Free Order - District Court of Connecticut - Connecticut

Case 2:89-cv-00859-AHN
Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Filed 10/01/2007

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Juan F. v. Rell Exit Plan Quarterly Report April 1, 2007 ­ June 30, 2007 Civil Action No. H-89-859 (AHN) September 24, 2007

Submitted by: DCF Court Monitor's Office 300 Church Street ~ 4th Floor Wallingford, CT 06492 Tel: 203-741-0458 Fax: 203-741-0462 E-Mail: [email protected]

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Table of Contents Juan F. v Rell Exit Plan Quarterly Report April 1, 2007 ­ June 30, 2007 Page Highlights April 1, 2007 through June 30, 2007 Exit Plan Outcome Measure Overview Chart Outcome Measure 3 & 15 Report (Second Quarter) Appendix 1 ­ Rank Scores for Outcome Measure 3 and Outcome Measure 15 ­Second Quarter 2007 Juan F. Action Plan Appendix 2 ­ The Department's Exit Plan Outcome Measures Summary Report Second Quarter Report April 1, 2007 ­ June 30, 2007 3 6

7 27

45 70

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Juan F. v Rell Exit Plan Quarterly Report April 1, 2007 ­ June 30, 2007 Highlights 1. The Monitor's quarterly review of the Department's efforts toward meeting the Exit Plan measures during the period of April 1, 2007 through June 30, 2007 indicates that the Department achieved 17 of the 22 measures. 2. The Department for three consecutive quarters achieved all three permanency measures, Reunification (Outcome Measure 7), Adoption (Outcome Measure 8), and Transfer of Guardianship (Outcome Measure 9). Permanency was accomplished within the two year time frame for 40.6% of the adoptions finalized, and 88.0% of the transfers of guardianship that occurred during the quarter were done in a timely manner. 3. The Department's efforts to improve the quality of treatment plans and better meet the needs of children did not result in overall improvements to scores for the second quarter. Based on the Monitor's review of a 76 case sample (the complete results are also included as a part of the Juan F. v Rell 2006 Comprehensive Targeted Review), many treatment plans lacked specific planning goals and clear comprehensive, time sensitive action steps. Many parties involved in the cases sampled (DCF, children, family, school, providers, etc.) had no action steps designated or goals articulated for them in the approved treatment plans. Explanations of progress for the prior period were also insufficient in many cases. Assessments within the treatment plans incorporated provider input were minimal, or were absent all together. With respect to Needs Met (Outcome Measure 15), children continue to remain in restrictive levels of care beyond the time that is clinically appropriate. System gridlock is apparent through the review of individual cases, the analysis of the available data, as well as interviews with stakeholders. The Juan F. Action Plan (incorporated within this document) includes additional information related to children and families needs being met. 4. The Department has met Residential Reduction (Outcome Measure 19) for five consecutive quarters. The performance rate this quarter was 11.0% which represents 647 Juan F. children. There are 255 fewer children in residential settings than were in residential care during the same period 2004. 5. The Department met Repeat Maltreatment (Outcome Measure 5) for the first time in several quarters with a performance rate of 6.3%. This includes families in which there was one or more additional substantiated abuse or neglect reports within a sixmonth period.

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6. The Monitor's quarterly review of the Department for the period of April 1, 2007 through June 30, 2007 indicates the Department has achieved compliance with a total of 17 measures: · Commencement of Investigations (97.1%) · Completion of Investigations (93.7%) · Search for Relatives (93.8%) · Repeat Maltreatment (6.3%) · Maltreatment of Children in Out-of-Home Care (0.1%) · Reunification (67.9%) · Adoption (40.6%) · Transfer of Guardianship (88.0%) · Multiple Placements (96.0%) · Foster Parent Training (100.0%) · Placement within Licensed Capacity (97.1%) · Worker-Child Visitation Out-of-Home Cases (94.6% Monthly/ 98.7% Quarterly) · Worker-Child Visitation In-Home Cases (90.9%) · Caseload Standards (100.0%) · Residential Reduction (11.0%) · Discharge Measures (100.0%) · Multi-disciplinary Exams (96.8%) 7. The Department has maintained compliance for at least two (2) consecutive quarters1 with 16 of the Outcome Measures. (Measures are shown with designation of the number of consecutive quarters for which the measure was achieved): · Commencement of Investigations (eleventh consecutive quarter) · Completion of Investigations (eleventh consecutive quarter) · Search for Relatives (seventh consecutive quarter) · Maltreatment of Children in Out-of-Home Care (fourteenth consecutive quarter) · Reunification (eighth consecutive quarter) · Adoption (third consecutive quarter) · Transfer of Guardianship (fourth consecutive quarter) · Multiple Placements (thirteenth consecutive quarter) · Foster Parent Training (thirteenth consecutive quarter) · Placement within Licensed Capacity (fourth consecutive quarter) · Visitation Out-of-Home (seventh consecutive quarter) · Visitation In-Home (seventh consecutive quarter) · Caseload Standards (twelfth consecutive quarter) · Residential Reduction (eighth consecutive quarter) · Discharge Measures (eighth consecutive quarter) · Multi-disciplinary Exams (sixth consecutive quarter)
The Defendants must be in compliance with all of the outcome measures, and in sustained compliance with all of the outcome measures for at least two consecutive quarters (six-months) prior to asserting compliance and shall maintain compliance through any decision to terminate jurisdiction.
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8. The Monitor's quarterly review of the Department for the period of April 1, 2007 through June 30, 2007 indicates that the Department did not achieve compliance with five (5) measures: · Treatment Plans (30.3%) · Sibling Placements (79.1%) · Re-Entry (8.5%) · Children's Needs Met (51.3%) · Discharge to DMHAS and DMR (83.0%)

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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____________________________ 2Q April 1- June 30, 2007 Exit Plan Report

Outcome Measure Overview
Measure Measure 1Q 2004 2Q 2004 3Q 2004 4Q 2004 1Q 2005 2Q 2005 3Q 2005 4Q 2005 1Q 2006 2Q 2006 3Q 2006 4Q 2006 1Q 2007 2Q 2007

1: Investigation Commencement 2: Investigation Completion 3: Treatment Plans** 4: Search for Relatives* 5: Repeat Maltreatment 6: Maltreatment OOH Care

>=90%

X

X

X

91.2% 92.5% 95.1% 96.2% 96.1% 96.2% 96.4% 98.7% 95.5% 96.5% 97.1%

>=85% 64.2% 68.8% 83.5% 91.7% 92.3% 92.3% 93.1% 94.2% 94.2% 93.1% 94.2% 93.7% 93.0% 93.7% >=90% >=85% <=7% <=2% X 93% 9.4% 0.5% X X 10% 17% X 8.9% 0.6% X X X 8.2% 0.8% X X X X X X 54% 41.1% 41.3% 30.3%

82% 44.6% 8.9% 0.8% X 9.4% 0.9% X

49.2% 65.1% 89.6% 89.9% 93.9% 93.1% 91.4% 92.2% 93.8% 8.5% 0.7% X 9.1% 0.8% 7.3% 0.6% 6.3% 0.4% 7.0% 0.7% 7.9% 0.7% 7.9% 0.2% 7.4% .2% 6.3% 0.1%

7: Reunification* >=60% 8: Adoption 9: Transfer of Guardianship 10: Sibling Placement* 11: Re-Entry 12: Multiple Placements 13: Foster Parent Training 14: Placement Within Licensed Capacity 15: Needs Met**

64.2% 61% 66.4% 64.4% 62.5% 61.3% 70.5% 67.9%

>=32% 10.7% 11.1% 29.6% 16.7% 33% 25.2% 34.4% 30.7% 40.8% 36.9% 27% 33.6% 34.5% 40.6% >=70% 62.8% 52.4% 64.6% 63.3% 64.0% 72.8% 64.3% 72.4% 60.7% 63.1% 70.2% 76.4% 78% 88.0% >=95% <=7% >=85% 100% 65% X X X 53% X X X X X X X X X 96% 7.2% 94% 7.6% 75% 6.7% 77% 7.5% 83% 85.5% 84.9% 79.1% 4.3% 8.2% 7.5% 8.5% 96.0%

95.8% 95.2% 95.5% 96.2% 95.7% 95.8% 96% 96.2% 96.6% 96.8% 95% 96.3%

100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

>=96% 88.3% 92.0% 93.0% 95.7% 97% 95.9% 94.8% 96.2% 95.2% 94.5% 96.7% 96.4% 96.8% 96.9%

>=80%

53% 72% 87% 39%

57% 86% 98% 40%

53% 73% 93% 46%

56%

X

X

X

X

X

X

62% 52.1% 45.3% 51.3%

16: Worker-Child >=85% Visitation (OOH)* 100% 17: Worker-Child >=85% Visitation (IH)* 18: Caseload Standards+ 19: Residential Reduction 20: Discharge Measures 21: Discharge to DMHAS and DMR 22: MDE 100%

81% 77.9% 86.7% 83.3% 85.6% 86.8% 86.5% 92.5% 94.7% 95.1% 94.6% 91% 93.3% 95.7% 92.8% 91.9% 93.1% 90.9% 91.5% 99.0% 99.1% 98.7% 33% X 81.9% 78.3% 85.6% 86.2% 87.6% 85.7% 89.2% 89% 90.9%

73.1% 100% 100% 100% 100% 100% 99.8% 100% 100% 100% 100% 100% 100% 100%

<=11% 13.9% 14.3% 14.7% 13.9% 13.7% 12.6% 11.8% 11.6% 11.3% 10.8% 10.9% 11% 10.9% 11% >=85% 74% 52% 93% 83% X X 96% 92% 85% 91% 100% 100% 98% 100%

100%

43%

64%

56%

60%

X

X

78%

70%

95%

97%

100%

97%

90%

83%

>=85% 19.0% 24.5% 48.9% 44.7% 55.4% 52.1% 54.6% 72.1% 91.1% 89.9% 86% 94.2% 91.1% 96.8%

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Monitor's Office Case Review for Outcome Measure 3 and Outcome Measure 15 Overview The Juan F. v Rell Revised Exit Plan and subsequent stipulated agreement reached by the parties and court ordered on July 11, 2006, requires the Monitor's Office to conduct a series of quarterly case reviews to monitor Outcome Measure 3 (Treatment Planning) and Outcome Measure 15 (Needs Met). The implementation of this review began with a pilot sample of 35 cases during the third quarter 2006 and has been conducted quarterly since that time with samples of approximately 70-75 cases. For the Third Quarter 2007 the sample included 76 cases. Outcome Measure 3 requires that, "....in at least 90% of the cases, except probate, interstate and subsidy only cases, appropriate treatment plans shall be developed as set forth in the "DCF Court Monitor's 2006 Protocol for Outcome Measures 3 and 15" dated June 29, 2006 and the accompanying "Directional Guide for OM3 and OM15 Reviews" dated June 29, 2006." Review Findings and Trends The fourth quarter case review data for Outcome Measure 3 indicates that the Department attained the level of "Appropriate Treatment Plan" in 23 of the 76-case sample or 30.3%. · This reduction in the treatment plan scores reflects the overarching issue raised by reviewers ­ the need for greater supervisory oversight in the development of and approval of plans. Currently, plans are often approved that clearly are not in accordance with expected practice. Recent changes in the Administrative Case Review (ACR) SWS role in relation to reviewing plans with an eye to Outcome Measure 3, as well as fulfilling the role of the third party, objective reviewer may improve scores in coming quarters. However, reviewers have noted many times in the past that the documentation provided by the ACR SWS often addresses action steps, goals, and services, yet fails to be incorporated prior to the approval of the plan. The Ongoing SWS bears a great deal of the responsibility for improving the level of performance for this measure. · Treatment plans continue to lack inclusive action steps, identified goals for the upcoming six months, identification of services, and the input of providers (other than with foster parents ­ who are being engaged in discussion with regularity). 98.7% of the cases sampled had a plan less than 7 months old at the point of review. Three of the plans not passing (3.9%) did not have SWS approval. All three of these plans had one or more sections with less than a "very good" rating and would have been deemed inappropriate regardless of approval status. With respect to accommodating the primary language of clients, 94.7% of the cases had documentation that families' language needs were met (4 cases did not have documentation of meeting language needs).

·

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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·

In-Home cases (n=22) appear to be most problematic in regards to inclusive and appropriate treatment planning. In all only 18.2% of the In-Home Cases were deemed as having appropriate treatment plans. Child in Placement cases with CPS designation had the greatest percentage of appropriate treatment planning for the sample set, with 69.6% of those cases deemed appropriate. Voluntary Service Child in Placement cases were considered appropriate in 60% of the cases reviewed. There have been recent changes to the definitions of the APPLA goals, and changes in expectations related to assignment of these less permanent scores. It may be that this transition along with the confusion of implementing this new policy is impacting the scoring for both treatment plans and needs met related to permanency. There was documented engagement of foster parents in discussions around treatment planning in 94.4% of the cases sampled. This is the highest rate to date. Mothers (73.8%), and identified support/kin (66.7%) are the next participants most frequently involved in discussions. Attendance rates at the ACRs and Family Conferences remain problematic for most case participants. Reviewers noted a failure to invite adolescents and fathers, and the overall lack of engagement with both children's and parents' attorneys.

·

·

As a result of discussion with area offices regarding the in-home cases reviewed, the Monitor has determined a need for a methodological change for the future reviews. Area Offices were identifying cases that they felt had appropriate treatment planning but that were not passing as a result of poor or missing LINK documentation or information known to the SW or SWS that was not represented in the LINK narrative but was of importance to how the treatment planning efforts unfolded. While we feel that scoring has given an accurate accounting of the treatment planning documents and records we reviewed, beginning with the Third Quarter 2007 reviews, we have made a change in approach. Many in-home cases do not have a family conference that typically provides an opportunity for the reviewer to clarify issues or obtain first hand knowledge. Therefore, for all in-home cases where there is no opportunity to attend the family conference and speak with the SWS or SW in person, we will include a brief phone interview with the SWS or SW. Outcome Measure 15 requires that, "....at least 80% of all families and children shall have all their medical, dental, mental health and other service needs met as set forth in the "DCF Court Monitor's 2006 Protocol for Outcome Measures 3 and 15 dated June 29, 2006, and the accompanying `Directional Guide for OM3 and OM15 Reviews dated June 29, 2006."

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Review Findings and Trends The case review data indicates that the Department attained the designation of "Needs Met" in 51.3% of the 76-case sample. · Nine of the 11 categories measured within Outcome Measure 15 showed some level of improvement over the prior quarter. The Department shows promising practices in legal action, safety of children in placement, attending to medical needs, and recruitment efforts for the prior period. Most problematic are provision of timely dental services, mental health, behavioral health, and substance abuse services. The permanency goals of children appear to have an impact on the ability of the Department to attain a level of practice and service provision that meets the identified needs of children and families. Children with non-preferred treatment planning permanency goals more frequently do not have their identified needs met. APPLA: Permanent Non-Relative Foster Care, APPLA: Other and Long Term Foster Care with a Relative are respectively 33.3%, 42.9% and 33.3% compliant. Preferred goals are compliant at rates greater than 55.0%. Structured Decision Making (SDM) training is now completed across the state area offices. The practice shows great promise if DCF maintains the integrity of the scoring protocols' definitions. There is an expected learning curve as SW and SWS work with the assessment tools in establishing both permanency and services needs. Of the needs which remained unmet from the prior planning period, mental health services continued to be most prevalent. Most frequently, the barrier documented was "client refusal"; however, reviewers noted that these circumstances often did not have documented engagement efforts such as client contact by SWS or ARG, or collaborative efforts with active providers to engage clients in needed services. 68.4% of the cases reviewed had clear documentation of a service need that should have been carried over to the treatment plan reviewed for this quarter, but was not.

·

·

·

·

For more details regarding each of these areas of measurement see the analysis within this chapter. Methodology: The Juan F. v Rell Revised Exit Plan and subsequent stipulated agreement reached by the parties and court ordered on July 11, 2006, requires the Monitor's Office to conduct a series of quarterly case reviews to monitor Outcome Measure 3 (Treatment Planning) and Outcome Measure 15 (Needs Met). The implementation of this review began with a pilot sample of 35 cases during the Third Quarter 2006. During the Second Quarter 2007, the Monitor's Office reviewed a total of 76 cases2 . Methodology will change with the Third Quarter 2007 reviews in that 50 cases will be reviewed by individual reviewers. This was necessitated by changes in DCF staff assignments and additional monitoring activities resulting from the Juan F. v Rell Action Plan.

2

The Exit Plan required a total of 70 cases be reviewed. Due to rounding and ensuring that each area office had representation of both in-home and out of home case assignments, a total of 76 cases were selected.

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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This quarter's 76 case sample was stratified based upon the distribution of area office caseload on March 1, 2007. The sample incorporated both in-home and out-of-home cases based on the overall statewide percentage reflected at the point that each sample is determined. Table 4: Second Quarter 2007 Sample Based on March 1, 2007 Caseload
Area Office Total Caseload % of Caseload % of In-Home Cases Bridgeport Danbury Greater New Haven Hartford Manchester Meriden Middletown New Britain New Haven Metro Norwalk Norwich Stamford Torrington Waterbury Willimantic Grand Total 1,081 330 933 1,879 1,245 575 400 1,488 1,487 288 1,147 272 436 1,316 850 13,727 7.9% 2.4% 6.8% 13.7% 9.1% 4.2% 2.9% 10.8% 10.8% 2.1% 8.4% 2.0% 3.2% 9.6% 6.2% 100.0% 28.2% 14.8% 25.1% 21.0% 26.3% 30.4% 26.0% 33.5% 29.5% 34.0% 29.3% 43.0% 12.4% 20.8% 26.6% 26.5% 2 1 1 2 2 1 1 3 2 1 2 1 1 1 1 22 4 2 4 8 4 2 2 5 6 1 4 1 2 6 3 54 6 3 5 10 6 3 3 8 8 2 6 2 3 7 4 76 In-Home Sample OOH Sample Total Sample

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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This is the last quarter where the methodology included pairing of DCF staff with Monitor's Review staff. Within the course of seven to twelve hours, each case was subjected to the following methodology. 1. A review of the Case LINK Record documentation for each sample case concentrating on the most recent six months. This includes narratives, treatment planning documentation, investigation protocols, and the provider narratives for any foster care provider during the last six-month period. 2. Attendance/Observation at the Treatment Planning Conference (TPC)/Administrative Case Review (ACR) or Family Conference (FC)3. 3. A subsequent review of the final approved plan is conducted fourteen to twenty days following the date identified within the TPC/ACR/FC schedule from which the sample was drawn. Each reviewer completes an individual assessment of the treatment plan and needs met outcome measures and fills out the scoring forms for each. 4. A final meeting with the assigned teammate is held to jointly arrive at the final scores for each section and overall scoring for OM3 and 15. Individual scoring and joint scoring forms are then submitted to the Monitor. (This step may change as determined appropriate by the DCF Court Monitor after evaluation of the process, feedback from review staff and fiscal/staffing considerations.) Although the criterion for scoring requires consistency in definition and process to ensure validity, no two treatment plans will look alike. Each case has unique circumstances that must be factored into the decision-making process. Each reviewer has been provided with direction to evaluate the facts of the case in relationship to the standards and considerations and have a solid basis for justifying the scoring. In situations where agreement cannot be reached, the team requests that the supervisor become a third voice on those areas of concern. They present their opinions and findings and the supervisor determines the appropriate score to reflect the level of performance for the specific item(s) and assists them in the overall determination of compliance for OM3 and OM15. If the team indicates that there are areas that do not attain the "very good" or "optimal" level, yet consensus is the overall score should be "an appropriate treatment plan" or "needs met" the team clearly outlines their reasoning for such a determination and it is reviewed by the Court Monitor for approval of an override exception. These cases are also forwarded to the Technical Advisory Committee (TAC) for review. During the Fourth Quarter, there were 19 such cases submitted for consideration/assistance of supervisory oversight. Of the 19 cases, seven resulted in the approval of an override to allow one or the other measure to achieve a passing score. These cases will be identified in the overall scoring tables later in this document.

3

Attendance at the family conference is included where possible. In many cases, while there is a treatment plan due, there is not a family conference scheduled during the quarter we are reviewing. To compensate for this, the monitoring of in-home cases includes hard copy documentation from any family conference held within the six month period leading up to the treatment plan due date.

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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To address the areas of disparity identified in the third quarter pilot, a post review team meeting was held in October to address individual reviewer's and teams' issues related to the review process. Clarifications were provided, and a better understanding of some of the finer points of the process resulted from this trial review process and debriefing. A sample case was jointly reviewed by all reviewers and then each subcategory was analyzed. As necessary, additional training and clarification will be ongoing throughout the process. Descriptive Information As indicated earlier, the sample consisted of 73 cases distributed among the 15 Area Offices. Sample cases are identified by Assignment Type. At the point of review, the data indicates that the majority of cases (71.4%) are children in care for child protective service reasons. A full description of the sample is provided below: Crosstabulation 5: What is the Type of Case Assignment Noted in LINK? * Does Child in Placement Have Involvement with the Juvenile Justice System?
What is the type of case assignment noted in LINK? Does child in placement have involvement with the juvenile justice system? In-Home CPS or Voluntary Service Case 1 39 3 43 21 0 0 21

Yes CPS In-Home Family Case (IHF)4 CPS Child in Placement Case (CIP) Voluntary Services Child in Placement Case (VSCIP) Total 0 10 2 12

No

Total 22 49 5 76

Of the children in placement at any point during the quarter (n=55), twelve children (21.8%) had some involvement with the Juvenile Justice System during the quarter. This population had a 41.7% compliance rate with both the treatment plan and needs met outcome measures. In establishing the reason for the most recent case open date identified, reviewers were asked to identify all substantiations or voluntary service needs identified at the point of most recent case opening. This was a multiple response question which allowed the reviewers to select more than one response as situations warranted.

4

Includes one child who had placement episode during the quarter but was reunified at point of review.

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Table 5: Causes for DCF Involvement on Date of Most Recent Case Opening
Cause s for DCF's Involvement Physical Neglect Substance Abuse/Mental Health (Parent) Domestic Violence Emotional Neglect Physical Abuse Child's TPR Case prompted new opening Educational Neglect Abandonment Medical Neglect Voluntary Services Request (child) FWSN Referral Sexual Abuse Number 49 29 16 14 8 8 6 5 4 4 4 3 Percent 32.7% 19.3% 10.7% 9.3% 5.3% 5.3% 4.0% 3.3% 2.7% 2.7% 2.7% 2.0% Percent of Cases (n=76) 64.5% 38.2% 21.1% 18.4% 10.5% 10.5% 7.9% 6.6% 5.3% 5.3% 5.3% 3.9%

In total, 150 reasons were identified within the multiple response question. The data indicates that physical neglect remains the most frequent reason for a case opening in treatment, as 64.5% of the cases cited this as one of the factors for the case opening. This was again followed by Parental Substance Abuse/Mental Health which was present in 38.2% of the cases reviewed, and Domestic Violence cited in 21.1% of the cases edged out Emotional Abuse which was ranked third in the last quarter's data. Table 6: What is the primary reason cited for case opening/reopening?
Primary Reason Frequency Percent Valid Percent Cumulative Percent Abandonment 4 5.3 5.3 5.3 Child's TPR 8 10.5 10.5 15.8 Domestic Violence 10 13.2 13.2 28.9 Educational Neglect 3 3.9 3.9 32.9 Emotional Neglect 4 5.3 5.3 38.2 FWSN Referral 4 5.3 5.3 43.4 Medical Neglect 1 1.3 1.3 44.7 Physical Abuse 4 5.3 5.3 50.0 Physical Neglect 18 23.7 23.7 73.7 Sexual Abuse 1 1.3 1.3 75.0 Substance Abuse 16 21.1 21.1 96.1 Voluntary Service Request 3 3.9 3.9 100.0 Total 76 100.0 100.0

When asked to isolate the primary reason for case opening among those identified for each of the 76 cases; physical neglect was identified for 23.7% of the sample set.

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Juan F. v Rell Exit Plan Quarterly Report September 24, 2007

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Permanency/case goals were identified for 74 of the 76 cases reviewed (97.4%). Of the 26 situations in which "Reunification" was the permanency goal, there was a required concurrent plan documented in 21 cases (80.8%). Of the seven cases with the goal of "APPLA: Other", six identified "Independent Living" and one identified "Specialized Care to Transition to DMHAS/DMR". Table 7: What Is the Child or Family's Stated Permanency Goal on the Most Recent Approved Treatment Plan in Place During the Period?
Permanency Goal Reunification In-Home Goals - Safety/Well-being Issues Adoption APPLA: Permanent Non-Relative Foster Care APPLA: Other Long Term Foster Care with a licensed relative Goal indicated is not an approved DCF goal Total Frequency 26 20 9 9 7 3 2 76 Percent 34.2 26.3 11.8 11.8 9.2 3.9 2.6 100.0

Children in placement had various lengths of stay at the point of our review. This ranged from less than one month, to greater than 24 months. Below is a crosstab of cases by length of stay as it relates to the Termination of Parental Rights (TPR) filing and in relation to the ASFA requirement to file or identify an exception no later than 15 months into the out of home episode. In all cases in which the child's length of stay and permanency goal required the filing of TPR, it had been done or an exception was noted in LINK. One additional case open less than 15 months but with a goal requiring TPR still had not documented the filing as of the date of review. Crosstabulation 6: Has Child's Length of Stay Exceeded the 15 of the Last 22 Month Benchmark Set by ASFA? * For Child in Placement, has TPR Been Filed?
Has child's length of stay exceeded the 15 of the last 22 benchmark set by ASFA? For child in placement, has TPR been filed? N/A Exception Yes No Total noted in LINK 0 1 12 13 1 3 0 4 12 13 0 4 2 14 14 31

Yes No TPR has already been filed or granted Total

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Data Reporting for Outcome Measure 3 ­ Treatment Plans Of the three case types represented within the sample, in-home cases (n=22) appear the most problematic in regards to inclusive and appropriate treatment planning. In all only four (18.2%) of the in-home family cases were deemed as having appropriate treatment plans. Child in placement cases (CIP) with CPS designation had the greatest percentage of appropriate treatment planning for the sample set, with 69.6% of those cases deemed appropriate. Voluntary Services CIP cases were considered appropriate in 60% of the cases reviewed. Crosstabulation 7: What is the Type of Case Assignment Noted in LINK? * Overall Score for OM3
Overall Score for OM3 Appropriate Not an Treatment Appropriate Plan Treatment Plan
4 18.2% 17.4% 5.3% 16 32.7% 69.6% 21.1% 3 60.0% 13.0% 3.9% 23 30.3% 100.0% 30.3% 18 81.8% 34.0% 23.7% 33 67.3% 62.3% 43.4% 2 40.0% 3.8% 2.6% 53 69.7% 100.0% 69.7%

What is the type of case assignment noted in LINK? Count CPS In-Home Family Case (IHF) % within case assignment % within Overall Score % of Total CPS Child in Placement Case (CIP) Count % within case assignment % within Overall Score % of Total Count Voluntary Services Child in Placement Case (VSCIP) Total % within case assignment % within Overall Score % of Total Count % within case assignment % within Overall Score % of Total

Total
22 100.0% 28.9% 28.9% 49 100.0% 64.5% 64.5% 5 100.0% 6.6% 6.6% 76 100.0% 100.0% 100.0%

Engagement with children, families and providers in the development of the treatment plans was identified within the LINK documentation, treatment plans and attendance at the ACR or Family Conference. Each case had a unique pool of active participants for DCF to collaborate with in the process. The chart below indicates the degree to which identifiable/active case participants were engaged by the SW and the extent to which active participants attended the TPC/ACR/FC. Percentages reflect the level or degree to which a valid participant was part of the treatment planning efforts across all the cases reviewed.

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Table 8: Participation and Attendance Rates for Active Case Participants within the Sample Set
Identified Case Participant Foster Parent Mother Other Participants Active Service Providers Child Other DCF Staff Father Attorney/GAL (Child) Parents' Attorney Percentage with documented Participation/Engagement in Treatment Planning Discussion 94.4% 73.8% 66.7% 66.4% 64.7% 58.8% 39.0% 16.7% 14.9% Percentage Attending the TPC/ACR or Family Conference 66.7% 61.4% 55.3% 41.2% 37.5% 52.3% 24.0% 6.3% 4.8%

Engagement of foster parents in treatment planning discussions was present in 94.4% of the cases sampled, the highest rate to date. Mothers, and identified support/kin are the next participants most frequently involved in discussions. Attendance rates remain problematic for most case participants. Active service providers were approached to engage in treatment planning in 66.4% of the sample, only 41.2% of these providers actually attended the administrative case review. Many, if not all private providers, develop internal treatment plans for referred DCF clients, these providers should be approached to identify specific goals for the child or family from those plans to be incorporated within the DCF treatment planning process so that various participants are not ill-informed or working at cross purposes. Reviewers also noted a failure to invite adolescents and fathers, and the overall lack of engagement with both children's and parents' attorneys. As with the third quarter, this review process looked at eight categories of measurement when determining overall appropriateness of the treatment planning (OM3). Scores were based upon the following rank/scale: Optimal Score ­ 5 The reviewer finds evidence of all essential treatment planning efforts for both the standard of compliance and all relevant consideration items (documented on the treatment plan itself). Very Good Score ­ 4 The reviewer finds evidence that essential elements for the standard of compliance are substantially present in the final treatment plan and may be further clarified or expanded on the DCF 553 (where latitude is allowed as specified below) given the review of relevant consideration items. Marginal Score ­ 3 There is an attempt to include the essential elements for compliance but the reviewer finds that substantial elements for compliance as detailed by the Department's protocol are not present. Some relevant considerations have not been incorporated into the process.

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Poor Score ­ 2 The reviewer finds a failure to incorporate the most essential elements for the standard of compliance detailed in the Department's protocol. The process does not take into account the relevant considerations deemed essential, and the resulting document is in conflict with record review findings and observations during attendance at the ACR. Absent/Adverse Score ­ 1 The reviewer finds no attempt to incorporate the standard for compliance or relevant considerations identified by the Department's protocol. As a result there is no treatment plan less than seven months old at the point of review or the process has been so poorly performed that it has had an adverse affect on case planning efforts. Overall treatment plans of children in placement fared better in achievement of the "appropriate treatment plan" designation. The crosstabulation below provides the percentage of appropriate and not appropriate designations for within the group as a whole and within the specific case assignment designation. Crosstabulation 8: Overall Score for OM3* What is the Type of Case Assignment Noted in LINK?
Overall Score Appropriate Treatment Plan: Count % Within Row % Within Type Not an Appropriate Treatment Plan: Count % Within Row % Within Type Total: Count % Within Row % Within Type What is the type of case assignment noted in LINK? CPS Voluntary In-Home CPS Child in Svcs Child in Family Placement Placement Total 4 17.4% 18.2% 18 34.0% 81.8% 22 28.9% 100.0% 16 69.6% 32.7% 33 62.3% 67.3% 49 64.5% 100.0% 3 13.0% 60.0% 2 3.8% 40.0% 5 6.6% 100.0% 23 100.0% 30.3% 53 100.0% 69.7% 76 100.0% 100.0%

"Reason for Involvement" and "Present Situation to Date" were most frequently ranked with an Optimal Score. Deficits were most frequently noted in two categories: "Determination of Goals/Objectives" and "Action Steps to Achieve Goals". The following table provides the scoring for each category for the sample set and the corresponding percentage of cases within the sample that achieved that ranking. There is an overall reduction in the number of "Poor" and "Adverse" scores identified across the full sample population assessed in the last quarter. However, as in prior quarters the eight categories measured indicate that DCF continues to struggle with assignment of action steps for the case participants in relation to goals and objectives (II.3); identifying the goals and objectives for the coming six month period (II.1), and in detailing progress in the previous six months(II.2). 17

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Permanency Planning (II.4) also has shown a decline from the prior quarter's results. It is likely the recent changes to the APPLA goal definition have had an impact upon this section's overall scoring. The following set of three tables provide at a glance, the scores for each of the eight categories of measurement within Outcome Measure 3. The first is the full sample (n=76), the second is the children in out of home placement (CIP) cases (n=54) and the third is the inhome family cases (n=22). For a complete listing of rank scores for Outcome Measure 3 by case, see Outcome Measure 3 - Appendix 1.

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____________________________ Table 9: Measurements of Treatment Plan OM 3 ­ Number and Percent of Rank Scores for All Cases Across All Categories of OM3
Category I.1 Reason for DCF Involvement I.2. Identifying Information I.3. Strengths/Needs/Other Issues I.4. Present Situation and Assessment to Date of Review II.1 Determining the Goals/Objectives II.2. Progress5 II.3 Action Steps to Achieving Goals Identified II.4 Planning for Permanency Optimal "5" 42 (55.3%) 3 (3.9%) 17 (22.4%) 17 (22.4%) 15 (19.7%) 19 (25.0%) 3 (3.9%) 24 (31.6%) Very Good "4" 30 (39.5%) 57 (75.0%) 37 (48.7%) 38 (50.0%) 26 (34.2%) 30 (39.5%) 27 (35.5%) 34 (44.7%) Marginal "3" 4 (5.3%) 15 (19.7%) 22 (28.9%) 20 (26.3%) 29 (38.2%) 22 (28.9%) 37 (48.7%) 14 (18.4%) Poor "2" 0 (0%) 1 (1.3%) 0 (0%) 1 (1.3%) 6 (7.9%) 2 (2.6%) 8 (10.5%) 2 (2.6%) Adverse/Absent "1" 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (1.3%) 1 (1.3%) 2 (2.6%)

Table 10: Measurements of Treatment Plan OM 3 ­ Number and Percent of Rank Scores for Out of Home (CIP) Cases Across All Categories of OM3
Category I.1 Reason for DCF Involvement I.2. Identifying Information I.3. Strengths/Needs/Other Issues I.4. Present Situation and Assessment to Date of Review II.1 Determining the Goals/Objectives II.2. Progress6 II.3 Action Steps to Achieving Goals Identified II.4 Planning for Permanency Optimal "5" 25 (46.3%) 1 (1.9%) 13 (24.1%) 16 (29.6%) 8 (14.8%) 13 (25.0%) 2 (3.7%) 14 (25.9%) Very Good "4" 26 (48.1%) 40 (74.1%) 26 (48.1%) 23 (42.6%) 19 (35.2%) 24 (46.2%) 23 (42.6%) 24 (44.4%) Marginal "3" 3 (5.5%) 12 (22.2%) 15 (27.8%) 14 (25.9%) 23 (42.5%) 13 (25.0%) 23 (42.6%) 13 (24.1%) Poor "2" 0 (0%) 1 (1.9%) 0(0%) 1 (1.9%) 4 (7.4%) 1 (1.9%) 6 (11.1%) 2 (3.7%) Adverse/Absent "1" 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (1.9%) 0 (0%) 1 (1.9%)

Table 11: Measurements of Treatment Plan OM 3 ­ Number and Percent of Rank Scores for In-Home Family Cases Across All Categories of OM3
Category I.1 Reason for DCF Involvement I.2. Identifying Information I.3. Strengths/Needs/Other Issues I.4. Present Situation and Assessment to Date of Review II.1 Determining the Goals/Objectives II.2. Progress II.3 Action Steps to Achieving Goals Identified II.4 Planning for Permanency Optimal "5" 17 (77.3%) 2 (9.1%) 4 (18.2%) 1 (4.5%) 7 (31.8%) 6 (27.3%) 1 (4.5%) 10 (45.5%) Very Good "4" 4 (18.2%) 17 (77.3%) 11 (50.0%) 15 (68.2%) 7 (31.8%) 6 (27.3%) 4 (18.2%) 10 (45.5%) Marginal "3" 1 (1.3%) 3 (13.6%) 7 (31.8%) 6 (27.3%) 6 (27.3%) 9 (40.9%) 14 (63.6%) 1 (4.5%) Poor "2" 0 (0%) 0 (0%) 0 (0%) 0 (0%) 2 (9.1%) 1 (4.5%) 2 (9.1%) 0 (0%) Adverse/Absent "1" 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (4.5%) 1 (4.5%)

5 6

Excludes two cases that were newly opened ­ ranked as N/A- too early to note progress (2.6%). Excludes two cases that were newly opened ­ ranked as N/A-too early to note progress (3.7%).

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Data Reporting for Outcome Measure 15 ­ Needs Met There is only a slight variation when looking at the case assignment type in relation to needs met. Of the 22 cases selected as in-home family cases, eleven or 50.0% achieved "needs met" status. Twenty-six of the 49 CPS cases with children in placement (53.1%) achieved "needs met" status, and two of the five Voluntary Services children in placement cases (40.0%) achieved "needs met" status. Crosstabulation 9: Overall Score for Outcome Measure 15 * What is the Type of Case Assignment Noted in LINK?
What is the type of case assignment noted in LINK? CPS InCPS Child Voluntary Services Home in Family Case Placement Child in Placement Case (VSCIP) (IHF) Case (CIP) Total 11 26 2 39 28.2% 50.0% 11 29.7% 50.0% 22 28.9% 100.0% 66.7% 53.1% 23 62.2% 46.9% 49 64.5% 100.0% 5.1% 40.0% 3 8.1% 60.0% 5 6.6% 100.0% 100.0% 51.3% 37 100.0% 48.7% 76 100.0% 100.0%

Overall Score for Outcome Measure 15

Needs Met

Count % within Overall Score % within case assignment type

Needs Not Met

Count % within Overall Score % within case assignment type

Total

Count % within Overall Score % within case assignment type

The overall score was also looked at through the filter of the stated permanency goal. This quarter's plans were still operating under the guidelines including subcategories of the APPLA goals. Clearly demonstrated, as in the prior quarter, the less permanent the goal, the more frequently "needs met" was not achieved (APPLA: "Permanent NonRelative Foster Care", APPLA: "Other", and "Long Term Foster Care with a Licensed Relative" are 33.3%, 42.9%, and 33.3% compliant). The full breakdown is shown below:

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Crosstabulation 10: What is the child or family's stated goal on the most recent approved treatment plan in place during the period? * Overall Score for Outcome Measure 15
What is the child or family's stated goal on the most recent approved treatment plan in place during the period? Count Reunification % within goal % within Overall Score Adoption Count % within goal % within Overall Score Count % within goal % within Overall Score Count % within goal % within Overall Score Count % within goal % within Overall Score Count % within goal % within Overall Score Count % within goal % within Overall Score Count % within goal % within Overall Score Overall Score for Outcome Measure 15 Needs Needs Met Not Met Total 15 11 26 57.7% 42.3% 100.0% 38.5% 6 66.7% 15.4% 1 33.3% 2.6% 3 33.3% 7.7% 3 42.9% 7.7% 11 55.0% 28.2% 0 .0% .0% 39 51.3% 100.0% 29.7% 3 33.3% 8.1% 2 66.7% 5.4% 6 66.7% 16.2% 4 57.1% 10.8% 9 45.0% 24.3% 2 100.0% 5.4% 37 48.7% 100.0% 34.2% 9 100.0% 11.8% 3 100.0% 3.9% 9 100.0% 11.8% 7 100.0% 9.2% 20 100.0% 26.3% 2 100.0% 2.6% 76 100.0% 100.0%

Long Term Foster Care with a licensed relative

APPLA: Permanent NonRelative Foster Care7 APPLA: Other8

In-Home Goals - Safety/Wellbeing Issues Goal indicated is not an approved DCF goal Total

Outcome Measure 15 looks at eleven categories of measurement and an overall score to determine the level with which the Department is able to meet the needs of families and children. When looking at a break between passing scores (5 or 4) and those not passing
7

This APPLA goal is no longer an acceptable permanency goal, but given the crossover of area office training and our review process for this quarter, we are not identifying them as "unapproved goals" at this juncture. 8 This APPLA goal is no longer an acceptable permanency goal, but given the crossover of area office training and our review process for this quarter, we are not identifying them as "unapproved goals" at this juncture.

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(3 or less) there is a marked difference in performance among the categories. The Department shows promising practices in legal action, safety of children in placement, attending to medical needs, and recruitment efforts for the prior period. Most problematic are provision of timely dental services, mental health, behavioral health, and substance abuse services. Though the majority of reviewers identified children in intact family situations as safe, there were uncertain or marginal safety situations in 26.9% of the cases. In only one case did the reviewer score the in-home situation "poor". There are no adverse scores noted related to safety. Table 12: Scoring of Categorical Sections of Outcome Measure 15
Category DCF Case Management ­ Legal Action to Achieve the Permanency Goal During the Prior Six Months (II.2) Safety ­ Children in Placement (I.2) Medical Needs (III.1) DCF Case Management ­ Recruitment for Placement Providers to achieve the Permanency Goal during the Prior Six Months (II.3) Child's Current Placement (IV.1) DCF Case Management ­ Contracting or Providing Services to achieve the Permanency Goal during the Prior Six Months (II.4) Educational Needs (IV. 2) Securing the Permanent Placement ­ Action Plan for the Next Six Months (II.1) Safety ­ In Home (I.1) Dental Needs (III.2) Mental Health, Behavioral and Substance Abuse Services (III.3) # Passing (Scores 4 or 5) 97.4% # Not Passing (Scores 3 or Less) 2.6% Improved over prior Qtr? Yes

89.7% 82.9% 82.5%

10.3% 17.1% 17.5%

Yes Yes Yes

76.8% 74.7%

23.2% 25.3%

No Yes

74.6% 74.1% 73.1% 71.1% 71.0%

25.4% 25.9% 26.9% 28.9% 29.0%

Yes No Yes Yes Yes

There are some notable shifts in performance from the last quarter. "Safety" for both inhome cases and children in placement has improved since the prior quarter. The in-home population achieved passing scores in 60.9% in the prior quarter and was ranked 73.1% during this quarter. Children in placement cases achieved passing scores related to safety in 81.5% of the cases reviewed last quarter and achieved passing scores in 89.7% of the cases this quarter. While there is still room for improvement, the Department scores within the "Mental Health, Behavioral and Substance Abuse Services" category increased from 60.6% in the First Quarter to71.0% in the Second Quarter's review. On the other hand, declines were noted in two categories: the "Child's Current Placement" which was ranked as 80.8% in the 1st Quarter vs. the 2nd Quarter passing rate of 76.8%; and not surprisingly given the deficits in action plans within OM3, "Securing the Permanent Placement ­ Action Plan for the Next Six Months" dropped from 79.6% to 74.1%. All categories are in Table 13 below with the frequency and percentage of applicable cases achieving each rank score below.

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Table 13: Measurements of Treatment Plan OM 15 ­ Percentage of Rank Scores Attained Across All Categories9
Category I.1 Safety ­ In Home I.2 Safety ­ Children in Placement II.1 Securing the Permanent Placement ­ Action Plan for the Next Six Months II.2. DCF Case Management ­ Legal Action to Achieve the Permanency Goal During the Prior Six Months II.3 DCF Case Management ­ Recruitment for Placement Providers to achieve the Permanency Goal during the Prior Six Months II.4 DCF Case Management ­ Contracting or Providing Services to achieve the Permanency Goal during the Prior Six Months III.1 Medical Needs III.2 Dental Needs III.3 Mental Health, Behavioral and Substance Abuse Services IV.1 Child's Current Placement IV.2 Educational Needs # Ranked Optimal "5" # Ranked Very Good "4" # Ranked Marginal "3" # Ranked Poor "2" # Ranked Adverse/Absent "1" N/A To Case

8 (30.8% 28 (48.3%) 25 (43.1%) 54 (71.1%) 38 (60.3%)

11 (42.3%) 24 (41.4%) 18 (31.0%) 20 (26.3%) 14 (22.2%)

6 (23.1%) 5 (8.6%) 14 (24.1%) 1 (1.3%) 11 (17.5%)

1 (3.8%) 1 (1.7%) 1 (1.7%) 1 (1.3%) 0 (0%)

0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

50 18 18 0 13

29 (38.7%)

27 (36.0%)

19 (25.3%)

0 (0%)

0 (0%)

1

35 (46.1%) 43 (56.6%) 19 (27.5%) 25 (44.6%) 25 (42.4%)

28 (36.8%) 11 (14.5%) 30 (43.5%) 18 (32.1%) 19 (32.2%)

10 (13.2%) 15 (19.7%) 15 (21.7%) 13 (23.2%) 10 (16.9%)

1 (1.3%) 3 (3.9%) 5 (7.2%) 0 (0%) 4 (6.8%)

2 (2.6%) 4 (5.3%) 0 (0%) 0 (0%) 1 (1.7%)

0 0 7 20 17

For a complete listing of rank scores for Outcome Measure 15 by case, see appended document.

Percentages are based on applicable cases for the individual measure. Those cases marked N/A are excluded from the denominator in each row's calculation of percentage. At the point of sampling, the total number identified for the in-home sample was 23 cases. However, a number of cases had both in-home and out of home status at some point during the six month period of review.

9

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In addition to looking at the twelve categories in Outcome Measure 15, the review also collected data on situations in which a case had a need identified at the prior ACR, treatment plan or within the period's LINK record. Data was collected on those that remained unresolved at the point of the most recent treatment planning efforts. In 37 of the 76 cases, the reviewers found no unmet needs. Within the remaining 39 cases (51.3%) a total of 81 discrete needs were identified. Of those identified needs remaining unmet during the last treatment planning cycle, "mental health services" was the most frequently cited. Others included in the data collection are listed below: Table 14: Unmet Service Needs Identified within the Sample Set Cases
Identified Category of Service Need Type Mental Health Services Out of Home Care Substance Abuse Treatment Dental Education Medical Out of Home Support Services Housing In-Home Support Services Domestic Violence Treatment Training DCF Case Management Total Frequency 20 11 11 10 9 5 4 3 3 2 2 1 81 % within Unmet Needs (n=39) 51.3% 28.2% 28.2% 25.6% 23.1% 12.8% 10.3% 7.7% 7.7% 5.1% 5.1% 2.6%

Barriers were identified for the unmet needs cited above. Most frequently the barrier was identified as client refusal (as identified by the SW), followed by delay in referral. We again note that instances of "client refusal" often fail to incorporate additional engagement efforts such as use of the SWS or ARG, or collaborative efforts with active providers to engage clients in needed services.

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Table 15: What Was the Primary Barrier that Prevented Families or Children from Having Their Medical, Dental, Mental Health or Other Service Need Met?
Barrier Client Refused Service Delay in Referral by Worker UTD from treatment plan or narrative Wait List No Slots Available Scheduling Issues of Family Child AWOL No service Identified BOE/School not providing timely/adequate services Provider Delay in referral Parent's Incarceration/Criminal Activity Requires more intensive level then engaged Approval Process Insurance Referred service is unwilling to engage client Service deferred pending completion of another Service not available in primary language Client not consistent with contact/attendance Delays in Special Study process Immigration issues Transient lifestyle Lack of engagement between DCF and Child Truancy Total Frequency 19 17 10 5 4 3 3 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 81 % of Barriers Identified 23.5% 21.0% 12.3% 4.9% 4.9% 3.7% 3.7% 2.5% 2.5% 2.5% 2.5% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2% 1.2%

In addition, when looking specifically at the current treatment planning document, 52 cases (68.4%) had evidence of a service need that was clearly identified at the ACR/TPC or within LINK documentation, but not incorporated into the current treatment plan document. This included 117 service needs that the reviewers felt were clearly identifiable as a carried over unmet need, or a need recently identified at the ACR or within the LINK record. This was most frequently noted as an out-of-home support service followed by mental health service needs. It is important to note that while there were many needs that may not have been incorporated into the treatment planning document, in many cases, discussions observed at the ACR/TPC/FC adequately addressed casework and or the responsibility of participants toward meeting the identified needs.

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Table 16: Service Needs Not Incorporated into the Current Treatment Plan
Identified Category of Service Needs Out of Home Support Services Mental Health services Dental Medical In-home Support services DCF Education Substance Abuse Treatment Training Domestic Violence Treatment Out of home care Childcare Employment Frequency 18 17 15 15 11 10 9 6 6 4 4 1 1 117 % within Cases with Missing Service Needs (n=52) 34.6% 32.7% 28.8% 28.8% 21.2% 19.2% 17.3% 11.5% 11.5% 7.7% 7.7% 1.9% 1.9%

The failure to include these services in treatment plan action steps to achieve stated goals for the current cycle leads to a subsequent failure to address the engagement and progress of these items in future treatment planning documents. It also misrepresents the level of expectation for clients, providers and DCF during the period to follow.

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Rank Scores for Outcome Measure 3 And Outcome Measure 15

Appendix 1

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Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Very Good Marginal Marginal Marginal Very Good Very Good Marginal Marginal Marginal

Area Office Bridgeport 1

Was the family or child's language needs accommodated? yes

Has the treatment plan been approved by the SWS? yes

Reason for DCF Involvement Optimal

Identifying Information Very Good

Strengths, Needs and Other Issues Optimal Very Good Very Good Very Good Very Good Optimal Marginal Very Good Very Good

Present Situation and Assessment to Date of Review Very Good

Determining the Goals/Objectives Very Good

Progress Too early to note progress Optimal Optimal Optimal Optimal Optimal Very Good Optimal Marginal

Planning for Permanency Very Good

Overall Score for OM3 Appropriate Not Appropriate Not Appropriate Not Appropriate Appropriate Appropriate Not Appropriate Not Appropriate Not Appropriate

2 yes 3 yes 4 yes 5 yes 6 yes 1 Danbury 2 yes 3 yes yes Optimal Very Good yes Optimal Very Good yes yes Very Good Very Good yes Very Good Very Good yes Optimal Marginal yes Optimal Very Good yes Optimal Marginal yes Marginal Very Good

Very Good Very Good Very Good Very Good Optimal Very Good Very Good Very Good

Marginal Very Good Marginal Optimal Optimal Marginal Optimal Marginal

Very Good Optimal Very Good Optimal Optimal Very Good Marginal Optimal

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Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Marginal Marginal Marginal Marginal Very Good

What is the SW's area office assignment? 1 Greater New 2 Haven 3

Was the family or child's language needs accommodated? yes yes yes

Has the treatment plan been approved by the SWS? yes yes yes yes yes

Reason for DCF Involvement Optimal Marginal Very Good Very Good Very Good

Identifying Information Marginal Very Good Very Good Very Good Very Good

Strengths, Needs and Other Issues Very Good Marginal Very Good Very Good Marginal

Present Situation and Assessment to Date of Review Optimal Marginal Very Good Marginal Very Good

Determining the Goals/Objectives Optimal Marginal Very Good Marginal Marginal

Progress Very Good Marginal Marginal Marginal Very Good

Planning for Permanency Marginal Marginal Optimal Marginal Very Good

Overall Score for OM3 Not Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate

4 yes 5 yes

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Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Marginal Marginal Marginal Marginal Optimal Optimal Marginal Very Good Marginal Marginal

What is the SW's area office assignment? Hartford 1 2

Was the family or child's language needs accommodated? yes yes

Has the treatment plan been approved by the SWS? no yes yes yes yes yes yes yes yes yes

Reason for DCF Involvement Very Good Very Good Very Good Optimal Optimal Very Good Very Good Very Good Optimal Very Good

Identifying Information Marginal Very Good Marginal Very Good Very Good Very Good Very Good Very Good Very Good Very Good

Strengths, Needs and Other Issues Very Good Very Good Very Good Marginal Optimal Optimal Very Good Optimal Marginal Marginal

Present Situation and Assessment to Date of Review Very Good Very Good Very Good Marginal Very Good Optimal Very Good Very Good Very Good Marginal

Determining the Goals/Objectives Marginal Very Good Marginal Poor Very Good Optimal Very Good Very Good Very Good Optimal

Progress Marginal Very Good Very Good Marginal Very Good Optimal Marginal Very Good Very Good Marginal

Planning for Permanency Very Good Marginal Marginal Marginal Very Good Very Good Very Good Optimal Very Good Very Good

Overall Score for OM3 Not Appropriate Not Appropriate Not Appropriate Not Appropriate Appropriate Appropriate Not Appropriate Appropriate Not Appropriate Not Appropriate

3 yes 4 yes 5 yes 6 yes 7 yes 8 yes 9 yes 10 yes

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Outcome Measure 3: Treatment Plan Case Summaries
Has the treatment plan been approved by the SWS? yes yes yes yes yes yes yes yes yes Present Situation and Assessment to Date of Review Marginal Marginal Optimal Optimal Very Good Very Good Marginal Optimal Marginal Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Absent/Averse Very Good Very Good Very Good Marginal Marginal Poor Very Good Poor

What is the SW's area office assignment? 1 Manchester 2

Was the family or child's language needs accommodated? yes yes 3 yes 4 yes 5 yes 6 yes 1

Reason for DCF Involvement Very Good Optimal Very Good Very Good Very Good Optimal Optimal Optimal Optimal

Identifying Information Marginal Very Good Very Good Very Good Marginal Marginal Very Good Very Good Marginal

Strengths, Needs and Other Issues Very Good Very Good Very Good Optimal Marginal Marginal Very Good Optimal Very Good

Determining the Goals/Objectives Marginal Very Good Very Good Optimal Very Good Marginal Marginal Optimal Marginal

Progress Marginal Very Good Very Good Optimal Very Good Marginal Marginal Optimal Marginal

Planning for Permanency Very Good Very Good Very Good Optimal Very Good Marginal Very Good Optimal Very Good

Overall Score for OM3 Not Appropriate Appropriate Appropriate Appropriate Not Appropriate Not Appropriate Not Appropriate Appropriate Not Appropriate

Meriden 2

yes yes 3 no

31

Case 2:89-cv-00859-AHN
Juan F. v Rell Exit Plan Quarterly Report September 24, 2007 _______________________________

Document 537-2

Filed 10/01/2007

Page 32 of 76

Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Marginal Marginal Very Good Poor Marginal Marginal Marginal Poor Marginal Marginal Marginal

What is the SW's area office assignment? 1 Middletown 2

Was the family or child's language needs accommodated? yes yes 3 yes 1

Has the treatment plan been approved by the SWS? yes yes yes yes yes yes yes yes yes yes yes

Reason for DCF Involvement Very Good Very Good Optimal Very Good Very Good Optimal Marginal Optimal Marginal Optimal Very Good

Identifying Information Very Good Marginal Very Good Marginal Very Good Very Good Marginal Marginal Very Good Very Good Very Good

Strengths, Needs and Other Issues Marginal Very Good Very Good Marginal Marginal Very Good Very Good Marginal Marginal Optimal Very Good

Present Situation and Assessment to Date of Review Marginal Marginal Very Good Very Good Marginal Marginal Optimal Marginal Very Good Very Good Optimal

Determining the Goals/Objectives Poor Marginal Very Good Marginal Marginal Marginal Marginal Marginal Poor Very Good Marginal

Progress Marginal Marginal Very Good Marginal Marginal Optimal Marginal Absent/Averse Poor Very Good Marginal

Planning for Permanency Optimal Marginal Very Good Absent/Averse Very Good Optimal Marginal Very Good Absent/Averse Optimal Optimal

Overall Score for OM3 Not Appropriate Not Appropriate Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate Not Appropriate

New Britain

yes 2 yes 3 yes 4 yes 5 yes 6 no 7 no 8 yes

32

Case 2:89-cv-00859-AHN
Juan F. v Rell Exit Plan Quarterly Report September 24, 2007 _______________________________

Document 537-2

Filed 10/01/2007

Page 33 of 76

Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Marginal Very Good Very Good Very Good Very Good Marginal Marginal Very Good Poor Marginal

What is the SW's area office assignment? 1 New Haven 2 Metro 3

Was the family or child's language needs accommodated? yes yes yes

Has the treatment plan been approved by the SWS? yes yes yes no yes yes yes yes no yes

Reason for DCF Involvement Optimal Optimal Optimal Optimal Optimal Optimal Very Good Optimal Very Good Optimal

Identifying Information Optimal Very Good Very Good Very Good Very Good Very Good Very Good Very Good Marginal Very Good

Strengths, Needs and Other Issues Very Good Marginal Very Good Very Good Optimal Marginal Marginal Very Good Marginal Optimal

Present Situation and Assessment to Date of Review Very Good Marginal Marginal Very Good Optimal Poor Optimal Optimal Very Good Very Good

Determining the Goals/Objectives Optimal Optimal Very Good Marginal Optimal Poor Marginal Very Good Marginal Optimal

Progress Very Good Marginal Very Good Optimal Optimal Marginal Very Good Optimal Poor Optimal

Planning for Permanency Very Good Very Good Optimal Very Good Optimal Very Good Very Good Very Good Very Good Optimal

Overall Score for OM3 Not Appropriate Not Appropriate Appropriate Not Appropriate Appropriate Not Appropriate Not Appropriate Appropriate Not Appropriate Not Appropriate

4 yes 5 yes 6 yes 7 yes 8 yes 1 Norwalk 2 yes yes

33

Case 2:89-cv-00859-AHN
Juan F. v Rell Exit Plan Quarterly Report September 24, 2007 _______________________________

Document 537-2

Filed 10/01/2007

Page 34 of 76

Outcome Measure 3: Treatment Plan Case Summaries
Action Steps to Achieving Goals Identified for the Upcoming Six Month Period Very Good Very Good Very Good Very Good Marginal Marginal Very Good Very Good Very Good Very Good Very Good

What is the SW's area office assignment? 1 Norwich 2

Was the family or child's language needs accommodated? yes yes 3 yes 4 yes 5 yes 6 yes 1

Has the treatment plan been approved by the SWS? yes yes yes yes yes yes yes yes

Reason for DCF Involvement Optimal Optimal Optimal Optimal Optimal Optimal Very Good Optimal

Identifying Information Very Good Very Good Very Good Very Good Very Good Optimal Very Good Very Good

Strengths, Needs and Other Issues Marginal Optimal Very Good Very Good Optimal Marginal Very Good Very Good Very Good Optimal Very Good

Present Situation and Assessment to Date of Review Marginal Optimal Very Good Very Good Very Good Optimal Very Good Very Good

Determining the Goals/Objectives Very Good Marginal Very Good Very Good Optimal Marginal Very Good Optimal

Progress Optimal Optimal Very Good Very Good Very Good Optimal Very Good Optimal Too early to note progress Very Good Very Good

Planning for Permanency Optimal Very Good Optimal Optimal Optimal Optimal Marginal Very