4533. Behavior Rehabilitation Services

Original Date: September 27, 1995

Revised Date: September 25, 2020

Sunset Review: September 25, 2024

Approved by:  Jody Becker, Deputy Secretary Children and Families

Purpose

The purpose of this policy is to provide guidance to child welfare employees for identifying and providing services to children and youth with high-level complex needs.

Scope

This policy applies to Department of Children, Youth, and Families (DCYF) child welfare employees.

Laws

RCW 13.34.130 Order of disposition for a dependent child, alternatives - Placement with relatives, foster family home, group care facility, or other suitable persons

RCW 74.13.031 Duties of Department - Child Welfare Services - advisory committee.

RCW 74.13.080 Group Care Placement - Prerequisites for payments

Policy

  1. Caseworkers must verify children or youth have been referred to and received a Wraparound Intensive Services (WISe) screen prior to considering a referral to BRS.　
    1. If the WISe screen shows the child or youth is eligible and recommended for services, WISe must be given priority over BRS.
    2. Consider BRS if:　
      1. WISe alone cannot safely serve the child or youth’s needs. BRS and WISe can be opened concurrently.
      2. The WISe agency is unable to meet the child or youth’s needs and intensive services is required to meet their needs.
  2. BRS Managers may only refer children and youth to contracted BRS service providers when the child or youth:
    1. Has a high-level complex service need.
    2. Received a WISe screen from a provider on the WISe Referral Contact List.
    3. Been assessed to need BRS level of care based on all of the following:
      1. A completed WISe screen.
      2. The BRS Referral DCYF 10-166A form and supporting documentation packet.
      3. The Children’s Functional Assessment Rating Scale (CFARS).
      4. Recommendations from the shared planning meeting (SPM) or Family Team Decision Making (FTDM) meeting.
    4. Received the required approvals on the BRS Referral DCYF 10-166A form.
  3. The DCYF Contracts Unit can only approve BRS ongoing contracts to out-of-state agencies if they are located within 50 miles of Washington State.
  4. Caseworkers must continue to pay BRS In-Home or Support Services if they are being provided at the contract rate. This rate is not intended to be all inclusive. Services and other funds DCYF would normally pay for should continue, e.g., rent, child care, concrete goods, etc.
  5. Employees must follow the Placement - Intensive Resources policy when a child or youth’s individual service needs are beyond what can be provided through the BRS contract and other more intensive services are needed.
  6. Caseworkers assigned to children or youth in BRS must:
    1. Participate in the BRS Child and Family Team (CFT) case review meetings.
    2. Facilitate discussions identifying a targeted discharge date and transition placement.
  7. Caseworkers must obtain DCYF and court approval for children and youth placed in a BRS Qualified Residential Treatment Program (QRTP) and request the following:
    1. A court review hearing within 60 calendar days of the QRTP placement.
    2. A court review at least every six months.
    3. Regional administrator (RA) approval for youth age:
      1. Twelve and younger after the first consecutive or non-consecutive six months.
      2. Thirteen and older, after the first 12 consecutive months, or 18 non-consecutive months.

Procedures

  1. Eligibility and Referral
    1. Before a BRS referral is made, caseworkers must:
      1. Refer the child or youth for a WISe screen from a provider on the WISe Referral Contact List if a screen has not already been completed within the last 60 calendar days.
      2. Consult with the regional BRS Program Manager (PM) to determine if BRS is appropriate.
      3. Conduct a SPM or FTDM meeting to identify needed supports and services for the child or youth and family, and determine if BRS is an appropriate and needed resource for the child or youth.
    2. If the SPM or FTDM meeting determines BRS is needed, caseworkers must:
      1. Complete a BRS Referral DCYF 10-166A form and provide the documentation listed on the form. The BRS referral must include:
        1. Information about the child or youth’s current needs.
        2. The SPM or FTDM meeting recommendations.
        3. The most current supporting documentation in the BRS packet.
      2. Review the WISe results and:
        1. Include a copy of the completed WISe screen results in the BRS packet, when available.
        2. Document on the BRS Referral DCYF 10-166A form:
          1. Reasons why the youth is not eligible for WISe or is screened eligible, but WISe services are not being used.
          2. The results of the WISe screen, if a copy of the completed WISe screen is not available.
          3. If the WISe screen was not completed:
            1. The reason it was not completed and date of the request.
            2. The plan to complete the WISe screen.
        3. Document in a FamLink case note:
          1. When a WISe referral is made.
          2. WISe screening completion date.
          3. Results of the WISe screening.
      3. Obtain supervisor and area administrator (AA) approval and send the completed BRS referral packet to the regional BRS PM for final approval.
      4. Determine if the child or youth will need an out-of-state BRS contract placement. If so:
        1. Complete the Interstate Compact on the Placement of Children (ICPC).
        2. Obtain court approval, when required.
    3. When receiving the BRS referral packet, regional BRS PMs must:
      1. Verify the BRS referral packet is complete and includes the WISe screen results and reasons why BRS is needed for a child or youth who is eligible for WISe. If a WISe screen was not completed, verify the BRS Referral DCYF 10-166A form includes:
        1. The date of the WISe screen request and reasons why it was not completed.
        2. The plan to complete the WISe screen.
      2. Review the BRS referral packet:
        1. For current supporting documentation and recommendations from the SPM or FTDM meeting.
        2. To determine the child or youth's eligibility for BRS based on information provided. This includes:
          1. The results of the WISe screen.
          2. Documentation listed in the BRS Referral DCYF 10-166A form.
          3. The SPM or FTDM meeting recommendations.
        3. To complete a QRTP Assessment DCYF 10-167 on BRS eligible children or youth to determine their needed level of care.
      3. Make a referral to BRS contractors based on the assessment of the child or youth’s needs, the contractor’s ability to adequately provide services for those unique needs, quality of services provided, and performance on outcome data.
      4. Only refer children or youth to a QRTP who are assessed to need that level of care.
      5. Provide the completed QRTP Assessment DCYF 10-167 to the assigned caseworker if a child or youth is placed in a QRTP.
      6. Review the child or youth's discharge or permanency plan.
      7. Only send complete and current referral packets to contractors.
      8. Notify the caseworker once the referral has been accepted by a contractor, with contractor information, service level, and contracted rate.
      9. Determine if the child or youth's supervision needs exceed the BRS level of care.
        1. Negotiate one-to-one supervision as needed to address the child or youth’s specific behaviors with in-state agencies.
        2. Complete the extra supervision rate proposal using Child Specific Contract Rate Proposal DCYF 10-490 form and submit for approval and signatures listed on the document.
        3. Provide the approved completed Contract Rate Proposal DCYF 10-490 form to a fiduciary for the additional payment.
        4. Follow Placement - Intensive Resources policy for Intensive Residential Child Specific contract if one-to-one supervision through the BRS provider does not meet the specific needs of the child or youth.
        5. Follow the Placement - Intensive Resources policy if an out-of-state child specific contract is required.
  2. After placement and ongoing services are provided:
    1. Regional BRS PMs must provide the service agreement to the regional fiscal analyst that includes the following:
      1. Type
      2. Placement, if needed
      3. Payment type and level
    2. Regional Fiscal Analysts or designees must:
      1. Enter the placement and payment information into FamLink.
      2. Upload the service agreement.
    3. CFT Meetings
      Caseworkers must:
      1. Participate in CFT case review meetings and actively involve the child or youth, their family, and other identified supports in case planning.
      2. Focus on measurable outcomes related to the child or youth’s safety, stability, permanency, and discharge planning including transitioning to less intensive services or a permanent home.
      3. During the CFT meetings with the BRS provider:
        1. Review the child or youth’s progress and transition planning, WISe screen results, and CFARS to guide case and discharge planning.
        2. Document the results of case reviews in FamLink case notes.
      4. Follow the Health and Safety Visits with Children and Monthly Visits with Out-of-home Caregivers and Parents policy, and:
        1. Discuss safety, stability, permanency, and discharge planning, with the child or youth. If necessary, conduct a SPM to address these areas .
        2. Share information with the child or youth about the court processes and their right to request legal representation.
      5. Assist youth age 15 years and older and placed in out-of-home care for more than 30 calendar days in completing the Casey Life Skills Assessment (CLSA) and Learning Plan (LP), per the Transitioning Youth for a Successful Adulthood policy.
      6. Follow Transitioning Youth for a Successful Adulthood and The Transition Plan policies to effectively engage, support, and prepare youth for adulthood.
    4. Youth Placed in a QRTP
      1. For court hearings, caseworkers must:
        1. Immediately notify the assistant attorney general (AAG) to request a court hearing to:
          1. Inform them that court approval is needed for the placement.
          2. Occur within 60 calendar days of the QRTP placement if one is not already scheduled, e.g. shelter care hearing, dependency hearing, permanency review hearing, etc.
        2. Initial and Ongoing Court Hearings
          1. Provide the court with the completed QRTP Assessment DCYF 10-167 and justification for the QRTP.
          2. Obtain court approval for the QRTP placement.
          3. Upload the completed court order and other court documentation, as applicable, into FamLink.
          4. Provide copies of court approved documents to the regional BRS program manager.
          5. For ongoing dependency or permanency planning hearings:
            1. Request a copy of the current QRTP Assessment DCYF 10-167 from the regional BRS managers at least 14 calendar days prior to the hearing.
            2. Provide the court with the updated QRTP Assessment DCYF 10-167 and court report including justification for the continued need for QRTP.
      2. Administrative Approvals
        1. Caseworkers must complete the Administrative Approval Request DCYF 05-210 form and send to the RA for approval when youth:
          1. Age 12 and younger have been placed six consecutive or non-consecutive months.
          2. Age 13 and older and have been placed 12 consecutive or 18 non-consecutive months.
        2. RAs, after determining approval, must send:
          1. The form to the caseworker.
          2. A copy of the form to the Field Operations director for youth age 12 and younger.
        3. Caseworkers must:
          1. Once they receive the completed DCYF 05-210 form:
            1. Provide a copy of the completed and signed DCYF 05-210 form to the regional BRS PM.
            2. Upload the document in FamLink.
            3. Document the date this review was completed in the Court Report, per the Mapping Guide.
          2. Follow the Extended Foster Care policy when a youth will remain in BRS past their 18th birthday.
    5. Regional BRS PMs must:
      1. Provide oversight, guidance, and consultation regarding BRS provider's compliance. Including quality of service, outcomes, and performance.
      2. Monitor and track regional BRS data, including, but not limited to:
        1. Date of entry
        2. Exit
        3. Length of stay
        4. Placement type
        5. Service and rate
        6. Dates of the six-month case review hearings (children or youth in QRTP only)
        7. Contractor outcomes and performance measures on the BRS Monthly Census Report.
      3. Review the child or youth's service needs, level of care, expected exit date, and transition plan every six months in collaboration with the caseworker and contracted service provider.
      4. Participate in CFT meetings, when possible.
      5. If a child or youth is placed in a QRTP:
        1. Provide the caseworker with a current QRTP Assessment DCYF 10-167 at least 14 calendar days prior to all dependency or permanency planning review hearings.
        2. Provide a copy of the assessment to the caseworker.
  3. Aftercare support services are provided to children or youth transitioning out of BRS to a less restrictive environment. When this occurs:
    1. Caseworkers must:
      1. Participate in CFT meetings, at least quarterly, to discuss aftercare wraparound planning that supports the child or youth and family to achieve stability, permanency, or placement transition.
      2. Verify discharge planning and family-based aftercare support is provided to children and youth transitioning from a QRTP for at least six months as determined by the transition plan, if applicable.
      3. Arrange aftercare support with another contractor closer to the child or youth’s discharge placement, if needed. WISe must be used as the discharge support service, when applicable.
    2. Regional BRS PMs must:
      1. Consult with caseworkers to develop an aftercare service plan.
      2. Negotiate with the contracted provider on an aftercare service plan.

Forms