ensure permanency.

FKC 3: Comprehensive Assessment

Children, parents, and resource families are engaged in an individualized, strengths-based, and culturally responsive comprehensive assessment process that guides supports, service and permanency planning.

Interpretation: When the organization receives an assessment from another provider this assessment should contain all components identified within the standards or the organization should use a supplemental assessment that satisfies the standards and provides additional opportunities to engage with and learn about children and families.

Research Note: Personnel that conduct initial and comprehensive assessment should be aware of the indicators of a potential victim of human trafficking. Several tools are available to help identify a potential victim and determine next steps toward an appropriate course of treatment. Examples of these tools include, but are not limited to, the Rapid Screening Tool for Child Trafficking and the Comprehensive Screening and Safety Tool for Child Trafficking.

 
Research Note: Assessment should be an ongoing, collaborative, and functional process that tracks and analyzes child and family strengths, needs, and functioning. Assessment training and tools should be designed to equip the worker with the skills to engage children and families in dialogue about their strengths, experiences, struggles, and fears. Considering how families currently and have historically functioned helps to identify strengths and underlying needs.   Strengths and needs assessment should continue throughout the work with families and focus on the underlying causes behind behaviors and situations that put children at risk. Comprehensive assessment that guides effective service planning will be best achieved when families are engaged as partners in identifying their strengths and needs. 

Rating Indicators
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g., 
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Culturally responsive assessments are the norm and any issues with individual staff members are being addressed through performance evaluations (HR 6.02) and training (TS 2.05); or
  • Active client participation occurs to a considerable extent; or
  • Diagnostic tests are consistently and appropriately used, but interviews with staff indicate a need for more training (TS 2.08).
3
Practice requires significant improvement, as noted in the ratings for the Practice standards.  Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Assessment and reassessment timeframes are often missed; or
  • Assessment are sometimes not sufficiently individualized;
  • Culturally responsive assessments are not the norm and this is not being addressed in supervision or training; or
  • Staff are not competent to administer diagnostic tests , or tests are not being used when clinically indicated; or
  • Client participation is inconsistent; or
  • Assessments are done by referral source and no documentation and/or summary of required information present in case record; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • There are no written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Procedures for:
      1. Initial comprehensive assessment
      2. Ongoing assessment
      3. Case review
    • Assessment tool(s) and/or criteria included in assessment
    • A description of strategies for family engagement (FKC 3.01, FKC 3.04)
    • Data on the timeliness of assessments
    • Regulatory or administrative requirements that define intervals for safety assessments, if applicable
    • Interview:
      1. Program director
      2. Relevant personnel
    • Review case records

  • FKC 3.01

    In order to promote a comprehensive and responsive assessment process:
     

    1. all immediate family members are engaged in the assessment;
    2. the process includes the child and family’s telling of their own story;
    3. the organization makes a diligent attempt to locate absent fathers, as applicable; and
    4. extended family members and other supports are identified and involved whenever possible.

    Interpretation: The assessment process should be adapted based on the characteristics and needs of families, as necessary and appropriate. For example, the process for engaging family members should be adapted to protect the safety of victims of domestic violence, and strategies for family engagement should account for and accommodate the dynamics of family systems and histories, particularly when kin are caring for children. 

    When the organization is working with an Indian family, tribal representatives or other tribal community members must be involved in the assessment process, as determined by the tribe and the family. 


    Family participation in the assessment process may not be possible when the organization is serving children with limited family involvement or unaccompanied minors, however children should be actively engaged in the process. 

    Research Note: Identifying and engaging fathers, both custodial and non-custodial is critical to children’s well-being and may lead to the discovery of additional extended family resources. Research demonstrates that involved fathers can have an undeniably positive impact on child development. Some strategies for engaging fathers include:
    1. speaking with fathers to assess their needs, the program’s father friendliness, and program accessibility;
    2. understanding factors that impact father involvement;
    3. training staff on the impact of father involvement, the diversity of father’s roles within family systems, and ways that fathers may relate to their children;
    4. developing partnerships with community providers that are already accessible to fathers; and
    5. coordinating dads-only programming and offering multiple ways for fathers to connect with the organization.


  • FP
    FKC 3.02

    Assessments explore parents’ strengths, needs, and functioning related to the following areas: 
    1. family relationships, dynamics, and functioning, including any history of or exposure to domestic violence or human trafficking;
    2. informal and social supports, including relationships with extended family and community members, as well as connections to community and cultural resources;
    3. ability to meet basic financial needs and obtain adequate housing, food, and clothing;
    4. trauma exposure and related symptoms;
    5. physical health, including any chronic health problems;
    6. substance use;
    7. emotional stability, including mental health, adjustment, and coping abilities;
    8. parenting skills; and
    9. disciplinary practices.

    Update:

    • Added Interpretation - 10/31/17
      An Interpretation was added to support giving parents multiple opportunities to tell their story. 

    Interpretation: The Assessment Matrix - Private, Public, Canadian, Network determines which level of assessment is required for COA’s Service Sections. The assessment elements of the Matrix can be tailored according to the needs of specific individuals or service design.

    Interpretation: The assessment should consider individual and family functioning over time, including historical factors that may have contributed to concerns identified in the initial assessment. Standardized and evidence-based assessment tools are recommended to inform decision-making in a structured manner and objectively gather data across cases. 

    Tools such as ecomaps and genograms may help identify extended family and community support systems and facilitate in-depth conversations between workers and families.

    Regarding element (d), the expectation of this standard is that personnel will conduct a screening to identify trauma exposure and reactions, and arrange for a follow-up trauma-focused assessment when needed. Clinical trauma assessment must be provided by appropriately trained clinicians. 

    Research Note: Research has documented that trauma experienced by many members of kinship families, especially birth parents, needs particular attention in order to increase birth parent participation in kinship care arrangements.

    Research Note: Research on promoting trauma-informed care across an organization supports the use of evidence-based trauma screening tools, the incorporation of conversations around trauma into assessment tools, and the use of clinical assessment tools to further assess symptoms and identify treatment and intervention opportunities.

    NA The organization, by virtue of law or contract, does not serve parents. 


  • FP
    FKC 3.03

    Assessments explore children’s strengths, needs, and functioning related to the following areas:

    1. physical health, including any chronic health problems;
    2. emotional stability and adjustment;
    3. behavior;
    4. education and cognitive development, including school readiness;
    5. family relationships;
    6. informal and social supports, including relationships with adults and peers in the extended family and community, as well as connections to community and cultural resources;
    7. substance use;
    8. trauma exposure and related symptoms;
    9. gender identity and sexual orientation; and
    10. any history of human trafficking.

    Interpretation: Regarding element (i), when exploring gender identity and sexual orientation personnel should ask open-ended questions that prompt discussion and help establish rapport, as opposed to asking direct questions. Information shared should be used to inform service planning, as well as for matching children with resource families they may be able to join, when appropriate, and should only be included in written plans when children give explicit consent.

    Note: See also the Interpretations and Note to FKC 3.02.

    Note: See FKC 11 for additional information regarding health and mental health screenings and assessments. 
     

    NA The organization does not provide case management services for children. 


  • FKC 3.04

    A strengths-based and culturally-responsive approach to assessment is undertaken to:

    1. increase family engagement and identify available resources and individualized needs;
    2. gain a better understanding of families’ experiences;
    3. learn about times families managed challenging situations successfully; and
    4. identify competencies and resources family members can utilize and build upon to promote change and reduce the risk of maltreatment. 

    Interpretation: A strengths-based and culturally-responsive approach should be emphasized throughout training curricula and reflected in assessments, service plans, and other documentation. 

    Taking a culturally-responsive approach involves recognizing and valuing the varying sociocultural histories of families, taking the time to learn about families’ lived experiences, acknowledging one’s own culturally-based beliefs and norms, and adapting casework practice and service delivery to be responsive to differences. 

    Culturally-responsive assessment includes but is not limited to attention to: 
    1. age, 
    2. developmental level, 
    3. ethnicity,
    4. gender identity and expression,
    5. geographic location, 
    6. socioeconomic status;
    7. immigration/refugee history and status, including potential eligibility for Special Immigrant Juvenile Status (CIJS) and other immigration-related services;, 
    8. preferred language, 
    9. political status, 
    10. race,
    11. sexual orientation, 
    12. tribal affiliation, 
    13. religion, and
    14. cultural values and tradition.

    Research Note: Strengths-based practice includes the beliefs that: 
    1. children, youth and families are experts on themselves; 
    2. children, youth, and families must be fully engaged/involved in all decisions impacting their lives;
    3. the input of children, youth, and families is vitally important and will be treated with respect and value;
    4. lifelong connections should be promoted and maintained; and
    5. children, youth, and families should drive system planning and reforms.
    Research Note: It may be especially important to identify strengths related to the protective factors that have been shown to support effective parenting and promote child and family well-being, even under stress. Research has shown that protective factors including nurturing and attachment, knowledge of parenting and child and youth development, parental resilience, social connections, and concrete supports for parents are linked to lower incidence of child abuse and neglect.

    Research Note: When working with undocumented children, it is particularly important that workers assess children for their potential eligibility for Special Immigrant Juvenile Status (SIJS). Minors under 21 years-of-age may be eligible for SIJS if (1) they cannot be reunified with either parent because of abuse, neglect, or abandonment, and (2) it is not in their best interest to be returned to their home country. SIJS allows a child to remain in the United States and eventually obtain lawful permanent residency. It also provides an employment authorization document that allows the child to work and serves as a government-issued identification card.


  • FKC 3.05

    The assessment process is initiated through individual meetings: 
    1. with children within the first 72 hours of initial placement or any subsequent placements; 
    2. with parents within the first two weeks of placement; and 
    3. with resource parents within the first two weeks of placement.

    Interpretation: The individual interview should address physical, cognitive, emotional, social, cultural and spiritual/religious development from children’s own perspectives as outlined in the Assessment Matrix.  

    If staff have demonstrated competency in working with LGBTQI children/youth, exploration of gender identity and sexual orientation should be included in the individual conversation. As opposed to asking direct questions staff should ask open-ended questions that prompt discussion and help establish rapport. Information shared is used to responsively inform placement matching and service or treatment planning and should only be included in written plans when children and youth give explicit consent.  

    Interpretation: The initial meeting with children in treatment foster care is part of the admission process and occurs on the day of placement. The initial meeting with treatment foster parents occurs within 10 days of placement.

    Research Note: Because of the positive impact on child permanency outcomes, organizations are identifying creative strategies to bring parents and resource families together early on in the child welfare intervention. For example, some have instituted an introductory or “ice breaker” meeting within 72 hours of placement that gives parents the opportunity to share information about their children and to learn about the family that will be caring for their children.


  • FP
    FKC 3.06

    Assessment is ongoing and formal re-assessments of strengths, needs, risk, and safety are conducted with families periodically, including: 
    1. as part of case reviews;
    2. for decision making processes; and
    3. when children’s or families’ circumstances change.

    Interpretation: The organization should be in compliance with any regulatory or administrative requirements that define intervals for safety assessments.

    Interpretation: Assessments should be completed within timeframes established by the organization.  

    Interpretation: To prevent unnecessary placement changes and ensure placement in the least restrictive setting that meets their needs, an individualized re-assessment determines the appropriate level of care for youth who are pregnant or parenting and evaluates whether the youth’s needs can continue to be met in a family setting. See FKC 12 regarding supports and services for youth who are expectant or parenting.   
     

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